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Front Psychiatry. 2020 Jan 17;10:926. doi: 10.3389/fpsyt.2019.00926. eCollection 2019.

The interRAI Suite of Mental Health Assessment Instruments: An Integrated System for the Continuum of Care.

Author information

1
School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
2
Psychiatry and Neuropsychology Department, Maastricht University, Maastricht, Netherlands.
3
Centre for Health Services Research, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
4
Psychiatric Department, Rio Hortega University Hospital, Zamora, Spain.
5
Institute of Gerontology, University of Michigan, Ann Arbor, MI, United States.
6
Division of Psychiatry, Turku University Hospital, Turku, Finland.
7
Graduate Program in Health Promotion, Human Development and Society, Lutheran University of Brazil, Canoas, Brazil.
8
School of Criminology and Criminal Justice, Nipissing University, North Bay, ON, Canada.
9
Department of Health Sciences for Lynn Martin, Lakehead University, Thunder Bay, ON, Canada.
10
Departments of Psychiatry and Family Medicine Larner College of Medicine, University of Vermont, Burlington, VT, United States.
11
Faculty of Education, Althouse College, Western University, London, ON, Canada.
12
LUCAS Center for Care Research and Consultancy & Academic Center for General Practice in the Department of Public Health and Primary Care, KU Leuven University, Leuven, Belgium.

Abstract

The lives of persons living with mental illness are affected by psychological, biological, social, economic, and environmental factors over the life course. It is therefore unlikely that simple preventive strategies, clinical treatments, therapeutic interventions, or policy options will succeed as singular solutions for the challenges of mental illness. Persons living with mental illness receive services and supports in multiple settings across the health care continuum that are often fragmented, uncoordinated, and inadequately responsive. Appropriate assessment is an important tool that health systems must deploy to respond to the strengths, preferences, and needs of persons with mental illness. However, standard approaches are often focused on measurement of psychiatric symptoms without taking a broader perspective to address issues like growth, development, and aging; physical health and disability; social relationships; economic resources; housing; substance use; involvement with criminal justice; stigma; and recovery. Using conglomerations of instruments to cover more domains is impractical, inconsistent, and incomplete while posing considerable assessment burden. interRAI mental health instruments were developed by a network of over 100 researchers, clinicians, and policy experts from over 35 nations. This includes assessment systems for adults in inpatient psychiatry, community mental health, emergency departments, mobile crisis teams, and long-term care settings, as well as a screening system for police officers. A similar set of instruments is available for child/youth mental health. The instruments form an integrated mental health information system because they share a common assessment language, conceptual basis, clinical emphasis, data collection approach, data elements, and care planning protocols. The key applications of these instruments include care planning, outcome measurement, quality improvement, and resource allocation. The composition of these instruments and psychometric properties are reviewed, and examples related to homeless are used to illustrate the various applications of these assessment systems.

KEYWORDS:

care planning; case-mix; homelessness; integration; outcomes; psychometric properties; quality

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