Continuity of Care: Validation of a New Self-report Measure for Individuals Using Mental Health Services Janet Durbin, MSc Paula Goering, PhD, RN David L. Streiner, PhD, CPsych George Pink, PhD Abstract Continuity of care is a concern for individuals with persistent mental illness who need diverse services over time in response to multiple and changing needs. Efforts to study continuity have been hampered by lack of appropriate instruments. The Alberta Continuity of Services Scale - Mental Health is a newly developed, self-report scale that assesses continuity of care across settings and providers. This study examined the structure, reliability, and validity of the measure among users of community mental health programs. Findings were positive. Scores captured both positive and negative perceptions of care. Factor analyses elucidated 3 components of continuity--system access, interpersonal aspects, and care team function. Associations between the continuity scores and selected client and service use measures supported its validity. The tool holds promise for system monitoring, but would need refinements to create a shorter, conceptually clearer version. Also, performance among individuals with mild and vet3, severe levels of mental illness needs to be evaluated. Background During the last few decades, as systems of mental health care have reduced their reliance on long- term inpatient care, attention has shifted to ensuring that clients have timely access to needed services in the community. Psychiatric hospitals were designed to provide a self-contained setting that met client needs for basic care (eg, food, shelter) as well as mental health treatment and rehabilitation Address correspondence to Janet Durbin, MSc, Research Scientist, Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health, and Assistant Professor, Department of Psychiatry, University of Toronto, 33 Russell St, T310, Toronto, Ontario, Canada M5S 2S1. E-mail: Janet_I)urbin@Camh.net. Paula Goering, PhD, RN, is Professor in the Department of Psychiatry and Faculty of Nursing at the University of Toronto, and Director of the Health Systems Research and Consulting Unit at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada. David L. Streiner, PhD, CPsych, is Professor in the Department of Psychiatry at the University of Toronto, and Assistant VP, Research, and Director, Kunin-Lunenfeld Applied Research Unit at Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada. George Pink, PhD, is Professor in the Department of Health Policy and Administration at the University of North Carolina at Chapel Hill, Chapel Hill, NC. Journal of Behavioral Health Services & Research, 2004, 31(3), 279-296. @ 2004 National Council for Community Behavioral Healthcare. Validation of a New Self-report Measure DURBIN et al. 279