Creating positive experiences using
NOCC Outcome Measures
Within the mental health field, the regular assessment of consumer outcomes has been a priority initiative
for some years. The Mental Health National Outcomes and Casemix Collection (NOCC), comprising a range of clinician and consumer rated measures, was first specified in August 2002 and implemented progressively by states and territories in the years that followed. This process followed a commitment by states and territories, under the Second National Mental Health Plan, to introduce the routine collection of outcome and casemix data in public mental health services.
The use of outcome measures attempts to measure whether a change has occurred for a consumer as a result of mental health care. By using a range of outcome measures, consumers and clinicians can work together to map the journey of recovery over time.
The NOCC measures contribute to the development of clinical practice, aiming to improve the quality of care for consumers of Australia’s public sector mental health services. Outcome measures can assist consumers in considering options for their care and treatment and support the development of a therapeutic relationship between the clinician and the consumer. The measures can also be used by clinicians to monitor the progress of the consumer, evaluate the effectiveness of treatments and thereby provide information that will assist decisions about clinical practices. The outcome measures can also be used by team leaders and service managers to better understand the needs of consumers, to plan for the allocation of resources and to identify where service improvements are required.
Collection and use of consumer-rated outcome measures, however, has lagged behind the routine uptake of clinician rated measures. The cultural and structural barriers to why this is the case are largely known. They include clinician inertia, uncertainty about their value to clinical care, concerns about consumers’ capacity to complete the measures, and organisational cultural issues that have hampered more holistic assessment and consumer collaboration in care.
Less is known about positive experiences of providing the consumer-rated measures to mental health service consumers. This could provide important impetus for the mental health workforce to increase their use of the measures with consumers.
This project sought to fill this gap, and the findings will support AMHOCN to promote the value and positive use of the NOCC consumer-rated outcome measures within its training to the national mental health workforce.
Ten consumers with lived experience of completing outcome measures associated with their mental health were interviewed. Participants varied in age, gender, location and mental health conditions.
The 'Creating positive experiences using NOCC Outcome Measures' report, including full details and quotes from consumers can be downloaded using the button below.
Need the key themes and recommendations so you can get straight into it? We've created a summary you can download through the button below.
Throughout the discussions, these themes were identified by consumers about their experiences with the NOCC Outcome Measures.
Theme 1: Help me complete the measures
Participants spoke about the challenges they faced when completing the measures; the following three key areas highlight the themes of their comments.
Think about what is going on for me when using the measure
Help me at a time when this is difficult
Consider my preferences when completing the measures
Theme 2: Explain what is going on
Participants described their experiences of the various ways that they were offered and then used the measures with health professionals, and how this then influenced how they engaged with those health professionals. Two key points came up consistently.
1. Not just an administrative exercise; and
2. Explaining the purpose is important.
Theme 3: Being honest with yourself and others
Participants indicated that the act and process of completing the measures inherently challenged and confronted them to be honest with themselves and others about their circumstances. This helped them in two key ways:
1. Putting their feelings into clear context
2. Taking control
Theme 4: Talk about things that are important to me
Several participants expressed the desire for a shared dialogue with the health professional and having their support at-hand in case it was needed as part of the process of completing the measures. Some participants were particularly concerned that some questions may trigger distress. Others saw the health professional’s presence as enhancing the transparency of the process and then enhancing the shared discussions that could then occur, either whilst they were completing the measures, or immediately after as part of their contact and therapeutic work with the health professional.
Really, when you’re in it, you don’t know how below the horizon you’ve sunk … And maybe doing that questionnaire, it has been kind of reaffirming to think, yeah there is a reason why.
Recommendations for Clinicians
Actively engage in a conversation with consumers around the consumer-rated measure and its implications
Offer the measures in a way that engenders hope and the opportunity for recovery
Adopt an approach that encourages the consumer to reflect on their current situation and how it has changed over time
Explain the purpose of the measures and identify the consumer’s preferred method for completing
Discuss the ratings of the measures with the consumer each time they are completed
Encourage consumers to explore the use of the measure for their own self-management and empowerment
I filled it out and gave it to her and then she did the scoring, and she was like ‘oh I can see that things have been really tough for you lately, for your scores to be this high this is not like you’, and then we went in and had a session … So that showed to me that she actually cares and she actually knows where I am at because that
was her response and it was true, things had not been going well, and so she recognised that instantly just from the scoresheet from the DASS 21 which was quite phenomenal.
For full detail of the responses collated for this project, please download the full report.
For more information about this report, and how it might be used, please contact our team.
We wish to thank the participants who undertook interviews for this research and also the consumer and clinical
advocate participants who helped us to design the interview questions. We also wish to thank Tim Coombs and
Rosemary Dickson from AMHOCN for the tremendous support to this project.
The data analysis for this project was approved by the Flinders University Human Research Ethics Committee