Consumer and service determinants of completion of a consumer self-rating outcome measure

To study the relative contribution of consumer, clinician and service factors to whether or not consumers completed a self-rating measure in the context of routine outcome measurement.

Four Victorian mental health services commenced routine outcome measurement in their adult services in mid-2000. Clinician-completed measures (Health of the Nation Outcome Scales (HoNOS) and Life Skills Profile (LSP)) and a consumer self-rated measure (Behaviour and Symptom Identification Scale (BASIS)) were entered into specialized software. Analyses were restricted to assessments conducted at review in the community.

Wide differences were observed between the four agencies in the rates of completion of the self-rating measure. Overall, consumer characteristics associated with greater likelihood of completion were lower age, non-organic diagnosis, lesser severity as measured by the HoNOS, and lesser disability as measured by the LSP. A more focused analysis showed that agency, lower age, and higher compliance were most reliably associated with completion. Significant proportions of clinicians had no recorded instances of consumer self-rating associated with their assessments.

Service and clinician factors appear to be equally important as consumer factors in whether or not a self-rating measure was completed. Information systems designed for outcomes measurement should include indications of whether or not a self-rating was invited, and, if not, why not. The results suggest that consumer self-rating is not yet firmly established in the outcomes measurement culture.