Patient-reported outcomes in child and adolescent mental health services (CAMHS): Use of idiographic and standardized measures MIRANDA WOLPERT 1,3 , TAMSIN FORD 2 , EMMA TRUSTAM 3 , DUNCAN LAW 4 , JESSICA DEIGHTON 1 , HALINA FLANNERY 3 & REW J. B. FUGARD 1,3 1 Child and Adolescent Mental Health Services Evidence Based Practice Unit, UCL and Anna Freud Centre, London, UK, 2 Peninsula Medical School, University of Exeter, Exeter, UK, 3 CORC, London, UK, and 4 Health Centre, Hertfordshire Partnership Foundation Trust, Hoddesdon, UK Abstract Background: There is increasing emphasis on use of patient-reported outcome measures (PROMs) in mental health but little research on the best approach, especially where there are multiple perspectives. Aims: To present emerging findings from both standardized and idiographic child-, parent- and clini- cian-rated outcomes in child and adolescent mental health services (CAMHS) and consider their correlations. Method: Outcomes were collected in CAMHS across the UK. These comprised idiographic measures (goal-based outcomes) and standardized measures (practitioner-rated Children’s Global Assessment Scale; child- and parent-rated Strengths and Difficulties Questionnaire). Results: There was reliable positive change from the beginning of treatment to later follow-up according to all informants. Standardized clinician function report was correlated with standardized child difficulty report (r = - 0.26), standardized parent report (r = - 0.28) and idiographic joint client-determined goals (r = 0.38) in the expected directions. Conclusions: These results suggest that routine outcome monitoring is feasible, and suggest the possi- bility of using jointly agreed idiographic measures alongside particular perspectives on outcome as part of a PROMs approach. Keywords: routine outcome monitoring, patient-reported outcomes, CAMHS Introduction Assessing outcomes in health settings has featured in healthcare research for many decades (Jefford et al., 2003) and has become an increasing policy priority worldwide (Department of Health, 2010; Manchinkanti & Hirsh, 2009; Patterson et al., 2006) but the literature ident- ifies many challenges in relation to how best to implement routine outcome evaluation in mental health (Busch & Sederer, 2000). This paper examines two particular areas of interest (a) in relation to whose views should take precedence and (b) in relation to the relative merits of standardized as opposed to idiographic approaches. Correspondence: Miranda Wolpert, Child and Adolescent Mental Health Services Evidence Based Practice Unit, UCL and Anna Freud Centre, 21 Maresfield Gardens, London NW3 5SU, UK. Tel: +020 7443 2218. Fax: +020 7794 6506. E-mail: miranda.wolpert@annafreud.org Journal of Mental Health, April 2012 21(2): 165–173 © 2012 Informa UK, Ltd. ISSN: 0963-8237 print / ISSN 1360-0567 online DOI: 10.3109/09638237.2012.664304 J Ment Health Downloaded from informahealthcare.com by University College London on 02/01/13 For personal use only.