The British Journal of Psychiatry (2006) 189: 330-336. doi: 10.1192/bjp.bp.105.015412
© 2006 The Royal College of Psychiatrists
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Use of standardised outcome measures in adult mental health services

Randomised controlled trial

MIKE SLADE, PhD and PAUL McCRONE, PhD

Health Services Research Department, Institute of Psychiatry, King’s College London

ELIZABETH KUIPERS, PhD

Department of Psychology, Institute of Psychiatry, King’s College London

MORVEN LEESE, PhD

Health Services Research Department, Institute of Psychiatry, King’s College London

SHARON CAHILL, PhD

Department of Psychology, University of East London

ALBERTO PARABIAGHI, MD

Health Services Research Department, Institute of Psychiatry, King’s College London

STEFAN PRIEBE, PhD

Department of Psychiatry, University of London, Newham Centre for Mental Health

GRAHAM THORNICROFT, PhD

Health Services Research Department, Institute of Psychiatry, King’s College London, UK

Correspondence: Dr Mike Slade, Health Services Research Department (Box P029), Institute of Psychiatry, King’s College London, London SE5 8AF, UK. Tel.: +444 (0) 20 7848 0795; fax: +444 (0) 20 7277 1462; email: m.slade{at}iop.kcl.ac.uk

Declaration of interest None. Funding by the Medical Research Council.

Background Routine use of standardised outcome measures is not universal.

Aims To evaluate the effectiveness of standardised outcome assessment.

Method A randomised controlled trial, involving 160 representative adult mental health patients and paired staff (ISRCTN16971059). The intervention group (n=101) (a) completed monthly postal questionnaires assessing needs, quality of life, mental health problem severity and therapeutic alliance, and (b) received 3-monthly feedback. The control group (n=59) received treatment as usual.

Results The intervention did not improve primary outcomes of patient-rated unmet need and of quality of life. Other subjective secondary outcome measures were also not improved. The intervention reduced psychiatric inpatient days (3.5 v.16.4 mean days, bootstrapped 95% CI1.6–25.7), and hence service use costs were £2586 (95% CI 102–5391) less for intervention-group patients. Net benefit analysis indicated that the intervention was cost-effective.

Conclusions Routine use of outcome measures as implemented in this study did not improve subjective outcomes, but was associated with reduced psychiatric inpatient admissions.




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