Matching resources to care: the acceptability, validity and inter-rater reliability of a new instrument to assess severe mental illness (MARC-1)

Huxley, Peter; Reilly, Siobhán; Gater, Richard; Robinshaw, Eva; Harrison, Judy A.; Mohamad, Hasmaini; Butler, Tom; Windle, Barry

doi:10.1007/s001270050244

Cited by 17 publications

(14 citation statements)

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“…Clearly there would be benefits if these assessments were standardized, and clinical assessors trained to apply similar thresholds to ratings of psychopathology and social functioning (Huxley et al, 2000). Current practice within secondary care often falls short of such aspirations, and compounds earlier deficiencies in the communication of information between primary and secondary care healthcare professionals (Blaney and Pullen, 1989;Burbach and Harding, 1997).…”

Section: Introductionmentioning

confidence: 98%

Multilevel investigation of variation in HoNOS ratings by mental health professionals: a naturalistic study of consecutive referrals

Ecob

Croudace

White

et al. 2004

Int J Methods Psych Res

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Episodes of mental healthcare in specialist psychiatric services often begin with the assessment of clinical and psychosocial needs of patients by healthcare professionals. Particularly for patients with complex needs or severe problems, ratings of clinical and social functioning at the start of each episode of care may serve as a baseline against which subsequent measures can be compared. Currently, little is known about service variations in such assessments on referrals from primary care. We set out to quantify variability in initial assessments performed by healthcare professionals in three CMHTs in Bristol (UK) using the Health of the Nation Outcome Scales (HoNOS). We tested the hypothesis that variations in HoNOS total and sub-scale scores are related to referral source (general practices), healthcare assessor (in CMHTs) and the assessor's professional group. Statistical analysis was performed using multilevel variance components models with cross-classified random effects. We found that variation due to assessor substantially exceeded that due to referral source (general practices). Furthermore, patient variance differed by assessor profession for the HoNOS--Impairment scores. Assessor variance differed by assessor profession for the HoNOS--Social scores. As HoNOS total and subscale scores show much larger variation by assessor than by referral source, investigations of HoNOS scores must take assessors into account. Services should implement and evaluate interdisciplinary training to improve consistency in use of rating thresholds; such initiatives could be evaluated using these extensions of multilevel models. Future research should aim to integrate routine diagnostic data with continuous outcomes to address selection effects (of patients to assessors) better.

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Section: Introductionmentioning

confidence: 98%

Multilevel investigation of variation in HoNOS ratings by mental health professionals: a naturalistic study of consecutive referrals

Ecob

Croudace

White

et al. 2004

Int J Methods Psych Res

View full text Add to dashboard Cite

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“…The inter-rater reliability of the MARC-2 is 87%. Its internal reliability using Cronbach's "α" is 0.83 (Huxley et al, 2000).…”

Section: Methodsmentioning

confidence: 99%

“…The Global Assessment Scale (GAS: Endicot, Spitzer, Fleiss, & Cohen, 1976) and the MARC-2 (Huxley et al, 2000) were used to establish concurrent validity as they were being introduced into the local service system at the time of this study to evaluate a service reconfiguration. The MARC-2 was used to record demographic data.…”

Section: Designmentioning

confidence: 99%

The Development and Properties of the Support Needs Questionnaire

Davis

Burns

2015

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The Support Needs Questionnaire (SNQ) measures the support people with severe mental illness need to attain valued social roles as a route to social inclusion. Its design derives from Wolfensberger's Social Role Valorisation theory. It is a clinical tool comprising a comprehensive lifestyle inventory of "universal basic" and "disability" needs; and "revalorisation needs" arising from social devaluation and deep exclusion. The SNQ comprises eight discreet sub-scales based on O'Brien's Five Service Accomplishments, the domains of which include Community Presence, Community Participation, Choice and Control, Social Roles and Respect, Skills and Competencies, and Finance. There are also two descriptive subscales: Physical and Mental Health. The item set was developed collaboratively with service users. This paper introduces the SNQ, its design rationale and development, and investigates aspects of its reliability, validity and utility. Care coordinators in a Community Mental Health Team rated eighty-two service users' support needs at a two week interval using the SNQ, the Global Assessment Scale and the MARC-2. The SNQ is shown to have high test-retest reliability, good construct and concurrent validity, and good discriminatory power. It exhibited no floor or ceiling effects with the reference population. It could be used with a more diverse population. The descriptive sub-scales were weakest. The population profile showed moderate support was required for physical integration but high levels for social integration which is consistent with previous research. The SNQ has some good psychometric properties. Future research should address internal consistency and potential item redundancy, determine inter-rater reliability and change sensitivity.

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“…All trusts were invited to contribute funding to the enterprise and, without exception, those approached did so. The resulting study design included a survey of case-loads using the Matching Resources to Care-2 (MARC-2; Huxley et al, 2000), Health of the Nation Outcome Scales (HoNOS; Wing et al, 1998) and Global Assessment Scale (GAS; Endicott et al, 1976). The MARC-2 generates an 18-point summary score of severity and risk, called M3, and also contains a number of items that relate directly to service use history and risk, which are directly comparable to the Policy Implementation Guide criteria.…”

Section: Methodsmentioning

confidence: 99%

Assertive outreach: policy and reality

Schneider¹

2006

Psychiatr. bull.

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Assertive outreach: policy and reality AIMS AND METHODThis survey set out to profile the caseloads of assertive outreach teams in North East England, to discover whether they were reaching the people for whom they were meant. A survey of case-loads of 29 assertive outreach teams was carried out using the MARC-2, HoNOS and GAS instruments. Findings were compared with earlier surveys of the case-loads of community mental health teams in parts of the same region. RESULTSClients of assertive outreach teams proved to be at the more severe end of the spectrum on almost every measure: 95% were deemed 'psychotic'and 30% had three or more admissions in the previous 2 years. CONCLUSIONSAssertive outreach teams in the North East are reaching the people they are meant to target. The effects of this shift on existing teams remain to be evaluated.

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Matching resources to care: the acceptability, validity and inter-rater reliability of a new instrument to assess severe mental illness (MARC-1)

Abstract: It is possible to use a simple census form in both health and social services agencies. The completion rates were good in both services. The levels of reliability were good, and concurrent validity was established with specific types of care in the community.

Cited by 17 publications

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Multilevel investigation of variation in HoNOS ratings by mental health professionals: a naturalistic study of consecutive referrals

Multilevel investigation of variation in HoNOS ratings by mental health professionals: a naturalistic study of consecutive referrals

The Development and Properties of the Support Needs Questionnaire

Assertive outreach: policy and reality

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