For Mental Health and Addictions services, outcomes information collection is about monitoring and measuring changes in service users' health, wellbeing, and quality of life over a period of time; the period of time depending on who is measuring changes, and for whom (for services receiving government funding (NGO and DHB) this period of time is usually based on the length of time between referral into and discharge from a service).
Outcomes evaluation looks at whether a service has effectively achieved the outcomes it is seeking.
Measuring the changes in outcomes over time of people using Mental Health and Addictions services supports organisations to not only learn more about an individual service user's recovery, but also enables NGOs to develop the best possible services which will achieve the best possible outcomes for a wider population.
When outcomes information is combined with other evaluative information (e.g. the cartoon below), such as process evaluation information, providers are able to adjust services to provide quality and resource efficient services.
As the cartoon to the right implies, when outcomes information (e.g. the mammoth's change in neck pain) measured over a specific time period, is paired with process information (e.g. 11 cavemen and woman simultaneously throw spears at the mammoth's rear end), and this information is collected over many interactions, an understanding can be built of what does, and does not support recovery (in this instance neck pain recovery).
Current Outcomes Projects Platform is Involved In
HoNOS (Health of the Nation Outcome Scales) refers to a set of measures, originally developed by the Royal Psychiatrists' Research Unit in the UK, which have been adopted by the Ministry of Health as a means of standardising the measurement of health and social functioning of people experiencing mental illness.
Five of the HoNOS measures are currently in use within DHBs, with some NGOs showing interest, these are:
- HoNOS - intended for use with adults between 18 and 65 years
- HoNOSCA - intended for use with children between 4 and 17 years
- HoNOS65+ - for use with adults over 65 years
- HoNOS-LD - for use with adults with learning disabilities
- HoNOS-secure - for use within forensic services
The scales used in HoNOS cover a wide range of symptoms, for example:
1. Overactive, aggressive, disruptive or agitated behaviour
2. Non-accidental self-injury
3. Problem drinking or drug-taking
4. Cognitive problems
5. Physical illness or disability problems
6. Problems associated with hallucinations and delusions
7. Problems with depressed mood
8. Other mental and behavioural problems
9. Problems with relationships
10. Problems with activities of daily living
11. Problems with living conditions
12. Problems with occupation and activities
Casemix is a process which involves the grouping of similar 'cases' of mental health service use in order to be able to compare outcomes. This classification process is done in order to better understand true similarities and/ or differences in Mental Health and Addictions Services.
Alongside the implementation of PRIMHD comes the ability to analyse outcomes data using Casemix.