A Brief Mental Health Outcome Scale

Abstract

GAF proved to be a reliable and, within the limits of the indicators used, a valid measure of psychiatric disturbance in our sample of the severely mentally ill. Differences in relationships between the three GAF scores and medication/support needs indicate the usefulness of obtaining all three scores for monitoring levels and type of psychiatric disturbance in this population.

The Rehabilitation Effectiveness for Activities for Life (REAL) study: a national programme of research into NHS inpatient mental health rehabilitation services across England

“…We pre-specified the list of potential predictors based on our knowledge of the literature. It included service users' sex, age, GAF 50 score, admission status (involuntary or not), subscale D of the SPRS 77 assessing challenging behaviours (i.e. incontinence, risk of suicide, self-harm) and, where applicable, baseline costs.…”

“…Location of unit, hospital versus community (collapsing of ITEM140A) MINI 45 Percentage male (ITEM003/ITEM002) Mean age (Collapse by unit mean AGE) Mean GAF 50 (Collapse by unit mean Q100) Percentage detained under the Mental Health Act (ITEM005) Mean length of stay (PROF003) AMENDMENT 13/04/2011 it was decided that this variable should be dropped because it is poorly estimated (the unit managers often guess the mean length of stay) and also there is a high percentage of missing data for this variable (37%). Some covariates (age, GAF) were only measured at the service user level, so will be collapsed by rehabilitation unit to give mean values for continuous variables and percentages with the given characteristic for categorical variables.…”

“…Data were gathered on service user participants at recruitment from a review of case notes and staff-rated measures, as follows: demographics (age, sex, ethnic group); diagnosis; length of history; length of current admission; previous admissions; previous involuntary admissions; risk history; social function, assessed using the LSP; 75 engagement in activities, assessed using the staff-rated version of the time-use diary; 74 and function, assessed using the GAF scale. 50 Potential mediators of outcomes were also assessed through staff ratings: quality of care in the unit was assessed using the QuIRC 43,44 completed by the unit manager; staffing of the unit and the availability of specific interventions were included in the QuIRC; service users' substance use was assessed using the Clinician Alcohol and Drug Use Scales; 76 and challenging behaviours that may make community placement difficult were assessed using the SPRS. 77 At the 12-month follow-up, the researchers contacted a key informant to clarify whether or not the service user had been successfully discharged, and the details of community placements were recorded.…”

“…The primary and secondary outcome measures were completed as described above. Potential mediators of outcomes were also assessed, including the staffing of the unit (collected from the unit manager), patients' overall functioning (assessed using the GAF scale 50 ), substance use (assessed using the staff-rated Clinician Alcohol and Drug Use Scales) 76 and challenging behaviours that may make community placement difficult [assessed using the staff-rated Special Problems Rating Scale (SPRS)]. 77 …”

“…Service users' views on the unit's therapeutic milieu were assessed using the General Milieu Index (GMI); 49 the service user rates their general satisfaction with the unit, with staff and with other residents, and the degree to which they feel the unit facilitates their confidence and abilities, on a scale of 1 to 5 (from 'not at all' to 'very much'), and a total mean score between 5 and 25 is generated. An assessment of service user function was also made by the researcher using the Global Assessment of Functioning (GAF) scale 50 to take this into account as a potential mediator between service quality and clinical outcomes. All service user interviews were completed within 1 month of the unit manager interview.…”