Outcomes for mental health services: what really matters?

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Commissioned by Janssen, this report examines the pursuit of outcomes by mental health services. 

There has been an increasing interest in the concept of value-based health care and how resources are allocated to improve outcomes. However, measuring outcomes in mental health services is often complex and fraught with difficulty, with professionals and service users often having very different perspectives on the nature of mental illness and the role of services in addressing it.

About the report

Through a series of over 100 conversations with people actively involved in mental health services in England including current and former service users, the report highlights how frameworks for measuring outcomes are often too narrowly focused on clinical outcomes. Whilst recovery-based frameworks are trying to widen this, neither fully captures what really matters to people. 
 
The report challenges those in mental health to find a consensus on the outcomes that matter to people with mental health problems. Services should adopt a broader perspective on outcomes as a basis for collaborating with service users and a foundation for delivering more humane and effective care.

Comments

Alastair Macdonald

Position
Outcomes researcher,
Organisation
South London & Maudsley NHS Trust
Comment date
11 April 2021

You are quite right that different groups involved in healthcare will have different reasons for interest in outcomes, different desired outcomes and prefer different indicators of outcomes. This had been noted since the 1990s (e.g. the Outcomes Grid- UK Clearing House for Health Outcomes- http://www.ukrcom.org/grid.htm). What's to be done about this? The trouble with the conversational method of your paper is that equal weight appears to be given to assertions that it's all a waste of time and to those who are trying to achieve progress in this area. Their main approach by the UKRCOM network (with whom you seem to have had no conversation) is to measure mental health outcomes from all main perspectives and then work out any major disagreements within the context of the service and its patients and staff. I subscribe to the ancient proverb that people who say something is too difficult to be done should not interrupt people doing it.

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