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Health Dynamics Inventory
The Health Dynamics Inventory (HDI) is a 50 item self-report questionnaire developed to evaluate mental health functioning and change over time and treatment. The HDI was written to evaluate the three aspects of mental disorders as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM): "clinically significant behavioral or psychological syndrome or pattern...associated with present distress...or disability".〔American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC〕 This also corresponds to the phase model described by Howard and colleagues〔Howard, K.J., Lueger, R.J., Mailing, M.S., & Martinovich, Z. (1993). A phase model of psychotherapy outcome: Causal mediation of change. Journal of Consulting and Clinical Psychology, 61(4), 678-682.〕 Accordingly, the HDI assesses (1) the experience of emotional or behavioral symptoms that define mental illness, such as dysphoria, worry, angry outbursts, low self-esteem, or excessive drinking, (2) the level of emotional distress related to these symptoms, and (3) the impairment or problems fulfilling the major roles of one's life.
The HDI was developed for use with mental and behavioral health outpatient, day treatment, hospital, and chemical health programs for both children and adults.〔Saunders, S.M., & Wojcik, J.V., (2003). The Health Dynamics Inventory. Multi-Health Systems, Toronto.〕〔Saunders, S., & Wojcik, J.V. (2004). The reliability and validity of a brief self-report questionnaire to screen for mental health problems. Journal of Clinical Psychology in Medical Settings. 11, 233-241〕〔Saunders, S. & Wojcik, J.V. (2003). The Health Dynamics Inventory technical manual. Multi-Health Systems, Toronto.〕〔Bowersox, N., Saunders, S.M., and Wojcik, J.V. (2009). An evaluation of the utility of statistical versus clinical significance in determining improvement in alcohol and other drug (AOD) treatment in correctional settings. Alcohol Treatment Quarterly, 27, 113-129〕 It has multiple applications for improving the mental health treatment of children and adults, including in primary care medicine and integrated care. It was designed to be responsive to treatment effects and has descriptive anchors on a 5 point scale to allow for discrimination of frequency and severity of symptom expression.
The HDI was developed for ease of use for patients, researchers, clinicians, and clinics. It was designed to be easy to administer and to score, easy to complete, and to provide results that are easily understood and transformed into meaningful decisions, diagnoses and treatment plans. Most importantly, the HDI was designed to allow clear comparison between multiple administrations, demonstrating the degree of effectiveness of the services provided to individuals throughout their treatment, and to other changes of condition. This allows clinicians and patients to recognize their successes and failures, alert clinicians to high risk situations, target and modify treatment as necessary, and for clinics and clinic managers to track and monitor the process and progress of persons under their care.
==Comparison to Other Instruments==
The authors have used the criteria specified by Erbes,''et al.'',〔Erbes, C., Polusny, M. A., Billig, J., Mylan, M., McGuire, K., Isenhart, C., Olson, D. 2004. Developing and applying a systematic process for evaluation of clinical outcome assessment instruments. Psychological Service, 1, 31-39〕 to evaluate the HDI. Erbes, ''et al.'' considered the following criteria to evaluate outcomes measurement instruments: reliability; validity; factor structure; sensitivity to change; scope of measurement; utility across patient populations; the potential to enhance critical decisions about clinical care; briefness; whether the instrument was self-report; ease of administration; ease of interpretation; reasonable price; applicability across multiple settings; computerization capability; computer scoring and comparison to standardization samples; and face validity (whether it makes sense to patients and clinicians). See: http://www.minneapolis.va.gov/services/ptsrt/serv_pts_our.asp
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