ASSESSING OUTCOMES FOR SUFFERERS OF SEVERE MENTAL DISORDER - A CONCEPTUAL-FRAMEWORK AND REVIEW

A conceptual framework is presented for classifying the outcomes of services for sufferers of severe mental disorders. The proposed classification framework contains three dimensions: (a) the respondent type, (b) the social context; and (c) the domain of treatment outcomes. Respondent types include the client, the family, the extended social network, the clinician and the scientist. Social contexts include the individual, the family, work/school and the broader community. Domains of treatment outcome include ''clinical status, '' ''functional status, '' ''life satisfaction and fulfillment, '' and ''safety and welfare. '' This multidimensional framework is used to organize an illustrative review of existing outcome measures. It is concluded that. (a) measures of safety and welfare raise important social and policy questions and these measures require considerable development in order for utility to be realized; (b) although a good beginning has been made, more attention needs to be focused on defining and measuring ''life satisfaction and fulfillment'' and combining this domain with others to produce ''well being'' or ''quality of life '' scales; (c) the functional status area requires additional research and development especially when measurement is conducted in contexts other than work/school; and (d) although measures of clinical status are relatively well developed, the family perspective and context must be integrated into these measures.