What do we know about using ACORN with severely mentally ill (SMI) populations?

-It has been done successfully. Not only do we have many organizations using our SMI and SPMI forms, we have one agency that is entirely focused on SMI that can boast a .71 Effect Size.

-Most SMI clients are in treatment for a very long time.

-SMI clients tend to self-report symptoms as much lower than a provider would rate them. Part of this is, as providers, we tend to see SMI clients as very ill and highly symptomatic compared to the rest of our case load. They report fewer symptoms so they get less "improvement" over treatment.

What should I pay attention to with SMI Clients?

-Stability over time rather than large improvements. 

-Keep an especially close watch on self harm items as these tend to spike more than a general population.

What else can I do? 

-Start to implement Client Registration forms within your agency. This will allow us to case-mix adjust for your SMI clients, weighing their scores against similar patients the toolkit has seen in the past