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ORIGINAL RESEARCH article

Front. Psychiatry
Sec. Public Mental Health
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1486734

Validation of a Composite Outcome Measure For Inpatient Psychiatry Using Scales from the interRAI-MH

Provisionally accepted
Howard E Barbaree Howard E Barbaree 1*Christopher Perlman Christopher Perlman 2Elke Ham Elke Ham 3Gregory Brown Gregory Brown 4John P Hirdes John P Hirdes 2
  • 1 Waypoint Centre for Mental Health Care, Midland, Ontario, Canada
  • 2 School of Public Health Sciences, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
  • 3 Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada
  • 4 Nipissing University, North Bay, Ontario, Canada

The final, formatted version of the article will be published soon.

    Background: Inpatient psychiatry is a critical service in a community-based care system for persons with serious mental illness (SMI). Currently, there are few generally accepted or widely used outcomes to assess the effectiveness of inpatient treatment.Method: Following a Donabedian Model of Health Care Quality, we utilized eight scales from the RAI Mental Health assessment to derive a clinician-scored outcome measure consisting of 4 domains (Psychosis, Depression, Impairment, and Aggression). We combined subscales measuring these domains into a Composite Measure. We used this measure to assess the entire population (N=719) of our large specialized mental health hospital at the beginning (T1) and end (T2) of three months in the hospital (or admission to discharge in shorter stays). We evaluated the content validity of the measure by comparing items and scales with a list of putative contributors to hospital admission (symptoms and complications). To evaluate concurrent validity, we compared mean scores among hospital units with varying lengths of stay and clinical complexity (acute versus chronic versus complex chronic). We used ROC analysis to evaluate the CIIMHS's ability to predict discharge from the hospital. To evaluate construct validity, we examined the measure's responsiveness to changes among patients after treatment in the hospital.We found strong evidence for all four kinds of validity.The composite measure represents a valid measure of inpatient mental health status and will serve as a valuable measure of the quality of care for inpatient psychiatry.

    Keywords: Inpatient psychiatry, outcome measures, health care quality, interRAI Mental Health, Content Validity, Concurrent validity, predictive validity, construct validity

    Received: 26 Aug 2024; Accepted: 09 Jan 2025.

    Copyright: © 2025 Barbaree, Perlman, Ham, Brown and Hirdes. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Howard E Barbaree, Waypoint Centre for Mental Health Care, Midland, L9M 1G3, Ontario, Canada

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.