ABSTRACT
The Outcome Questionnaire is a self-report questionnaire developed mainly for treatment impact assessment and monitoring of status change because it can measure the cross-sectional condition very accurately by being sensitive to small changes. The present study aimed to psychometrically evaluate and validate the instrument on a sample of Hungarian university students. 7,695 higher education students (28.6% male, 68.8% female, 1% other, M = 23.7, SD = 6.78) participated in the study and completed a questionnaire package (OQ-45, Beck Depression Inventory, WHO Well-being Questionnaire-5, Connor-Davidson Resilience Scale, MOS-Social Support Survey, Maslach Burnout Inventory-SS) online, developed to measure general and more specific mental health conditions. The Hungarian version of the questionnaire has a high internal consistency (Cronbach's alpha = 0.951). Based on the confirmatory factor analysis, the original three-factor version of the instrument (due to inadequate fit indicators) did not gain support in our sample. Five subscales were identified and subjected to content analysis in the exploratory factor analysis. Our final questionnaire consists of 39 items. The full scale and the subscales show a high correlation with other questionnaires measuring similar constructs. The psychometric indicators of the questionnaire are adequate and, therefore, considered reliable. The separation of the five factors was confirmed by construct and convergent validation. The questionnaire's psychometric properties may be worth testing in the future on a clinical sample and a sample of adults from a wider age range. The use of the measurement tool has important implications in research areas beyond therapeutic impact assessment, as it may offer a bridging solution to the methodological problems encountered in the construction of complex questionnaire packages consisting of several instruments. International findings suggest that some items in the questionnaire are particularly sensitive to cultural context, so it is crucial to use a measure adapted to the region of the study sample. Other strengths of the questionnaire include its ability to address subclinical and clinical symptoms in one dimension and provide a comprehensive cross-sectional picture of the bio-psycho-social status of individuals, which allows systematic monitoring of a large and heterogeneous population (higher education students).
ABSTRACT
The Coronavirus disease 2019 (COVID-19) posed unexpected global economic and societal challenges. These include a heavy impact on mental health due to fast changing lockdown and quarantine measures, uncertainty about health and safety and the prospect of new waves of infections. To provide crisis mental health support during the pandemic, Eötvös Loránd University in Hungary launched a specialist online counselling programme, consisting of one to three sessions. The programme was available to all university members between 4th March and 25th May 2020. Overall, 47 clients received support. In this paper we discuss challenges reported by clients, key features of providing a brief mental health intervention online, reflect on counsellor experiences and give recommendations on how mental health services could be developed in the time of crisis. Most clients had challenges with developing a daily routine under quarantine; and many had hardship related to finances, housing, and distance learning. Common mental health consequences included fear from the virus and stress, anxiety, and fatigue due to the interruption to everyday life. In some cases, more complex conditions were triggered by the pandemic. Examples include addictive behaviours and symptoms of depression or psychosis. However, referring cases beyond the competency of counselling proved to be a challenge due to the closure of specialist services. Counsellors observed three key features to the online delivery of a brief crisis mental health intervention: [1] an explicit problem-oriented approach to counselling; [2] challenges of building rapport online; and [3] frames of online counselling. Counsellor experiences often overlapped with those of clients and included challenges of working from home and adjusting to online counselling methods. The possibility of online counselling allowed that mental health care could take place at all during the pandemic. Client experiences reflect findings from previous literature. Like other mental health initiatives launched to tackle COVID-19, the intervention's effectiveness was not measured given the unexpected context and short time frame for programme development. We recommend the use of impact measurement tools to develop mental health services in crises. Meanwhile, the pandemic brought to attention the need to better understand online delivery models. Counsellors should have access to training opportunities on online counselling and managing work-life balance in a remote setting. The COVID-19 counselling programme in Eötvös Loránd University, Hungary is an example of providing online mental health counselling in the time of crisis. Clearly, more studies are needed discussing delivery models and effectiveness of mental health interventions during the pandemic. Experience and knowledge sharing across practitioners should be encouraged to improve how the field reacts to unexpected, high risk events and crises.
