This knowledge summary provides an introduction to understanding mental health outcome measures. It covers general and patient rated outcome measures and specific measures for emotional difficulties, bipolar disorder, psychosis, substance misues and cognitive function.
The information presented here is adapted from fully referenced source material at Emotional Wellbeing.
There are many standardised outcome measures that have been developed for research purposes for a variety of indications and circumstances. Many are lengthy and not suitable for clinical practice but some are simpler, easier to use and patient centred. The list below is not exhaustive, there are other measures which are relevant to clinical practice.
General Outcome Measures
Health of the Nation Outcome Scales (HoNOS)
HoNOS (Health of the Nation Outcomes Scales) was developed during the early 90s by the Royal College of Psychiatrists as a measure of the health and social functioning of people with severe mental illness. Read more »
The introduction of Payment by Results clustering is promoting the use of HoNOS (with additional items).
Patient Rated Outcome Measures (PROMS)
PROMS are outcome measures which service users themselves complete and which have been developed in consultation with them to assess the needs that they identify.
The Recovery Star developed by the Mental Health Providers Forum, is an outcomes measure which enables people using services to measure their own recovery progress, with the help of mental health workers or others. Read more »
Carer and User Expectations of Services (CUES)
CUES is Patient Rated Outcome Measures (PROMS) which enable users of mental health services to rate their experience across the range of domains that they consider to be important. Read more »
DIALOG is an outcomes measure to support structured conversation between patients and clinician focussing on the patients’ views of quality of life, needs for care and treatment satisfaction. Read more »
INSPIRE is an outcomes measure designed to assess a service user’s experiences of the support they receive from a mental health worker for their recovery. Read more »
Warwick-Edinburgh Mental Wellbeing Scale
The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) is a validated population measure of mental wellbeing developed by Warwick and Edinburgh Universities. It comprises a scale of 14 positively worded items, with five response categories. It is being suggested (and piloted) as a PROM for general use. Read more »
Outcome measures for use with children
For children’s services, CAMHS Outcomes Research Consortium (CORC) provides valuable information.
Outcome measures for emotional difficulties
(the Improving Access to Psychological Therapies site has a broad selection of measures)
- Depression – Patient Health Questionnaire (PHQ) 9
- Anxiety – Generalised Anxiety Disorder (GAD) 7
- Obsessive compulsive disorder – Yale-Brown Obsessive Compulsive Disorder Scale (Y-BOCS)
- Eating disorders – The SCOFF questionnaire (for identification), BMI healthy weight calculator
Outcome measures for bipolar disorder
- Mania – Young Mania Rating Scale (YMRS)
- Depression – The Hamilton Rating Scale for Depression (HAMD), Patient Health Questionnaire (PHQ) 9
Outcome measures for psychosis
- Psychosis – Positive And Negative Syndrome rating Scale (PANSS)
- Delusions – Psychotic Symptom Rating Scale (PSYRATS)
- Hallucinations – Psychotic Symptom Rating Scale (PSYRATS)
- Social Performance – Personal and Social Performance Scale (PSP)
- Negative symptoms – Scale for the Assessment of Negative Symtoms (SANS)
Outcome measures for substance misuse
- Screening tool – Screening Tools for alcohol related risk
- Treatment – Treatment Outcomes Profile (TOP)