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The British Journal of Psychiatry (2005) 186: 146-152
© 2005 The Royal College of Psychiatrists

Routine use of mental health outcome assessments: choosing the measure

GIOVANNI SALVI, MD

Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Italy

MORVEN LEESE, PhD and MIKE SLADE, PhD, CPsychol

Health Services Research Department, Institute of Psychiatry, London, UK

Correspondence: Dr Giovanni Salvi, Sezione di Psichiatria e di Psicologia Clinica, Dipartimento di Medicina e Sanitá Pubblica, Ospedale Policlinico, Piazzale Scuro, 37134 Verona, Italy. Fax:: +39 (0)45 585871; e-mail: giovanni.salvi{at}medicina.univr.it

Declaration of interest None. Funding detailed in Acknowledgements.

Background There is little consensus about which outcome measures to use in mental healthcare.

Aims To investigate the relationship between the items in four staff-rated measures recommended for routine use.

Method Correlation analysis of total scores and factor analysis using combined data from the Health of the Nation Outcome Scales (HoNOS). The Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), the Threshold Assessment Grid (TAG) and the Global Assessment of Functioning (GAF) were performed. Procrustes analysis on factors and scales, and Ward's cluster analysis to group the items, were applied.

Results The total scores of the measures were moderately correlated. The Procrustes analysis, factor analysis and cluster analysis all agreed on better coverage of the patients' problems by HoNOS and CANSAS.

Conclusions A global severity factor accounts for 16% of the variance, and is best measured with TAG or GAF. The CANSAS and HoNOS each provide a detailed characterisation of the patient; only CANSAS provides information about met needs.




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