Oct 21, 2022  |   4 minute read

Emerging Technologies, Service Modalities, and the Value of Outcome Measurement

A Transcranial Magnetic Stimulation (TMS) Q&A with Kim Mercille, President of Metro Neurohealth

The demand for mental health care continues to rise, signalling an immediate need for improved quality and diversity of services that meet the needs of all those in need of support. Innovative approaches to care, technology advancement, and Measurement-Based Care will all play a pivotal role in allowing us to discover and offer people the most effective treatment options, and improve the overall quality of services available to anyone in need of support.

We’re excited to share that we’ve partnered with Metro Neurohealth, an organization that supports clinics as they implement Transcranial Magnetic Stimulation (TMS) Therapy, a non-invasive procedure used for treatment resistant depression.

TMS therapy uses electromagnetic pulses to stimulate the nerve cells in the brain, which is shown to positively impact brain functioning to improve overall mood and ease depression symptoms (Perera et al., 2016). Through our partnership, Greenspace will support Metro Neurohealth in offering our Measurement-Based Care (MBC) solutions to their clients and help guide them through their MBC implementations. 

This is an exceptional opportunity to bring awareness to the clinical value of mental health assessment tools, especially in combination with emerging service modalities like TMS. MBC will enable clinics and service providers to leverage client-reported data to enhance outcome tracking throughout therapy, which will help to improve outcomes for their patients and demonstrate the efficacy of TMS treatment.

We had the opportunity to sit down with Kim Mercille, President of Metro Neurohealth to learn more about TMS and discuss the value that MBC can provide to people in care, service providers, and the mental health industry. Here’s what she had to say:

Q: How will Metro Neurohealth organizations implement Measurement-Based Care? What are they most interested in measuring?

Kim: I personally feel that by measuring the quality of care that you’re providing, there’s an opportunity to consistently improve that care. The clinics we work with could benefit from additional mental health measurement tools to evaluate their overall effectiveness and patient outcomes. For our clinics, it’s important to know how they can improve the efficacy of TMS and also the longevity of TMS’ impact on patients. But, it’s also important to understand–for the percentage of patients that don’t get the results they hoped for–why that is.

If we can help our TMS clinics answer these questions and use clinical outcomes to improve the care they deliver, as well as the outcomes for their patients, then that’s what we want to do.

Q: How will Measurement-Based Care help TMS organizations function under Value-Based Care models and improve access to these treatments?

Kim: Improved and demonstrable outcomes could drive higher reimbursement rates for the provider and encourage insurance companies to review their medical guidelines for TMS, driving them to make important changes to reduce the overall costs related to treating moderate to severe depression.

Also, while there’s plenty of research and data demonstrating the efficacy of TMS for addictions, addiction specific treatment is not yet FDA-approved in the US. It would be beneficial to leverage MBC to track outcomes across numerous clinics using TMS for addiction recovery, and use the data to drive its approval in the US.

Q: How do you share assessment results and progress with clients? What impact does this have on their sense of hope and empowerment?

Kim: It’s interesting how, when it comes to a person who’s been suffering from depression for a long period of time, often people around them will notice a change in their behavior, their thinking, and the positive change in their life before the patient will. That’s why we find measurement so vital, sometimes seeing the change in the data helps patients recognize and celebrate the progress they’ve made.

On the 30th treatment, we recommend hosting a sit-down, exit consultation with patients. We print a graph that would show them where they started with their PHQ-9 and how that trended over a period of 6 to 9 weeks that they were in treatment. As I mentioned earlier, I think it’s key for people to be able to see the change they’ve made, in addition to any changes in how they’re feeling day to day.

Q: Who is eligible for TMS treatment?

Kim: In the US, TMS is FDA-approved for adults with major depressive disorder, specifically for severe recurrent and severe single episode, without psychosis.  When it comes to treatment resistant depression, most (if not all) commercial and government insurance networks will cover TMS for ages 18+. It’s also FDA approved for OCD, smoking cessation, and anxious depression (although most insurance providers do not yet cover treatment for these specific conditions). 

Q: Speaking from your own experience, can you give an example of the success you’ve seen with TMS Treatment?

Kim: One of the benefits of TMS is that measuring progress is a fundamental component of care and screenings are done with clients every two weeks, or more. Because of this measurement, we know that approximately 70% of the patients who receive TMS treatment will experience a 50% or greater reduction in their depression screening scores, thus improving their depression-related symptoms by 50% or greater. 

In my personal experience with the clinics I’ve led, our success rate was 87%. This means that 87% of the patients we treated had a greater than 50% improvement in the symptoms and depression rating scales. 73% of these patients had complete remission from their depression.

Q: What benefit do you see in working with the team at Greenspace and what goals do you have with this partnership?

Kim: I’m very passionate about improving the quality of care for patients struggling with mental health disorders, especially those that are treatment resistant. I think we have the opportunity to work collaboratively to help providers evaluate and improve patient outcomes—specifically in an outpatient setting.

Over a period of time, we can also leverage the data collected to make positive changes as it relates to insurance coverage, insurance reimbursement, etc. We have a unique opportunity to use the data that we find through MBC and propel it to further benefit patients, service providers, and clinics, thus improving treatment outcomes and access for those who need it most. 

We want to thank Kim for taking the time to chat with us— we look forward to bringing the MBC movement to TMS clinics and working together to shine a light on the important, evidence-based work they are doing every day.


Perera, T., George, M. S., Grammer, G., Janicak, P. G., Pascual-Leone, A., & Wirecki, T. S. (2016). The Clinical TMS Society Consensus Review and Treatment Recommendations for TMS Therapy for Major Depressive Disorder. Brain Stimulation, 9(3), 336-346. https://doi.org/10.1016/j.brs.2016.03.010.