NHS: Discovery measuring mental health outcomes

The ability to measure and track a young person’s symptoms and progress is a crucial component of children’s mental health treatment. But what if the systems in place make this important part of treatment more challenging? 

Children and young people’s mental health treatment is often a complicated and non-linear process. No two people are the same. Routine Outcome Measures (ROMs) are a range of pre-set questions designed to facilitate discussion between the clinician and young person, track progress of treatment, and assist diagnosis.

The NHS team we worked with had observed low rates in reporting ROMs, but couldn’t understand why this was happening. We ran a discovery to investigate the low rates of ROMs completion in the Children’s and Young People’s Mental Health Service (CAMHS).

What we did

This project was highly collaborative, from research participant recruitment, through to idea generation. Throughout the project we worked closely with the NHS team, including weekly project updates and workshops.

We conducted research with three audiences: clinicians, parents/carers, and young people. Clinicians from a range of areas of expertise were chosen to give a cross section of treatment methodologies, length of service, and training types.

We collaborated with Made Tech to understand what might be technically possible, given the clinical systems already in place. 


Rigorous interrogation of process, digital systems, content and user needs uncovered specific barriers to routine use of ROMs. 

Based on the findings, we created evidence-based concepts to support clinicians in their use of ROMs, in a way that also works for the young people and parent/carers.

A ROMs digital tool would speed up the process of entering data into the system and allow results to be analysed during a clinical session. It would mean a young person could complete a ROM on their own device at home, providing the young person with more time and space to reflect on their answers.

Alongside possible long-term changes, we also delivered recommendations to be implemented with current resources including supporting knowledge sharing between clinicians to explore how ROMs can be effectively used in their practice.

Avon and Wiltshire Mental Health Partnership said:

“We needed to understand poor return rates for routine outcome measures in child and adolescent mental health services, so that we could determine where to invest to improve.

“Mace & Menter brought expertise, a clear methodology and enthusiasm to the project. They had a good understanding of the problem space and involved the service delivery team in the planning of the project.

“Their work left us with an evidence-based plan to improve ROMs effectiveness and reported outcomes. Reported paired outcome measures had even increased by the end of the project.

“I’d recommend Mace & Menter because recommendations were clear, relevant and achievable. Importantly, not all the proposed solutions were dependent on additional resources or funding.”