title: Development and psychometric properties of the client's assessment of treatment scale for supported accommodation (CAT-SA).
abstract: BACKGROUND
  Patient-Reported Outcome Measures (PROMs) are important for evaluating mental health services. Yet, no specific PROM exists for the large and diverse mental health supported accommodation sector. We aimed to produce and validate a PROM specifically for supported accommodation services, by adapting the Client's Assessment of Treatment Scale (CAT) and assessing its psychometric properties in a large sample.
  
  
  METHODS
  Focus groups with service users in the three main types of mental health supported accommodation services in the United Kingdom (residential care, supported housing and floating outreach) were conducted to adapt the contents of the original CAT items and assess the acceptability of the modified scale (CAT-SA). The CAT-SA was then administered in a survey to service users across England. Internal consistency was assessed using Cronbach's alpha. Convergent validity was tested through correlations with subjective quality of life and satisfaction with accommodation, as measured by the Manchester Short Assessment of Quality of Life (MANSA).
  
  
  RESULTS
  All seven original items of the CAT were regarded as relevant to appraisals of mental health supported accommodation services, with only slight modifications to the wording required. In the survey, data were obtained from 618 clients. The internal consistency of the CAT-SA items was 0.89. Mean CAT-SA scores were correlated with the specific accommodation item on the MANSA (r s  = 0.37, p ˂ .001).
  
  
  CONCLUSIONS
  The content of the CAT-SA has relevance to service users living in mental health supported accommodation. The findings from our large survey show that the CAT-SA is acceptable across different types of supported accommodation and suggest good psychometric properties. The CAT-SA appears a valid and easy to use PROM for service users in mental health supported accommodation services.
authors.affiliation: Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, Newham Centre for Mental Health, London, E13 8SP, UK. s.sandhu@qmul.ac.uk.
authors.forename: Sima
authors.initials: S
authors.lastname: Sandhu
authors.affiliation: Division of Psychiatry, University College London, London, UK. h.killaspy@ucl.ac.uk.
authors.forename: Helen
authors.initials: H
authors.lastname: Killaspy
authors.affiliation: Division of Psychiatry, University College London, London, UK. j.krotofil@ucl.ac.uk.
authors.forename: Joanna
authors.initials: J
authors.lastname: Krotofil
authors.affiliation: Division of Psychiatry, University College London, London, UK. p.mcpherson@ucl.ac.uk.
authors.forename: Peter
authors.initials: P
authors.lastname: McPherson
authors.affiliation: Division of Psychiatry, University College London, London, UK. isobel.harrison@ucl.ac.uk.
authors.forename: Isobel
authors.initials: I
authors.lastname: Harrison
authors.affiliation: Division of Psychiatry, University College London, London, UK. sarah.dowling@ucl.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Dowling
authors.affiliation: North London Service User Research Forum, Division of Psychiatry, University College London, London, UK. mauricea@easy.com.
authors.forename: Maurice
authors.initials: M
authors.lastname: Arbuthnott
authors.affiliation: Department of Geography, Durham University, Durham, UK. s.e.curtis@durham.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Curtis
authors.affiliation: Division of Psychiatry, University College London, London, UK. michael.king@ucl.ac.uk.
authors.forename: Michael
authors.initials: M
authors.lastname: King
authors.affiliation: Bamford Centre for Mental Health and Wellbeing, School of Psychology, Ulster University, Londonderry, UK. g.leavey@ulster.ac.uk.
authors.forename: Gerard
authors.initials: G
authors.lastname: Leavey
authors.affiliation: Centre for Mental Health, London, UK. geoff.shepherd@centreformentalhealth.org.uk.
authors.forename: Geoff
authors.initials: G
authors.lastname: Shepherd
authors.affiliation: Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, Newham Centre for Mental Health, London, E13 8SP, UK. s.priebe@qmul.ac.uk.
authors.forename: Stefan
authors.initials: S
authors.lastname: Priebe
mesh_terms: D000328:Adult; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D017060:Patient Satisfaction; D011594:Psychometrics / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000592:standards; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D006113:United Kingdom