Needs assessment for mentally disordered offenders: measurement of 'ability to benefit' and outcome

Background The Department of Health defines needs as "the ability to benefit from healthcare interventions". Outcome measurement is an integral component of needs assessment because it underpins 'ability to benefit'. Aims To propose a framework for addressing the measurement of outcome in relation to mentally disordered offenders (MDOs). Method Based on a literature search, the paper reviews the definition and measurement of outcome in general mental health care and specifically in relation to MDOs. It analyses the problems of conducting outcome research in relation to MDOs. Results A framework for outcome measurement in relation to MDOs is presented. Outcome is placed within a broader framework that relates to service evaluation. Conclusions Current measurement of outcome in relation to MDOs is inadequate. A comprehensive framework that acknowledges the multi-dimensional nature of outcome is essential. Researchers must be able to justify the dimensions they prioritise.