Real-World Evaluation of the Resident Assessment Instrument-Mental Health Assessment System

Abstract

This evaluation suggests that the RAI-MH-based assessment platform may be better suited to longer-term services for severely impaired clients than to short-term, highly specialized services. In particular, the suitability of the RAI-MH for hospital-based addictions care should be re-examined. Issues of staff compliance and motivation and problems with assessment system performance would be highly entwined, making it inappropriate to attempt to allocate responsibility for areas of less than optimal performance to one or the other. The ability of the RAI-MH to perform well on clinical front lines is, in any case, essential for it to meet its objectives. Continued evaluation of this assessment platform should be a priority for future research.

READMIT: A clinical risk index to predict 30-day readmission after discharge from acute psychiatric units

“…Only individuals who were hospitalized for 72 h were included in our cohort because the characteristics of individuals hospitalized for shorter stays differ substantially from the characteristics of individuals who are hospitalized for at least 72 h, and the number of mandatory RAI-MH assessment variables is much lower for admissions <72 h than for longer-term admissions (Urbanoski et al, 2012).…”

Using Routinely Collected Clinical Assessments in Mental Health Services: The Resident Assessment Instrument—Mental Health

“…Dr Urbanoski and colleagues1 examined the use of the Resident Assessment Instrument–Mental Health (RAI-MH) for specialized inpatient mental health services. While the article underscores the importance of a comprehensive approach to implementation (for example, training or information technology infrastructure), much of the critique appears to reflect a lack of understanding of the design and applications of the RAI-MH.…”

“…The suggestion that most RAI-MH scales are “irrelevant for most patients”1 , p 692 is particularly surprising and misguided. The authors incorrectly identified several scales as outcome measures, or had flawed operationalizations of specific scales.…”

The use of a brief mental health screener to enhance the ability of police officers to identify persons with serious mental disorders

“…The RAI-MH instrument collects information from patients on more than 400 individual items measuring mental and physical health symptoms, sociodemographic characteristics, substance abuse, risk of harm to self or others, functional characteristics, and service utilization. Second, the instrument has good reliability and validity in inpatient psychiatry settings (Gibbons et al, 2008;Seto, Harris, & Rice, 2004;Urbanoski, Mulsant, Willett, Ehtesham, & Rush, 2012), with inter-rater agreement averaging 80% or more (Hirdes et al, 2002(Hirdes et al, , 2008. Third, with more than 41,000 individual mental health assessments available for analysis, the RAI-MH data represent a large population upon which to identify, analyze, and validate items as candidates for inclusion on a screener.…”

“…Third, as a pilot study, it was not possible to gather data from a randomized or matched control sample of police interactions with PSMD elsewhere in the province, although the results do compare favorably with other studies and data collected from different jurisdictions. Fourth, it was not possible to measure inter-rater reliability and obtain estimates of validity due to limited project resources and the relatively small sample size, although the individual items included on the screener as based on those in the RAI-MH have demonstrated good validity and reliability across diverse inpatient hospital settings (Gibbons et al, 2008;Seto et al, 2004;Urbanoski et al, 2012). Finally, the dependent variables were limited to police escort to hospital and admission, which does not reflect the current broad range of dispositions available to both police officers and clinicians.…”