Book contents
- Frontmatter
- Contents
- List of tables, boxes and figures
- List of contributors
- Foreword
- Foreword
- Preface: an evolving perspective of mental health outcome measures
- Part I Methodological issues
- Part II Domains of outcome measurement
- 5 Global functioning scales
- 6 Satisfaction with mental health services
- 7 Measuring family and carer burden in severe mental illness: the instruments
- 8 Measures of quality of life for persons with severe mental disorders
- 9 Measuring social disabilities in mental health and employment outcomes
- 10 Measuring the costs of mental healthcare
- 11 Assessing needs for mental healthcare
- 12 Measuring stigma and discrimination related to mental illness
- Part III Symptom severity outcome measures
- Part IV International approaches to outcome assessment
- Index
9 - Measuring social disabilities in mental health and employment outcomes
from Part II - Domains of outcome measurement
Published online by Cambridge University Press: 02 January 2018
- Frontmatter
- Contents
- List of tables, boxes and figures
- List of contributors
- Foreword
- Foreword
- Preface: an evolving perspective of mental health outcome measures
- Part I Methodological issues
- Part II Domains of outcome measurement
- 5 Global functioning scales
- 6 Satisfaction with mental health services
- 7 Measuring family and carer burden in severe mental illness: the instruments
- 8 Measures of quality of life for persons with severe mental disorders
- 9 Measuring social disabilities in mental health and employment outcomes
- 10 Measuring the costs of mental healthcare
- 11 Assessing needs for mental healthcare
- 12 Measuring stigma and discrimination related to mental illness
- Part III Symptom severity outcome measures
- Part IV International approaches to outcome assessment
- Index
Summary
Mental disorders, particularly schizophrenia and the major affective disorders, are in general strongly associated with social dysfunction. For a long time social dysfunction was considered an epiphenomenon of the disease process. Diagnostic criteria of mental disorders were and still are often derived from the domains of work and social relationships. There are, though, at least two related reasons why social functioning deserves a closer look:
There is an increasing trend to treat patients in the community instead of in hospital: this emphasis on community care requires careful evaluation with respect to its consequences. To what extent is survival in the community possible and what is the quality of life like there? Are community programmes better than hospital treatment, and for whom? Therefore, an emphasis on social dysfunction is justified in evaluating the outcome, costs and benefits of community care.
There is growing evidence that the time course of symptoms and social dysfunction may vary relatively independently. The social disablement of a patient may be characterised much more by social disabilities than by persistent psychiatric symptoms; the former may call for types of (non-clinical) care that are not readily available. For example, psychosocial rehabilitation focuses on those cognitive and social abilities of the patient which are crucial for a more or less independent life. Therefore, separate measurement is justified for the sake of the right choice of treatment.
Classification of social dysfunction
The standard diagnostic systems, primarily the ICD of the World Health Organization and the DSM of the American Psychiatric Association, offer no adequate solution to the problem of the classification and assessment of the social dysfunction that results from mental disorder. We have to look for other classification systems, such as the International Classification of Functioning, Disability and Health (World Health Organization, 2001), known as ICF, the overall aim of which is to provide a unified and standard language and framework for the description of health and health-related states.
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- Information
- Mental Health Outcome Measures , pp. 169 - 181Publisher: Royal College of PsychiatristsPrint publication year: 2010