Improving the quality of life of individuals with severe mental illness has been the focus of considerable research. With advances in treatments for severe mental illness, particularly in psychiatric rehabilitation, evaluating outcomes has become increasingly important. Given the complex and multidimensional nature of severe mental illness, outcome evaluation of psychiatric rehabilitation is particularly difficult. This article addresses issues in evaluating psychiatric rehabilitation outcomes, including key outcome domains, selection of methods and measures, and meaningful use of results. Continuing conceptual and methodological issues are discussed. Also, future directions are explored, including evaluating multidimensional treatment effects and interactions and building an integrated understanding of all of the outcomes involved in psychiatric rehabilitation. 1 The term psychiatric rehabilitation may be confused with psychosocial rehabilitation, and the two are sometimes used interchangeably. In practice, both are sometimes used as a contraction of biopsychosocial rehabilitation. However, psychosocial rehabilitation sometimes specifically refers to a particular type of program, associated with specific prototypes, such as Fountain House in New York and Thresholds in Chicago (McEvoy, Scheifler, & Frances, 1999).

The perceptions of patients and their family members about electroconvulsive therapy (ECT) are crucial to understanding the meaning attached to having ECT and the impact it has on quality of life. Thus, in this qualitative study, patients and their family members described their perceptions of having electroconvulsive therapy (ECT). The experience occurred in two distinct periods in the patient's life: making the decision to have ECT and the physical and emotional aftermath of treatment. One of the most important themes in the study was a need for patients and families to be better informed about the risks of ECT.

The primary goals of compulsory, inpatient, psychiatric treatment are to decrease dangerous behaviors and help improve functioning so that a safe discharge to a less restrictive environment can be obtained. This study examined the aggression rates, levels of functioning, and treatment adherence for persons treated for schizophrenia (N = 506) compared with persons treated for borderline personality disorder (BPD) (N = 98) in an inpatient psychiatric facility. Over half of persons engaged in at least one incident of aggressive behavior during hospitalization. Differences in the types of aggression and functional deficits between these two clinical sub-groups were found. In addition, overall impairment increased the likelihood of aggressive behavior for persons diagnosed with schizophrenia, whereas irritability and social dependence increased the risk of aggression for persons diagnosed with BPD. Treatment interventions that target the improvement of these deficits may help reduce the intensity and severity of aggressive behaviors and help improve functioning and discharge readiness.

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