Measuring outcomes in a child psychiatry inpatient unit

The aim of this article is to examine clinical outcomes in a child psychiatry inpatient unit using dedicated measures. Clinicians completed contextual (Paddington Complexity Scale - PCS) and clinical change (Health of the Nation Outcome Scales for Children and Adolescents - HoNOSCA) questionnaires on admission and discharge for consecutive admissions to the unit between 1999 and 2007 (n=167). Mean changes in HoNOSCA scores were analysed, and the predictors of HoNOSCA mean change were assessed using regression analysis. The results showed that the mean length of stay at the unit was 5.6 months (SD 3.1). PCS ratings identified high total, clinical, and environmental complexity scores. HoNOSCA ratings indicated high levels of psychological problems on admission and significant improvement at discharge (mean change 7.7 (SD 6.7)). Greater positive change was associated with higher initial HoNOSCA scores, diagnoses other than conduct disorder and schizophrenia, and a facilitative parental attitude. The authors conclude that the systematic use of standardised outcome measures in child psychiatric inpatient units is useful to document clinical features, complexity and clinical change.