Review

Beyond the QALY

QUALITY OF LIFE AND MENTAL HEALTH SERVICES
Joseph Oliver, Peter Huxley, Keith Bridges, Hadi Mohamad
Routledge, 1997, £14.99

In this book the authors recount their experience with their ‘Lancashire Quality of Life Profile’ tool (LQOLP), and also consider concepts and theories associated with ‘quality of life’.

Part I deals with the latter, and it is clear that the prime purpose was to produce a tool to measure ‘quality of life’ in a needs-led service. They offer three reasons for their own tool in preference to QALYs and the like.

They dismiss ‘the economic principle that an individual is necessarily the best judge of his or her own welfare’ for their specified client group. They suggest that in the field of mental health, the benefits of QALYs have not been shown, and finally, they assert that it was not their intention to focus on the possible efficiency benefits in relation to cost only.

Part II goes on to describe the LQOLP and its application in a wide range of clinical practice, such as community as well as long-stay inpatient settings. Two case studies are also described. This section of the book is supported by appendices detailing the questionnaire and instructions for its use.

Part III summarises, and considers the ‘lessons learned’ from the application of the LQOLP in both clinical practice and research settings. The authors argue that the LQOLP is a highly useful tool, not only for assessment in the needs-led service individualised for clients, but also for social research.

Overall, this is a well-written and easy to follow book that provides an example of a ‘profile’ which should be considered by clinicians as a possible assessment tool in its own right. Despite misgivings over some of the clinical language used (eg the frequent use of ‘schizophrenia’ as a diagnosis) I would recommend this book to all those working in the mental health field.