The ‘promise of the social’ lies in our knowledge that it is a powerful influence on both onset and outcomes of mental health problems. Additionally, when consulted regarding priorities for mental health care and mental health research, service users advocate more focus on goals that include reducing stigma and social exclusion, understanding and alleviating the impact on mental health of social adversities, and promoting good relationships and support within communities. Given the social (urban and rural) context of mental health problems, the relevance of meaningful daytime activity to recovery, and the dangers of relapse if social needs are not addressed, it is staggering that internationally there have been no attempts to introduce social assessment and outcome measures into measurement based care (MBC) (anywhere!). Especially since we have known for more than half a century that social factors predict clinical outcomes and not just in mental health problems, (Huxley 1978), but also in physical health problems (Querido, 1959)
In order to provide practitioners and researchers with social assessment and outcome measures Peter Huxley developed (in conjunction with others internationally) the following measures:
The Lancashire Quality of Life Profile. The development, reliability and internal consistency of the LQoLP was assessed in 404 patients in five European Centres (Gaite et al 2000) with similar results. Four translations (Dutch, Danish, Italian and Spanish) resulted.
Based on experiences and empirical evidence gained in studies using the Lancashire Quality of Life Profile (LQoLP: Oliver et al 1997), the Manchester Short Assessment of Quality of Life (MANSA) (Priebe et al 1999) was developed as a condensed and slightly modified instrument for assessing quality of life. The subjective ratings are made in each life domain on the seven point Delighted – Terrible scale that first appeared in a national survey of Life Quality in the USA and was used by Lehman et al (1982) in his Quality of Life interview. The scale and domain structure was retained in the LQoLP and the MANSA. Ratings on the scale are made in respect of overall quality of life and in nine life domains: family, social life, leisure activity, accommodation/living situation, employment, finances, mental and physical health and safety. In each of the domains there are objective questions relating to the amount of income, rate of family and friends contacts, employment status, help seeking etc. Murphy and Cutts (2009) found that MANSA’s use in clinical practice improved working relationships and care planning.
The Social and Communities Opportunity Profile was funded by the HTA programme and is a measure of social inclusion. The SCOPE long version includes 121 questions covering eight specific domains of inclusion, as well as general overall inclusion. The short SCOPE retains the same life domains and responses and measurement characteristics but reduces the number of questions to fewer than 50. The domains are the same as in the MANSA.
The ESRC funded our study that produced a Chinese-language measure of social inclusion (SCOPE-C) based on translation and cultural adaptation of the Social and Community Opportunities Profile (SCOPE). It has since been translated for used in Brazil and in Poland, and is regarded by Australian academics as one of the two best measures of social inclusion for research and practice. SCOPE-B is the Portuguese (Brazilian) translation of the SCOPE-C with coding adjustments to reflect local economic, environmental, and cultural circumstances in Brazil.
Gaite L, Vasquez-Bacquero JL Arriaga A et al (2000) Quality of Life in schizophrenia: development, reliability and internal consistency of the Lancashire Quality of Life Profile – European version. British Journal of Psychiatry 177(39) s49-54
Lehman A, Ward N, Linn L. et al (1982) Chronic mental patients: the quality of life issue. Am J Psychiat.139:1271-1276
Murphy N, Cutts H. (2009) Can the introduction of a quality of life tool affect individual professional practice and the quality of care planning in a community mental health team? Journal of Psychiatric and Mental Health Nursing, 2009, 16, 941–946.
Oliver J, Huxley P, Priebe S. et al (1997) Measuring the quality of life of severely ill people using the Lancashire Quality of Life Profile. Social Psychiatry and Psychiatric Epidemiology 32:76-83.
Priebe, S., Huxley, P.J., Knight, S. and Evans, S. (1999) Application and results of the Manchester Short Assessment of Quality of Life (MANSA). International Journal of Social Psychiatry 45 (1): 7-12.