Introduction

If you're a psychiatrist or psychiatric nurse practitioner, you may be familiar with the WHODAS 2.0. But where does it come from, and how can it help you with Measurement-Based Care (MBC)? In our "MBC Starter Kit," we, along with the American Psychiatric Association (APA), recommend the WHODAS 2.0 as a comprehensive tool for assessing disability and functioning.
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This guide covers the history, methods, and how you can use it to improve patient outcomes in less time (whether you use a PDF or the 50+ scales included in Osmind, with visualized progress—we recommend the latter).
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What is the WHODAS 2.0?

The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a comprehensive tool designed to measure health and disability across different cultures and populations. Its importance lies in its ability to provide a standardized and objective measure of functioning and disability, which is crucial for accurate assessment and effective treatment planning in psychiatric and general healthcare practice.
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WHODAS 2.0 Scoring and Interpretation

The WHODAS 2.0 is a self-administered questionnaire that assesses health and disability across six domains of functioning:
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1. Cognition – understanding and communicating
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2. Mobility – moving and getting around
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3. Self-care – attending to one's hygiene, dressing, eating, and staying alone
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4. Getting along – interacting with other people
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5. Life activities – domestic responsibilities, leisure, work, and school
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6. Participation – joining in community activities
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The WHODAS 2.0 is available in two versions: a 36-item version and a shorter 12-item version. Each item is rated on a 5-point scale from 0 (none) to 4 (extreme or cannot do), with higher scores indicating greater disability. The total score is calculated by summing the item scores, which can then be converted into a standardized score ranging from 0 to 100, with higher scores indicating greater disability.

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History and Development of the WHODAS 2.0

The WHODAS 2.0 was developed by the World Health Organization (WHO) to provide a standardized method for measuring health and disability in accordance with the International Classification of Functioning, Disability, and Health (ICF). The development process involved extensive field testing and validation studies across different cultures and populations to ensure the tool's reliability and validity.
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The WHODAS 2.0 was designed to be applicable across various health conditions and settings, making it a versatile tool for both clinical practice and research. Its development was driven by the need for a comprehensive and standardized measure of disability that could be used globally to facilitate comparisons and inform health policy and planning.
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When the DSM-5 was released, the APA eliminated the Axis V: Global Assessment of Functioning Scale and instead recommended clinicians use the WHODAS 2.0 in its place for a more comprehensive and reliable assessment of impairment.
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Using the WHODAS 2.0 for Measurement-Based Care in Clinical Practice

The WHODAS 2.0 is a versatile tool that serves multiple purposes in psychiatric and general healthcare practice, making it an essential component of measurement-based care (MBC). MBC emphasizes the routine use of standardized assessment tools to inform and guide treatment decisions, and the WHODAS 2.0 offers several key advantages in this context:

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1. Assessing Disability and Functioning: The WHODAS 2.0 is an effective instrument for assessing the level of disability and functioning in individuals with various health conditions, allowing clinicians to gain a holistic understanding of a patient's functional status and identify areas of impairment that may require intervention.
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2. Monitoring Treatment Progress: By administering the WHODAS 2.0 periodically at follow-up appointments (e.g., every 4-6 weeks), healthcare providers can track changes in disability and functioning over time and monitor treatment progress. This ensures that patients receive the appropriate level of support based on their current functional status.
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3. Informing Treatment and Rehabilitation Plans: WHODAS 2.0 scores, interpreted in the context of clinical observations and patient reports, can inform treatment and rehabilitation plans by identifying specific areas of disability that need to be addressed.
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4. Facilitating Communication and Collaboration: The WHODAS 2.0 provides a consistent and objective means of assessing and communicating about a patient's disability and functioning, enabling better collaboration between healthcare providers and patients.
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5. Enabling Research and Quality Improvement: The systematic use of the WHODAS 2.0 in MBC generates valuable data that can be used for research purposes and to inform quality improvement initiatives, ultimately leading to better patient outcomes and more efficient healthcare delivery.

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To effectively utilize the WHODAS 2.0 for MBC, healthcare providers should integrate it into their routine practice, using it to establish baseline disability and functioning measures, monitor progress, and guide treatment and rehabilitation plans in conjunction with other relevant clinical information. By leveraging the WHODAS 2.0 in this way, healthcare providers can deliver more personalized, evidence-based care and improve outcomes for patients with various health conditions.
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Case Examples of How the WHODAS 2.0 Informs Treatment Plans

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1. Patient A initially scored a 70 on the WHODAS 2.0, indicating significant disability across multiple domains. Based on this score and clinical evaluation, the healthcare provider initiated a comprehensive rehabilitation program that included physical therapy, occupational therapy, and cognitive rehabilitation. After 12 weeks, Patient A's WHODAS 2.0 score decreased to 40, indicating moderate disability. The provider decided to continue the current rehabilitation plan but increased the frequency of cognitive rehabilitation sessions to address persistent cognitive impairments.
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2. Patient B presented with a WHODAS 2.0 score of 50, indicating moderate disability. The healthcare provider started Patient B on a multidisciplinary treatment plan that included psychotherapy, social skills training, and vocational rehabilitation. After 8 weeks, Patient B's WHODAS 2.0 score had decreased to 20, indicating mild disability. The provider maintained the current treatment plan but added a community integration component to promote long-term well-being and social participation.
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Simplifying WHODAS 2.0 Implementation with Osmind

Implementing measurement-based care with the WHODAS 2.0 has never been easier, thanks to Osmind's all-in-one psychiatry EHR. Osmind is built for forward-thinking clinicians who want to harness the power of data to optimize patient care. Our platform includes:

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• 50+ validated scales, including the WHODAS 2.0, ensuring seamless integration of standardized assessments into your clinical workflow
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• Visualized progress dashboards that provide a clear overview of your patients' WHODAS 2.0 scores and disability trends over time, enabling you to make data-driven treatment decisions
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• A patient app for easy remote monitoring and journaling, allowing your patients to complete the WHODAS 2.0 and other assessments from the comfort of their own devices, improving engagement and adherence
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• Scheduling, insurance billing, payments, telepractice tools, eRX, Labs, and a forward-thinking community with private virtual events and curated forums, providing a comprehensive suite of tools to streamline your practice and keep you ahead of psychiatry's frontier
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By automating data collection, scoring, and interpretation, Osmind makes implementing measurement-based care with the WHODAS 2.0 seamless and hassle-free. Our platform takes care of the administrative tasks associated with standardized assessments, allowing you to focus on what matters most: delivering personalized, evidence-based care to your patients.

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Ready to future-proof your psychiatry practice? Schedule a demo with Osmind today.