MEASURING PARTICPATION IN MENTAL HEALTH: A SYSTEMATIC REVIEW OF OUTCOME MEASURES

Background: Evaluating the effectiveness of occupational therapy interventions, particularly in mental health, is a priority for the profession (AOTA 2007; Morley & Smyth, 2013). When designing a study to test the... [ view full abstract ]

Background:
Evaluating the effectiveness of occupational therapy interventions, particularly in mental health, is a priority for the profession (AOTA 2007; Morley & Smyth, 2013). When designing a study to test the effectiveness of an intervention a primary outcome measure needs to be selected. This study aimed to identify robust measures of participation for research in mental health.

Method:
A systematic review was conducted using CRD’s (2009) guidance. The relevance of each measure identified was assessed using a conceptual framework of participation related to mental health. All relevant measures were quality appraised against criteria for reliability and validity.

Results:
A wide ranging search strategy identified 61 measures of participation. None of the relevant measures identified (n=6) were judged to be reliable and valid. The relevant tools were then re-evaluated on the basis of their clinical utility. Two tools were identified as having clinical utility: Participation Scale (P-Scale) and Utrecht Scale for Evaluation of Rehabilitation Participation (USER-P)

Conclusion:
There is no reliable and valid measure of participation that could be used as the primary outcome measure in studies to assess the effectiveness of occupational therapy in mental health. The Participation Scale (P-Scale) and Utrecht Scale for Evaluation of Rehabilitation Participation (USER-P) have clinical utility so should be subjected to further psychometric testing to assess their reliability and validity.

Application to Practice:
The Participation Scale (P-Scale) and Utrecht Scale for Evaluation of Rehabilitation Participation (USER-P) are potentially useful tools for assessing the impact of occupational therapy on participation in mental health settings.