Validity and reliability of the Health of the Nation Outcome Scales in psychiatric patients in the community

1999 ◽  
Vol 174 (5) ◽  
pp. 409-412 ◽  
Author(s):  
Martin Orrell ◽  
Paula Yard ◽  
Julia Handysides ◽  
Robert Schapira
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Rating Scales ◽  
Psychiatric Patients ◽  
Psychotic Symptoms ◽  
Validity And Reliability ◽  
Wide Range ◽  
Day Hospitals ◽  
Age Range

BackgroundThe Health of the Nation Outcome Scales (HoNOS) have been developed for assessing the effectiveness of mental health services.AimsTo investigate the validity and reliability of the HoNOS in patients in contact with mental health services.MethodSubjects (age range 19–64) came from day hospitals, acute in-patient units and out-patient clinics in general practice. We obtained the opinions of experienced professionals, advocacy groups and patient groups to evaluate consensual and content validity.ResultsOne hundred patients were assessed using the package of rating scales. Interrater and test–retest reliability were good for some items and poor for others. The HoNOS had good criterion validity: acute in-patients had higher scores than day patients and out-patients. HoNOS also had good concurrent validity, correlating well with other scales. Comments suggested that the HoNOS was a useful and suitable scale for this population but psychotic symptoms and certain social factors were not sufficiently covered.ConclusionThe HoNOS had good validity but variable reliability. It may be better than existing scales because of the wide range of areas which it covers.

scholarly journals Mental health services for war-affected children

2003 ◽  
Vol 183 (6) ◽  
pp. 540-546
Author(s):  
Lynne Jones ◽  
Alban Rrustemi ◽  
Mimoza Shahini ◽  
Aferdita Uka
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Learning Disability ◽  
Stress Reactions ◽  
Educational Role ◽  
Number Of Patients ◽  
Wide Range ◽  
Adolescent Mental Health Service ◽  
Local Actors

BackgroundIn war-affected societies it is assumed that the major mental health problem facing the population will be stress reactions.AimsTo describe the creation of a child and adolescent mental health service (CAMHS) in Kosovo after the military conflict ended in 1999, and to establish the range of problems and diagnoses that presented.MethodData were collected on 559 patients over 2 years, including their referring problems and diagnoses.ResultsStress-related disorders constituted only a fifth of the case-load in year 1. A substantial number of patients were symptom-free but attended because they had been exposed to atraumatic event, and believed it might make them ill. Non-organic enuresis and learning disability were the most common diagnoses in year 2. Many patients had a complex mix of social and psychological difficulties that did not fit conventional diagnostic categories.ConclusionsMental health services that only address traumatic stress may fail to meet the needs of war-affected children. A comprehensive, culturally appropriate CAMHS is needed to address a wide range of problems including learning disability. It should be developed through local actors, and build on existing local infrastructure. Services can also have an educational role in ‘depathologising’ normative responses.

scholarly journals The Japanese version of the questionnaire about the process of recovery: development and validity and reliability testing

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Akiko Kanehara ◽  
Risa Kotake ◽  
Yuki Miyamoto ◽  
Yousuke Kumakura ◽  
Kentaro Morita ◽  
...  
Keyword(s):  
Mental Health ◽  
Factor Analysis ◽  
Mental Health Services ◽  
Health Services ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Short Form ◽  
Japanese Version ◽  
Internal Consistency Reliability ◽  
Validity And Reliability

Abstract Background Personal recovery is increasingly recognised as an important outcome measure in mental health services. This study aimed to develop a Japanese version of the Questionnaire about the Process of Recovery (QPR-J) and test its validity and reliability. Methods The study comprised two stages that employed the cross-sectional and prospective cohort designs, respectively. We translated the questionnaire using a standard translation/back-translation method. Convergent validity was examined by calculating Pearson’s correlation coefficients with scores on the Recovery Assessment Scale (RAS) and the Short-Form-8 Health Survey (SF-8). An exploratory factor analysis (EFA) was conducted to examine factorial validity. We used intraclass correlation and Cronbach’s alpha to examine the test-retest and internal consistency reliability of the QPR-J’s 22-item full scale, 17-item intrapersonal and 5-item interpersonal subscales. We conducted an EFA along with a confirmatory factor analysis (CFA). Results Data were obtained from 197 users of mental health services (mean age: 42.0 years; 61.9% female; 49.2% diagnosed with schizophrenia). The QPR-J showed adequate convergent validity, exhibiting significant, positive correlations with the RAS and SF-8 scores. The QPR-J’s full version, subscales, showed excellent test-retest and internal consistency reliability, with the exception of acceptable but relatively low internal consistency reliability for the interpersonal subscale. Based on the results of the CFA and EFA, we adopted the factor structure extracted from the original 2-factor model based on the present CFA. Conclusion The QPR-J is an adequately valid and reliable measure of the process of recovery among Japanese users with mental health services.

scholarly journals Mental health services for war-affected children

2003 ◽  
Vol 183 (06) ◽  
pp. 540-546 ◽  
Author(s):  
Lynne Jones ◽  
Alban Rrustemi ◽  
Mimoza Shahini ◽  
Aferdita Uka
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Learning Disability ◽  
Stress Reactions ◽  
Educational Role ◽  
Number Of Patients ◽  
Wide Range ◽  
Adolescent Mental Health Service ◽  
Local Actors

Background In war-affected societies it is assumed that the major mental health problem facing the population will be stress reactions. Aims To describe the creation of a child and adolescent mental health service (CAMHS) in Kosovo after the military conflict ended in 1999, and to establish the range of problems and diagnoses that presented. Method Data were collected on 559 patients over 2 years, including their referring problems and diagnoses. Results Stress-related disorders constituted only a fifth of the case-load in year 1. A substantial number of patients were symptom-free but attended because they had been exposed to atraumatic event, and believed it might make them ill. Non-organic enuresis and learning disability were the most common diagnoses in year 2. Many patients had a complex mix of social and psychological difficulties that did not fit conventional diagnostic categories. Conclusions Mental health services that only address traumatic stress may fail to meet the needs of war-affected children. A comprehensive, culturally appropriate CAMHS is needed to address a wide range of problems including learning disability. It should be developed through local actors, and build on existing local infrastructure. Services can also have an educational role in ‘depathologising’ normative responses.

scholarly journals Acute mental health presentations before and during the COVID-19 pandemic

BJPsych Open ◽  
2021 ◽  
Vol 7 (4) ◽  
Author(s):  
Naaheed Mukadam ◽  
Andrew Sommerlad ◽  
Jessica Wright ◽  
Abigail Smith ◽  
Aleksandra Szczap ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Mental Health Services ◽  
Health Services ◽  
Psychological Symptoms ◽  
Interrupted Time Series ◽  
Psychiatric Services ◽  
Psychotic Symptoms ◽  
Duration Of Symptoms ◽  
Mental Capacity Act

Background A number of community based surveys have identified an increase in psychological symptoms and distress but there has been no examination of symptoms at the more severe end of the mental health spectrum. Aims We aimed to analyse numbers and types of psychiatric presentations to inform planning for future demand on mental health services in light of the COVID-19 pandemic. Method We analysed electronic data between January and April 2020 for 2534 patients referred to acute psychiatric services, and tested for differences in patient demographics, symptom severity and use of the Mental Health Act 1983 (MHA), before and after lockdown. We used interrupted time-series analyses to compare trends in emergency department and psychiatric presentations until December 2020. Results There were 22% fewer psychiatric presentations the first week and 48% fewer emergency department presentations in the first month after lockdown initiated. A higher proportion of patients were detained under the MHA (22.2 v. 16.1%) and Mental Capacity Act 2005 (2.2 v. 1.1%) (χ2(2) = 16.3, P < 0.0001), and they experienced a longer duration of symptoms before seeking help from mental health services (χ2(3) = 18.6, P < 0.0001). A higher proportion of patients presented with psychotic symptoms (23.3 v. 17.0%) or delirium (7.0 v. 3.6%), and fewer had self-harm behaviour (43.8 v. 52.0%, χ2(7) = 28.7, P < 0.0001). A higher proportion were admitted to psychiatric in-patient units (22.2 v. 18.3%) (χ2(6) = 42.8, P < 0.0001) after lockdown. Conclusions UK lockdown resulted in fewer psychiatric presentations, but those who presented were more likely to have severe symptoms, be detained under the MHA and be admitted to hospital. Psychiatric services should ensure provision of care for these patients as well as planning for those affected by future COVID-19 waves.

Needs for care in psychiatric patients: a systematic review. I. General concepts and assessment measures. Needs for services

2000 ◽  
Vol 9 (3) ◽  
pp. 190-213 ◽  
Author(s):  
Antonio Lasalvia ◽  
Benedetta Stefani ◽  
Mirella Ruggeri
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
General Population ◽  
Health Services ◽  
Mental Health Care ◽  
Psychiatric Patients ◽  
Assessment Tools ◽  
Needs For Care ◽  
Number Of Patients

SummaryObjective – In Italy, mental health care is in phase of reorganisation. In this frame the measurement of users' needs may be a useftil tool in planning individualised mental health service interventions and in their evaluation. Aims of the present study are (I) to highlight the basic concepts of 'needs for care' and give a brief description of the main needs assessment tools specifically developed for psychiatric patients; (II) to review studies assessing needs for mental health services in the general population; (III) to discuss the role played by the assessment of needs in planning mental health care. Methods – Studies published in the international literature from January 1980 to June 1999 were reviewed. The studies were located through a computerised search of the databases MEDLINE and PsycLit; in addition, the reference lists of the studies located through the computerised search and the content of main international psychiatric journals were manually scanned in order to avoid possible omissions. Studies assessing needs for services and studies assessing needs on individual level were separately reviewed. Both groups of studies, in turn, were divided in studies assessing needs for mental health care in the general population and in psychiatric patients. Results – Although most studies on needs for services used indirect methodologies and employed quite heterogeneous experimental design, they provide at large overlapping results. In the general population, about 60%- 70% of patients with anxiety, depression and other neurotic disorders and 30%-40% of psychotic patients do not receive any specialist mental health care, suggesting that the majority of subjects suffering from a psychiatric disorder do not receive the mental health care they need. Conclusions – Unmet needs for services show a higher frequency in patients with neurotic and depressive disorders, indicating a shortage in services delivery that should be taken into account both by psychiatrists and mental health planners. Moreover, the finding that a large number of patients suffering from psychotic disorders do not receive any kind of mental health care is of particular relevance for planning mental health services, since these subjects are usually the most problematic and difficult to treat.

Identification of Prodromal Signs and Symptoms and Early Intervention in Manic Depressive Psychosis Patients: A Case Example

1995 ◽  
Vol 23 (4) ◽  
pp. 399-409 ◽  
Author(s):  
Alison Perry ◽  
Nicholas Tarrier ◽  
Richard Morriss
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Mental Health Services ◽  
Health Services ◽  
Signs And Symptoms ◽  
Pharmacological Intervention ◽  
Psychotic Symptoms ◽  
Prodromal Phase ◽  
Manic Depressive Psychosis ◽  
Manic Depressive

Recent research has revealed that relapse in manic depressive psychosis and schizophrenia is preceded by specific prodromal signs and symptoms that include dysphoria, other non-psychotic symptoms and features unique to individual patients. Treatment studies in schizophrenia have shown that early pharmacological intervention during a prodromal phase of psychotic relapse may be effective in the prevention of hospitalization. This paper describes the procedure of prodromal signs identification in manic depressive psychosis and the negotiation of an appropriate plan of action with the mental health services in order to abort the relapse or reduce its severity through early pharmacological intervention. A case example is presented to demonstrate this approach.

Mental health services in Germany

1992 ◽  
Vol 16 (01) ◽  
pp. 40-42 ◽  
Author(s):  
Christine M. Tyrie
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
West Germany ◽  
Wide Range ◽  
Professional Workers

On a recent study trip I was able to examine approaches to health care, in particular, mental health services in what was West Germany. I visited a range of facilities and met a wide range of professional workers.

Psychotic experiences in a mental health clinic sample: implications for suicidality, multimorbidity and functioning

2013 ◽  
Vol 44 (8) ◽  
pp. 1615-1624 ◽  
Author(s):  
I. Kelleher ◽  
N. Devlin ◽  
J. T. W. Wigman ◽  
A. Kehoe ◽  
A. Murtagh ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Suicidal Behaviour ◽  
Health Clinic ◽  
Psychotic Experiences ◽  
Global Functioning ◽  
Community Based Research ◽  
Wide Range

BackgroundRecent community-based research has suggested that psychotic experiences act as markers of severity of psychopathology. There has, however, been a lack of clinic-based research. We wished to investigate, in a clinical sample of adolescents referred to a state-funded mental health service, the prevalence of (attenuated or frank) psychotic experiences and the relationship with (i) affective, anxiety and behavioural disorders, (ii) multimorbid psychopathology, (iii) global functioning, and (iv) suicidal behaviour.MethodThe investigation was a clinical case–clinical control study using semi-structured research diagnostic psychiatric assessments in 108 patients newly referred to state adolescent mental health services.ResultsPsychotic experiences were prevalent in a wide range of (non-psychotic) disorders but were strong markers of risk in particular for multimorbid psychopathology (Z = 3.44, p = 0.001). Young people with psychopathology who reported psychotic experiences demonstrated significantly poorer socio-occupational functioning than young people with psychopathology who did not report psychotic experiences, which was not explained by multimorbidity. Psychotic experiences were strong markers of risk for suicidal behaviour. Stratified analyses showed that there was a greatly increased odds of suicide attempts in patients with a major depressive disorder [odds ratio (OR) 8.89, 95% confidence interval (CI) 1.59–49.83], anxiety disorder (OR 15.4, 95% CI 1.85–127.94) or behavioural disorder (OR 3.13, 95% CI 1.11–8.79) who also had psychotic experiences compared with patients who did not report psychotic experiences.ConclusionsPsychotic experiences (attenuated or frank) are an important but under-recognized marker of risk for severe psychopathology, including multimorbidity, poor functioning and suicidal behaviour in young people who present to mental health services.

HoNOS-Rome: an expanded, customized, and longitudinally oriented version of the HoNOS

2003 ◽  
Vol 12 (1) ◽  
pp. 53-62 ◽  
Author(s):  
Pierluigi Morosini ◽  
Antonella Gigantesco ◽  
Angelica Mazzarda ◽  
Loredana Gibaldi
Keyword(s):  
Mental Health ◽  
Factor Analysis ◽  
Mental Health Services ◽  
Health Services ◽  
Construct Validity ◽  
Weighted Kappa ◽  
Outcome Evaluation ◽  
Face Validity ◽  
Validity And Reliability ◽  
National Mental Health

SUMMARYAims– To clarify the acceptability, reliability and factorial validity of a new Italian version of the HoNOS called HoNOS-Rome. Its main innovations are both in design and in contents.Methods– Face validity was assessed by surveying 3 focus groups. Reliability was assessed in 8 different pairs of raters on a sample of 24 patients; construct validity was analysed by factor analysis using a sample of 187 patients at 6 day centres. Acceptability was investigated by means an anonymous questionnaire filled by professionals that were using the instrument.Results– Time of completion was low (range 4–12 minutes), the tool proved very acceptable and the reliability was good (weighted kappa ≥ 0.71 for all items). Factor analysis was consistent with the division of HoNOS–Rome into four sensible factors accounting for 52% of the total variance.Conclusions– The findings indicate that HoNOS–Rome has a satisfactory degree of acceptability, construct validity and reliability, and may promote the routine evaluation of outcomes in mental health services.Declaration of Interest: the authors declare that the study was supported by grant no. 96/Q/T41 of the Italian National Mental Health Project – Istituto Superiore di Sanità – Sub-project: Development and validation of tools for outcome evaluation of mental health services, Italy (Professor P. Morosini).

scholarly journals Differences between specialist community adolescent mental health teams and generic child and adolescent mental health services: training issues for specialist registrars

2006 ◽  
Vol 30 (6) ◽  
pp. 232-233 ◽  
Author(s):  
Carmen Pinto
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Department Of Health ◽  
National Service Framework ◽  
First Onset ◽  
Age Range

Following the National Service Framework (Department of Health, 2004) recommendation of extending the age range of child and adolescent mental health services to 18 years there is an increasing expectation that these generic services will provide the comprehensive care for severe mental health problems in areas where specialist teams do not exist. Services have responded to this with a variety of teams from generic adolescent teams to smaller first-onset psychosis or assertive outreach teams.

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