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Outcomes research in mental health

Systematic review

Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds

TREVOR A. SHELDON, DSc

Department of Health Studies, University of York, UK

Correspondence: Dr Simon M. Gilbody, Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, LS2 9LT, UK. Tel: +44 (0)113 233 1899; fax: +44 (0)113 243 3719; e-mail: s.m.gilbody{at}leeds.ac.uk

Declaration of interest S.M.G. is supported by the Medical Research Council Fellowship Programme in Health Services Research.

See editorial, pp. 1–2, this issue.

Background Outcomes research involves the secondary analysis of data collected routinely by clinical services, in order to judge the effectiveness of interventions and policy initiatives. It permits the study of large databases of patients who are representative of ‘real world’ practice. However, there are potential problems with this observational design.

Aims To establish the strengths and limitations of outcomes research when applied in mental health.

Method A systematic review was made of the application of outcomes research in mental health services research.

Results Nine examples of outcomes research in mental health services were found. Those that used insurance claims data have information on large numbers of patients but use surrogate outcomes that are of questionable value to clinicians and patients. Problems arise when attempting to adjust for important confounding variables using routinely collected claims data, making results difficult to interpret.

Conclusions Outcomes research is unlikely to be a quick or cheap means of establishing evidence for the effectiveness of mental health practice and policy.

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Highlights of this issue

MARY CANNON
BJP 2002 181: 0. [Full Text]  

Outcome measurement in mental health — welcome to the revolution

FRANK HOLLOWAY
BJP 2002 181: 1-2. [Full Text]  

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