Outcomes and indicators, measurement tools and databases for the national action plan for promotion, prevention and early intervention for mental health 2000
Mental health and psychological wellbeing - adults
Mental Health Inventory (MHI)
Brief Symptom Inventory (BSI)
Composite International Diagnostic Interview (CIDI)
Diagnostic Interview Scale (DIS)
Symptom Checklist— 90 Revised (SCL-90)
General Health Questionnaire (GHQ)
Short Form-36 Health Survey Questionnaire (SF-36)
Health of the Nation Outcome Scales (HoNOS)
Life Skills Profile (LSP)
Global Assessment Scale (GAS) and Global Assessment of Functioning Scale
Mental Health Inventory (MHI)A
Reference
Viet & Ware, 1983Description
- Type: Self-rated questionnaire rated on 6- point scale.
- Content: 38 items, 6 sub-scales: anxiety, depression, behavioural/emotional control, general positive affect, emotional ties, life satisfaction. Also provides a global mental health index. Other versions: MHI-18, same sub-scales as MHI-38; MHI-5
Practicality
- Range: Adult
- Time: 5–30 mins depending upon knowledge of patient; covers past month
- Application: Mental health & general population surveys
Reliability
- Internal: Highly acceptable
- Test-retest: Acceptable
Validity
- Content: Acceptable
- Construct: Acceptable
Norms & sensitivity
- Sensitivity to clinical change: Yes
- Cultural norms: Yes
Brief Symptom Inventory (BSI)
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Derogatis & Spencer 1982Description
- Type: Self-report measure
- Content: 53 items rated on a 5-point scale of distress; based on symptom checklist: somatisation, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism; 3 indexes—global severity, positive symptom total, positive symptom distress index
Practicality
- Time: 8–10 mins. Computer software available
- Application: Mental health and non-patient (general) population
- Use: Clinical assessment where minimal time available; screening and treatment evaluation; research
Reliability
- Internal: Acceptable
- Test-retest: Acceptable
Validity
- Content: Highly acceptable
- Construct: Highly acceptable
Norms & sensitivity
- Sensitivity to clinical change: Yes
Composite International Diagnostic Interview (CIDI)
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Robins et al. 1988Description
- Type: Structured diagnostic instrument. Self-administered computerised form available.
Practicality
- Range: 15–65 years
- Time: Approx 15 mins
- Application & use: Epidemiological and clinical research
Reliability
- Internal: Highly acceptable
- Test-retest: Highly acceptable
Validity
Validated in several cultural settings and countries- Concurrent: Acceptable
Norms & sensitivity
- Cultural use: Yes. Data available for Australian populations
- Sensitivity: Adequate
- Specificity: High
Diagnostic Interview Scale (DIS)
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Robins et al. 1981Description
- Type: Structured lay-administered instrument designed for community studies
- Content: A number of sub-scales related to psychiatric disorder (DSM-III-R definitions)
Practicality
- Range: Adult
- Time: 30-60 minutes
- Training: Lay-interviewers
- Application & use: Population screening and monitoring; clinical and research
Reliability
- Inter-rater: Highly acceptable
- Test-retest: Highly acceptable
Validity
Validated in a number of cultural settings and countries- Concurrent: Acceptable
Norms & sensitivity
- Cultural use: Yes
- Specificity: High
- Sensitivity: Low
Symptom Checklist— 90 Revised (SCL-90)A
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Derogatis, Lipman & Covi 1973Description
- Type: Self-rated questionnaire rated on 5- point scale of distress. Covers past week
- Content: 90 items, with 9 primary symptom dimensions: somatisation, obsessive-compulsive, inter-personal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism. 3 indices: global severity index, positive symptom distress index, positive symptom total
Practicality
- Range: Adolescent and adult
- Time: 10–20 mins
- Application: Mental health & primary health
- Use: Clinical research
Reliability
- Item: Acceptable
- Test-retest: Highly acceptable
Validity
- Construct: Highly acceptable
- Criterion: Acceptable
Norms & sensitivity
Sensitive to clinical changeGeneral Health Questionnaire (GHQ)
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Goldberg, 1972; Goldberg, 1978Description
- Type: Self-administered and clinician-rated semi-structured interview; 7-point rating scale with behavioural anchors.
- Versions: GHQ-60, GHQ-30, GHQ-28, and GHQ-12.
- Content: 2 major areas: inability to carry out normal functions and appearance of new and distressing phenomena. 4 versions: GHQ-60, GHQ-30, GHQ-28 & GHQ-12. GHQ-28 is intended for studies where more information is needed than provided by a single severity score. It includes 4 scales: somatic symptoms, anxiety and insomnia, social dysfunction and severe depression.
Practicality
- Range: Adolescent to adult
- Admin:
- GHQ-60, 6–8 mins;
- GHQ- 30 & 28, 3–4 mins
- Training: Minimal; not restricted to psychologists
- Application: Mental health; clinical research survey
Reliability
- Internal: Highly acceptable
- Test-retest: Acceptable
Validity
- Content: Highly acceptable
- Construct: Highly acceptable
- Criterion: Acceptable
Norms & sensitivity
Sensitive to clinical change- Cultural sensitivity: Yes
- Cultural norms: Yes. Data available for Australian populations
Short Form-36 Health Survey Questionnaire (SF-36)A
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Ware et al. 1993Description
- Type: Self-administered. 2 versions: one covers past 4 weeks, other covers past week. Brief accompanying version: depression screener based on Rand items (Short Form-36-D)
- Content: 36 items, 8 dimensions: physical and social functioning, role limitations due to physical problems, role limitations due to emotional problems, mental health, energy/ vitality, pain, general health perception, and single item about perception of health changes over past 12 months.
Practicality
- Range: Adolescent to adult
- Time: 5–10 mins
- Application: Subjective health status of mental and non-clinical populations; clinical and population-based research
Reliability
- Item: Acceptable
- Test-retest: Acceptable
Validity
- Content: Highly acceptable
- Construct: Highly acceptable
- Criterion: Acceptable
Norms & sensitivity
- Cultural sensitivity: Yes—used worldwide; different version used in UK Australian norms— see Stevenson 1995
- Developmental norms: Yes. Possible problems with clients over 65 years
Health of the Nation Outcome Scales (HoNOS)A
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Wing, Curtis & Beevor 1996Description
Measures the current health and social functioning of people with a mental illness. Developed as a routine measure of consumer outcomes.- Type: Clinician-rated rating scale. Consumer self-report version is also available.
- Content: 12 items, 5-point severity rating scale. There are four sub-scale scores: behaviour, impairment, symptoms and social skills.
Practicality
- Range: Adult
- Time: Approx 5–15 min
- Admin: Individual
- Training: Required, training package available
- Application: Determine effectiveness of mental health services and clinical practice
Reliability
- Internal: Unacceptable
- Test-retest: Varies across items from unacceptable to barely acceptable.
- Inter-rater reliability:Varies across items and sub-scales from unacceptable to acceptable.
Validity
- Construct: Acceptable
- Discriminative: Acceptable
Norms & sensitivity
- Norms: Yes. See Stedman et al. 1997
Life Skills Profile (LSP)A
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Rosen, Hadzi- Pavlovic & Parker 1989Description
Intended to measure function and disability in people with severe mental illnesses.- Type: Questionnaire completed by service providers, family member or carer.
- Content: 39 items, 4-point scale. (Also available in 20-item and 16-item scale versions)Five sub-scales include self-care, non-turbulence, social contact, communication and responsibility.
Practicality
- Range: Adult
- Time: Approx 15 mins
- Admin: Individual
- Training: Designed for use by mental health professional and non-professional raters. No special training.
- Application & use: Used to assess service delivery and consumer outcomes
Reliability
- Internal: Range from barely acceptable to acceptable
- Inter-rater: Barely acceptable (~0.70 for total score; between 0.41 and 0.75 for subscales)
- Test-retest: Acceptable
Validity
- Construct: Acceptable
- Discriminative: 89% accuracy in matching transition between hospital and community
Norms & sensitivity
- Cultural norms: Yes
- Sensitive to change: Yes
Global Assessment Scale (GAS) and Global Assessment of Functioning Scale
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GAS - Endicott, Spitzer & Fleiss 1976; Global Assessment of Functioning Scale - American Psychiatric Association 1994Description
A measure of overall severity of psychiatric disturbance.- Type: Clinician-rated scale based on all information available to the clinician.
- Content: One rating required, on a scale ranging from 1 to 100 with 10-point increments.
Practicality
- Range: Adult
- Application & use: Summary statement, assess treatment progress, augment other measures
Reliability
- Internal: Acceptable
- Inter-rater: Acceptable
Validity
- Construct: Significant correlation with measures of social and occupational functioning. Variable levels reported across different studies.
Norms & sensitivity
- Convergent/discriminative: Unacceptable to acceptable. Findings vary across different studies

