Use of standardised outcome measures in adult mental health services - Randomised controlled trial

Background Routine use of standardised outcome measures is not universal. Aims To evaluate the effectiveness of standardised outcome assessment. Method A randomised controlled trial, involving 160 representative adult mental health patients and paired staff (ISRCTNI6971059). The intervention group (n=101) (a) completed monthly postal questionnaires assessing needs, quality of life, mental health problem severity and therapeutic alliance, and (b) received 3-monthly feedback. The control group (n=59) received treatment as usual. Results The intervention did not improve primary outcomes of patient-rated unmet need and of quality of life. Other subjective secondary outcome measures were also not improved. The intervention reduced psychiatric inpatient days (3.5 v. 16.4 mean days, bootstrapped 95% CI 1.6-25.7), and hence service use costs were 2586 pound (95% CI 102-5391) less for intervention-group patients. Net benefit analysis indicated that the intervention was cost-effective. Conclusions Routine use of outcome measures as implemented in this study did not improve subjective outcomes, but was associated with reduced psychiatric inpatient admissions.