This serial cross-sectional survey indicated that use of the EssenCES alone might be a good practical measure of treatment progress/responsivity. A longitudinal study would be an important next step in establishing the extent to which it would be useful in this regard.

Between 1997-98 and 2006-07 in Australia, the age-standardised incidence rates of hip fractures declined by 20% and by 13%, in females and males, respectively. Although this may be related to the rollout of public health campaigns and strategies addressing osteoporosis, absolute numbers of hip fractures continued to increase.

Objectives Psychological therapy services are increasingly required to instate routine outcome monitoring (ROM), to demonstrate the clinical and economic impact of interventions. Professionals’ views of ROM are an acknowledged barrier to implementation. Service user perspectives have rarely been examined, but acceptability and perceptions of ROM are critical to successful implementation. We investigated service users’ experiences of ROM in an Improving Access to Psychological Therapies for people with Severe Mental Illness psychosis demonstration site. Design ROM comprised a periodic assessment battery completed at baseline, mid‐therapy, and end‐of‐therapy and a single measure completed session‐by‐session. Qualitative and quantitative feedback were sought at each periodic ROM administration, and, for sessional ROM, at mid‐therapy and end‐of‐therapy. Demographic and clinical correlates of satisfaction were examined cross‐sectionally at baseline. Consistency of satisfaction over time and associations of satisfaction with engagement were examined longitudinally. Methods Service users rated baseline (n = 281/289), mid‐therapy (n = 114/121), end‐of‐therapy (n = 124/154), and session‐by‐session (mid‐therapy n = 63/87 and end‐of‐therapy n = 90/123) ROM from 0 (‘extremely unhelpful’) to 10 (‘extremely helpful’) and gave qualitative feedback. Results Service users predominantly found ROM helpful (score 6–10; 64–72%) or neutral (score 5; 19–29%). Finding ROM less helpful was associated with younger age and poorer general outcomes, but not with psychotic symptoms or therapy dropout. Emerging qualitative themes included feeling understood, valuing opportunities to reflect, expressing feelings, and tracking progress towards goals. Shorter batteries would be preferable, particularly for younger respondents, and those with poorer outcomes. Conclusions ROM is acceptable for people with psychosis. Tailoring assessments to specific subgroups should be considered. Practitioner points Routine outcome monitoring for psychological therapy is acceptable to people with psychosis. Most respondents experienced outcome monitoring as an opportunity to feel understood. Younger people and those with poorer functioning and well‐being might be at higher risk of dissatisfaction. Short assessment batteries and less frequent outcome monitoring might be preferable for some service users. Feedback about session‐by‐session outcome monitoring was not contemporaneous with completion and may be subject to memory or other biases. Only two‐thirds of service users provided feedback about session‐by‐session ROM (compared to >94% for periodic ROM) so findings may not be fully representative. Feedback about measures was not provided anonymously, and it is possible that service users were reluctant to express criticism about ROM to the assessor.

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What follows is an attempt to describe the provision of mental health care for refugees (including asylum seekers). Our views are based on our work with refugees in inner-London and on consultation with service providers.