This book has many chapters on outcome assessments, from the global functioning scales to more specific and detailed measures for use in service evaluation as well as in measuring treatment outcome. So we suspect that the reader will be asking a number of questions before dipping into this first chapter, specifically on measures of outcome that are valued by service users. These we are sure will include:

The answers to the first two questions are: yes, but not many; and probably not. But it is the answer to the last question which is key. A chapter has been specifically allocated to this topic because such measures are important in evaluations of mental healthcare. Many professionals will consider that this is just a focus on what is politically correct and that service users’ experiences are not generally that helpful or, more often, that their clinical carers usually know best. We have some sympathy with the view that when healthcare resources are scarce there is a need to measure outcomes that reflect the performance of services and that this is sometimes at variance with service users’ views. Service users may not be interested in symptom remission, patient throughput or even the assessment of their global functioning. They may be more interested in their definition of recovery or simply their happiness and sometimes these aspirations may lie outside the remit of mental health service provision.

But even with this understanding of different perspectives, we believe that the pendulum has swung too far and for too long in the direction of outcomes which may not be relevant to service users, may not be appropriately measured even if they are relevant, or may just be the opposite of what service users would expect of a mental health service. In this chapter we try to rebalance the field by introducing or describing outcome measures that are accepted by service users, and show how methods involving service users can be used to develop new, relevant and acceptable measures of outcome that reflect the purpose of services.