A Review and Analysis of Routine Outcome Measures for Forensic Mental Health Services

Abstract

Considerable progress has been made in recent years towards implementing routine outcome measures within mental health services. However, the applicability of these tools for forensic-mental health populations has been questioned. A review and analysis was conducted to identify tools that could validly be applied in a forensic context, to provide a measure of functioning, recovery, risk, and placement pathways. Nineteen instruments were initially identified and evaluated against a hierarchy of criteria. While no tool assessed all domains of interest, six tools were ultimately considered to have potential utility as outcome measures for users of forensic mental health services.

Keywords:

• outcome measure
• forensic
• mental health

Notes

¹ The terms consumer, client and patient have been used interchangeably within this review to refer to a person who has engaged with a mental health service for assessment or treatment.

² The reader is referred to reports by the National Mental Health Working Group (2003; http://amhocn.org/static/files/assets/5ddbb17d/NOCC_Specs_V1.5.pdf) and Beveridge, Papps, Bower, & Smith (2012; http://www.tepou.co.nz/download/asset/502) for a review of all mandated measures currently used in Australia and New Zealand.

³ Search terms used: [“outcome measure*” or “routine outcome measure*” or (“outcome” & “measure*”) or (“need*” & “assess*”) or “risk assessment” or “instruments” or “measurement” or “achievement measure*” or “aptitude measure*” or “attitude measure*” or “criterion referenced tests” or “group testing” or “individual testing” or “instrument*” or “inventor*” or “occupational measure*” or “perform* tests” or “personality measure*” or “post test*” or “pre test*” or “profile*” or “psych* evaluation” or “psych* assessment” or “psychometrics” or “questionnaires” or “rating” or “screening” or “sociometric” or “standardized tests” or “statistical measure*” or “surveys” or “symptom checklists” or “test*” or “recovery” or “recovery measure*”] and [“forens*” or “justice” or “criminal” or “offend*”] (Limiters: Publication year: January 1980 – May 2011).

⁴ The authors are aware that the HCR-20 has recently been updated to version 3 (HCR-20^V3; Douglas, Hart, Webster, & Belfrage, 2013), however this was not available for consideration during the present review period.

⁵ 5*Denotes key references for ROM tools reviewed in this article.^†Denotes references of validation studies for the ROM tools reviewed.