Creating CHOIS: A Recovery-Oriented PROMIS-Based Measure for Mental Health Screening and Outcomes

The National Institutes of Health Patient Reported Outcomes Medical Information System (PROMIS) measures a few important domains of mental health, but does not yet measure some other important psychiatric symptoms, nor does it include recovery factors and strengths such as social connectedness, self-esteem, and coping ability. The CHOIS is a recovery-oriented PROMIS-based instrument designed to supplement traditional PROMIS administration by attempting to fill in these gaps in mental health assessment. It was created for settings that do not primarily focus on mental health issues such as primary care, non-psychiatric hospitals, and substance abuse services. It adds specific symptoms of mental disorders based on DSM-IV-TR, positive recovery factors that were drawn from focus groups of people with mental illnesses, andresponse inconsistency indicators. We first implemented the measure across 13 Alcohol and Drug Services programs as a screening measure and outcomes tool, and measured internal consistency of the scales among a wide variety of participants. Among the 3,712 people who completed the measure, the internal consistency of the scales was as follows: Depression .93, Anxiety .89, Anger .87, Psychosis .79, Cognition .71, and Recovery Factors .90. All of the scales were significantly correlated with functional limitations and wanting help for mental health issues. The CHOIS could become an important tool for allowing valid and comprehensive immediate use of the still-developing PROMIS in a variety of settings as a mental health screening and outcomes instrument. It works seamlessly as a supplement to the entire PROMIS outcomes system that measures other important health constructs, and creates a more recovery-oriented focus for healthcare systems, even in non-psychiatric settings.