Outcomes are increasingly more important in the mental health field. Insurance companies and accrediting agencies want to see data that a patient suffering from a mental illness is improving. This is difficult to document in many cases, and most agencies are developing their own outcome assessment tools using self-report measures. There are some general outcome assessment tools that more and more mental health agencies and counsellors are beginning to use.
Activities of Daily Living
Outcomes can be measured by noting a client's ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs). ADLs are basic tasks that people perform such as bathing, dressing or eating. IADLs are more complex tasks such as money management, cleaning or meal preparation. These assessments are often a checklist based on client's self-report and the counsellor's or doctor's observation. The checklist includes questions about a client's ability to take his own medication, prepare meals, go shopping, and pay bills. Different types of forms are used by different agencies. Doctor's offices will use a checklist to determine if a patient can live alone. Courts use them to determine fitness for guardianship among other things, and the Social Security Administration has a checklist of ADLs to determine disability. It is believed that if a client is improving, they will be able to perform more ADLs and IADLs.
Camberwell Assessment of Needs
The Camberwell Assessment of Need (CAN) is a needs assessment for the severely mentally ill. It is a 22-item interview-administered instrument that looks at various domains of an individual's life. A psychologist or therapist gives the assessment by talking to client. Each domain, such as sexuality, accommodation, food, transport, is discussed by client and therapist to determine if there is needs are being met or unmet. This is used as an outcome assessment tool in some mental health settings, which is evaluated by mental health providers. Mental health providers periodically give the CAN to see if clients are increasing the amount needs being met, which is a sign of improvement.
MOS Core Survey
The MOS Core Survey is an outcome assessment tool in mental health. It was created for a two-year study of patients with chronic conditions, such as schizophrenia, diabetes and major depression and has been tested for validity and reliability. It includes 116 questions on outcomes and quality of life relying on the self-report of patients. Clients complete the survey at every visit to their health care practitioner or at a designated interval. The survey asks patients to rate questions on a Likert scale, such as "Do you feel worn out?" with 1 being all of the time and 6 being none of the time. Other questions assess activities, general pain, feelings and social activities. The survey instrument is available online for agencies and practitioners to use.
The practitioner's report is one of the more common outcome assessment tools used in the mental health field. Agencies design short forms in order to track specific outcome measures, and practitioners fill out the form during every visit. Mental health therapists, social workers or psychologists use the report to ask clients specific questions. Oftentimes, mental health agencies will measure data such as how many days a client has worked or how many days client has been hospitalised since the last visit. These are routine outcome measurements that are recorded at every appointment in order to track a client's progress. The results are entered into a database for tracking, and the agency evaluate the client's progress.