Abstract
A quality of life theory is proposed as a framework for conceptualizing and evaluating mental health services. Quality of life consists of fulfilling needs, meeting social expectations, and accessing opportunities by using abilities. Abilities are impaired by mental illness. Mental health services moderate social demands, supplement opportunities, and restore abilities. A 263 item questionnaire was developed to assess the impact of mental health services on clients' quality of life. A 24 site study including 1,154 pre-tests, 758 post-tests, and 190 interviews with randomly selected community residents was conducted. Evidence for the reliability and validity of the questionnaire are presented. The instrument discriminates among four known client groups, client and community samples, communities with known quality of life differences, and pre- versus post-treatment samples of clients. The convergence between client's retrospective impressions of improvement and measured pre-post improvement is discussed.
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References
Barron, N. (1984). The quality of life of community support clients. Salem, Oregon: Mental Health Division.
Bigelow, D.A. & Beiser, M. (1978). Rehabilitation for the chronically mentally ill: A community program.Canada's Mental Health, 26(2), 9–11.
Bigelow, D.A., Brodsky, G., Stewart, L. & Olson, M. (1982). The concept and measurement of quality of life as a dependent variable in evaluation of mental health services. In W. Tash & G. Stahler (Eds.),Innovative approaches to mental health evaluation. New York: Academic Press.
Bigelow, D.A., Gareau, M.J., & Young, D.J. (in press). A quality of life interview for chronically disabled people.Psychosocial Rehabilitation Journal.
Bigelow, D.A., McFarland, B.H., Gareau, M.J. & Young, D.J. (1983). Implementation and effectiveness of the Dammasch Bed Reduction Project. Portland, Oregon: Department of Psychiatry, Oregon Health Sciences University.
Bigelow, D.A., & Hooper, J. (1977). Impact of community care on quality of life of severely mentally ill patients. Vancouver, British Columbia, Canada: Greater Vancouver Mental Health Service.
Bigelow, D.A. & Smoyer, S. (1981). Design of a statewide strategy for performance measures for mental health services. Salem, Oregon: Mental Health Division.
Bigelow, D.A. & Young, D. (1990). The implementation and impact of a case management program. Portland, Oregon: Department of Psychiatry, Oregon Health Sciences University.
Boys, G. (1976). An inter-rater reliability study of the multi-dimensional outcome measure. Portland, Oregon: Portland State University.
Bradburn, N.M. (1969).The structure of psychological well-being. Chicago, Illinois: Aldine.
Cox, G.B., Brown, T.R., Peterson, P.D., & Rowe, M.M. (1980).The two state collaborative mental health outcome study: State of Washington. Vol. I & II. Olympia, Washington: Department of Health Services.
Ciarlo, J.A. & Reihman, J. (1977). The Denver Community Mental Health Questionnaire: development of a multidimensional program evaluation instrument. In R. Coursey, et al.Program evaluation for mental health: methods, strategies, and participants. New York: Grune & Stratton.
Cronbach, L., Gleser, G., Nada, H. & Rajaratnam, R. (1972).The dependability of measurements. New York: John Wiley & Sons.
Field, G. & Yegge, L. (1982). A client outcome study of a community support demonstration project.Psychosocial Rehabilitation Journal, 6(2), 15–22.
Hammaker, R. (1983). A client outcome evaluation of the statewide implementation of community support services.Psychosocial Rehabilitation Journal, 7(1), 2–10.
Lannon, P. (1980). Quality of life: evaluating the community support program. Albany, New York: Bureau of Community Support Systems, New York State Office of Mental Health.
Lehman, A.F. (1988). A quality of life interview for the chronically mentally ill.Evaluation & Program Planning, 11, 51–62.
Lehman, A.F. (1983). The well-being of chronic mental patients.Archives of General Psychiatry, 40, 369–373.
Lehman, A.F., Ward, N.C., & Linn, L.S. (1982). Chronic mental patients: the quality of life issue.American Journal of Psychiatry, 139, 1271–1276.
Maslow, A. (1954).Motivation and personality. New York: Harper & Row.
Mercier, C. & Filion, J. (1987). La qualite de la vie: perspectives theoriques et empiriques.Sante Mentale au Quebec, 12, 135–143.
Nunnally, J.C. (1967).Psychometric theory. New York: McGraw-Hill.
Olson, M.M., Smoyer, S. & Stewart, L. (1981).Handbook for the manually operated program impact monitoring system. Salem, Oregon: Mental Health Division.
Pelligrino, J.W. (1988). Mental models and mental tests. Chapter 4 in H. Wainer & H.I. Braun (Eds.)Test validity. Hillsdale, New Jersey: Lawrence Erlbaum and Associates.
Pokorny, L. & Waters, R.M. (1981) The Tennessee mental health outcome project, final report. Nashville, Tennessee: Tennessee Department of Mental Health and Mental Retardation.
Rapp, C.A., Gowdy, E., Sullivan, W.P. & Wintersteen, R. (1988). Client outcome reporting: the status method.Community Mental Health Journal, 24, 118–133.
Sarbin, T. & Allen, V. (1968). Role theory. In G. Lindzey & E. Aronson (Eds.).The Handbook of Social Psychology, 2nd ed., Vol. 1. Reading, Mass.: Addison-Wesley.
Scott, W.A. & Wertheimer, M. (1962).Introduction to psychological research. New York: John Wiley & Sons.
Zautra, A., Beier, E. & Coppel, L. (1977). The dimensions of life quality in a community.American Journal of Community Psychology, 5, 85–97.
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The data collection was supported by National Institute of Mental Health contract 278-79-0053(OP), Enid Light, project officer, and Cecil Wurster, adviser, both contributed greatly to this work. The writing of this paper was supported by National Institute of Mental Health grant MH43458-02.
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Bigelow, D.A., McFarland, B.H. & Olson, M.M. Quality of life of community mental health program clients: Validating a measure. Community Ment Health J 27, 43–55 (1991). https://doi.org/10.1007/BF00752714
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DOI: https://doi.org/10.1007/BF00752714