CQAIMH - center for quality assessment and improvement in mental health


Level-of-Functioning Assessment

A functional assessment provides the clinician with a means to quantify the patient’s impairment.

  • Level-of-functioning instruments measure a person’s ability to interact with others, form relationships and handle day-to-day tasks. (1)
  • Self-report of level-of-functioning has been found to have an important role in treatment as it encourages patient participation and collaborative dialogue. (1)
  • Monitoring response to treatment in bipolar disorder should extend beyond symptom reduction to include a focus on a person’s improvement in functioning. (2)

Sheehan Disability Scale (SDS):

  • Highly validated instrument developed to assess functional impairment, which can be used to assess response to treatment.
  • Self-rated scale that evaluates 3 inter-correlated domains. The patient rates the extent to which his or her work, social life, and home life or family responsibilities are impaired by his or her symptoms on a 10 point visual analog scale.
  • This anchored visual analog scale uses spatiovisual, numeric, and verbal descriptive anchors simultaneously to assess disability.


  1. O’Malia L, McFarland B, et al, A Level-of Functioning Self Report Measure for consumers with severe mental illness. Psychiatric Services, March 2002, Vol 53, No 3 26-331
  2. Keck PE, Defining and Improving response to treatment in patients with bipolar disorder. J Clin Psychiatry 2004; 65 (suppl 15) 25-29

Copyright 2007 by the Center for Quality Assessment and Improvement in Mental Health