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INTRODUCTION: The Health of the Nation Outcome Scales (HoNOS) for adults, and equivalent measures for children and adolescents and older people, are widely used in clinical practice and research contexts to measure mental health and functional outcomes. Additional HoNOS measures have been developed for special populations and applications. Stakeholders require synthesised information about the measurement properties of these measures to assess whether they are fit for use with intended service settings and populations and to establish performance benchmarks. This planned systematic review will critically appraise evidence on the measurement properties of the HoNOS family of measures. METHODS AND ANALYSIS: Journal articles meeting inclusion criteria will be identified via a search of seven electronic databases: MEDLINE via EBSCOhost, PsycINFO via APA PsycNET, Embase via Elsevier, Cumulative Index to Nursing and Allied Health Literature via EBSCOhost, Web of Science via Thomson Reuters, Google Scholar and the Cochrane Library. Variants of 'Health of the Nation Outcome Scales' or 'HoNOS' will be searched as text words. No restrictions will be placed on setting or language of publication. Reference lists of relevant studies and reviews will be scanned for additional eligible studies. Appraisal of reliability, validity, responsiveness and interpretability will be guided by the COnsensus-based Standards for the selection of health Measurement INstruments checklist. Feasibility/utility will be appraised using definitions and criteria derived from previous reviews. For reliability studies, we will also apply the Guidelines for Reporting Reliability and Agreement Studies to assess quality of reporting. Results will be synthesised narratively, separately for each measure, and by subgroup (eg, treatment setting, rater profession/experience or training) where possible. Meta-analyses will be undertaken where data are adequate. ETHICS AND DISSEMINATION: Ethics approval is not req

Background: Functioning is one of the key domains emphasised in the routine assessment of outcomes that has been occurring in specialised public sector mental health services across Australia since 2002, via the National Outcomes and Casemix Collection. For adult consumers (aged 18-64), the 16-item Life Skills Profile (LSP-16) has been the instrument of choice to measure functioning. However, review of the National Outcomes and Casemix Collection protocol has highlighted some limitations to the current approach to measuring functioning. A systematic review was conducted to identify, against a set of pre-determined criteria, the most suitable existing clinician-rated instruments for the routine measurement of functioning for adult consumers. Method: We used two existing reviews of functioning measures as our starting point and conducted a search of MEDLINE and PsycINFO to identify articles relating to additional clinician-rated instruments. We evaluated identified instruments using a hierarchical, criterion-based approach. The criteria were as follows: (1) is brief (<50 >items) and simple to score, (2) is not made redundant by more recent instruments, (3) relevant version has been scientifically scrutinised, (4) considers functioning in a contemporary way and (5) demonstrates sound psychometric properties. Results: We identified 20 relevant instruments, 5 of which met our criteria: the LSP-16, the Health of the Nation Outcome Scales, the Illness Management and Recovery Scale-Clinician Version, the Multnomah Community Ability Scale and the Personal and Social Performance Scale. Conclusion: Further work is required to determine which, if any, of these instruments satisfy further criteria relating to their appropriateness for assessing functioning within relevant service contexts, acceptability to clinicians and consumers, and feasibility in routine practice. This should involve seeking stakeholders' opinions (e.g. about the specific domains of functioning covered by ea

This paper examines an Australian approach to the measurement of social inclusion for consumers of public-funded mental health services. The former Australian Government Department of Health and Ageing commissioned the new measure, called the Living in the Community Questionnaire (LCQ), needed to be brief, able to be completed by consumers with minimal support (if any), quantifiable, allow normative comparison as available and demonstrate the social outcomes of care so the measure could be used to support recovery-orientated therapeutic practice. This paper describes the early development and initial psychometric testing of the LCQ.

The current study seeks to answer the question, ‘What is the content and process of a comprehensive mental health nursing assessment?’ Mental health nurses are required to undertake comprehensive mental health nursing assessments as part of their routine clinical practice. The current study was prompted by the author’s experience of implementing standard clinical documentation and measures of health status to the clinical practice of mental health nurses and the reaction of nurse’s to this implementation. In a series of six articles the question is answered, the implications of the findings explored and a potential solution for the issues identified offered. The first article is a literature review which failed to identify one study addressing the content and process of a comprehensive mental health nursing assessment. Therefore, in order to find out more about this topic, a qualitative study was undertaken. A qualitative approach is the best method for learning about a subject area where little is known. Eighteen interviews were undertaken with mental health nurses asking them to describe the content and process of a comprehensive mental health nursing assessment. These interviews were thematically analysed using a constant comparative method informed by grounded theory. The results of this qualitative study are reported in articles two, three and four. Article two describes how the content of what constituted a comprehensive assessment varied from nurse to nurse. Article three describes the process of a comprehensive assessment which involves engaging with the consumer to enable problem identification, while article four identifies that no nurse in this study used a formal model to guide their mental health nursing assessment practice and explores the implications of this finding for mental health nursing. The findings from this qualitative study are then explored in two additional articles. Article five explores the implications of problem identification in relat

Object: The concept of recovery has been recognized as important in the treatment of mental illness. A number of specific instruments exist which are designed to: (i) measure recovery at an individual level; and (ii) assess the recovery orientation of services. The current review aimed to identify these and evaluate their potential for routine use in Australian public sector mental health services. Method: We identified potential instruments by drawing on existing reviews, searching MEDLINE and PsycINFO, and consulting with experts. We used a hierarchical criterion-based approach to assess whether given instruments might be candidates for measuring recovery in the Australian context. Results: We identified 33 instruments: 22 designed to measure individuals'' recovery and 11 designed to assess the recovery orientation of services (or providers). Four of the former (Recovery Assessment Scale; Illness Management and Recovery Scales; Stages of Recovery Instrument; Recovery Process Inventory) and four of the latter (Recovery Oriented Systems Indicators Measure; Recovery Self Assessment; Recovery Oriented Practices Index; Recovery Promotion Fidelity Scale) were identified as promising candidates for routine use in Australian public sector mental health services. Conclusions: Further work is required, however, to determine which, if any, might best be used for this purpose; the possibility that modifications to existing instruments or the development of new instruments might be required should not be ruled out. It might be desirable to invest in two instruments: one designed to measure individuals'' recovery and one designed to measure the recovery orientation of services. If Australia were to go down this path, it would make sense to align indicators in each as far as possible, and to ensure that they were consistent with existing endeavours aimed at monitoring and improving recovery-focused aspects of service quality.

Clinicians have been found to hold predominantly negative attitudes toward routine outcome assessments (ROA). This study aims to assess changes in clinicians’ attitudes to ROA, and in particular, the provision of feedback from such assessments following a training workshop. Ninety-six mental health workers attended a training workshop on ROA, which was supported by the use of a CD-ROM video resource. Participants completed a questionnaire before and after training that assessed their attitudes toward ROA and the provision of feedback from these assessments. Attitudes toward feedback were predominantly positive at baseline. Significantly more positive attitudes on general attitudes and specific attitudes related to the provision of feedback were found following training. Generating positive clinician attitudes is the first step toward improving the processes and effectiveness of ROA. Controlled trials with a follow up of clinicians’ behaviour are needed to determine whether the changes found are maintained and reflected in practice.

Background: The attitudes and beliefs of patients toward their treatment have been found to be an important factor in treatment outcome, particularly as it relates to treatment adherence. There are also suggestions that knowledge, attitudes and beliefs held by nurses about treatments may also be important influences on treatment outcome but there has been little research relating these to specific clinical behaviour. Aims: This study explored the knowledge and beliefs of nurses toward neuroleptic medications in the treatment of severe mental ill health with the view to identifying specific nurse training needs. Method: A convenience sample of 64 nurses was given an anonymous questionnaire. Measures taken were then related to perceived difficulties using standard adherence strategies with patients. Results: The results suggested a relationship between knowledge and attitudes such that poor knowledge and attitudes were associated with greater difficulty using standard clinical interventions. Conclusions: Poor knowledge and negative attitudes toward medications impede the effective use of adherence strategies. This study highlights the need for specific nurse training programs and further research into the educational needs of nurses. Declaration of interest: This research was financed in part by a grant from the Australian Quality use of Medicines (Grant number SG497).