Blue Cross Blue Shield mental health self-assessment forms questioned

We are not so sure what to make of this report

The state's largest health insurer wants mental health patient to fill out a detailed self-assessment, including questions about their sleep patterns, sex lives and any suicidal thoughts.

The questionnaire from Blue Cross Blue Shield of Massachusetts aims to assess a person's state of mind and the quality of mental health care the patient is receiving, The Boston Globe reported. But psychiatrists are questioning whether the forms are accurate or too intrusive.

"Who in their right mind would fill out such a form?" said Chatham psychiatrist Dr. Marc Whaley, president of the Southeastern Massachusetts Psychiatric Society. "It's just an intrusive invasion of privacy."

About 100,000 Blue Cross subscribers will receive the form, which was described in a mailing last week to psychiatrists and other mental health counselors. The questions address a range of emotions and conditions, from guilt and worry to substance abuse and sexual satisfaction.

The questionnaires are voluntary, though if a large number of a therapist's or doctor's patients decline to fill them out, the practitioner could fail to qualify for annual increases in Blue Cross reimbursement.

Questionnaires will only be seen by the patient's therapist and the insurer, Blue Cross officials said.

The insurer said it's trying to treat mental health care the same as other medical care, and needs ways to measure results. The company said the forms will eventually allow it to establish quality rankings for doctors and to reimburse providers based on performance.

The Massachusetts Psychiatric Society has raised concerns about using about patient answers about moods and feelings as the basis for quality rankings and reimbursement.

"We are skeptical that any measures they are going to do will be truly meaningful," said Dr. Eugene Fierman, president-elect of the Massachusetts Psychiatric Society. "In general medicine, you can measure deaths in surgery and adverse outcomes. It's very difficult to do that in mental health."