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Community Mental Health

CMH Measures

Scales and Measures developed by the Section of Community Mental Health (CMH) can be found below.

The ITHACA Toolkit

Project ITHACA (Institutional Treatment, Human Rights and Care Assessment) identifies and disseminates best practice to improve the protection of human rights and dignity and the general health status of residents in health or social care institutions with mental ill-health, mental disabilities or dependency.

The ITHACA toolkit in the 13 project languages & Summaries for service users, professionals and policy makers is available here:

PDF of English language version of the ITHACA toolkit.

CAN: Camberwell Assessment of Need

Camberwell Assessment of Need measures the health and social needs of people with mental health problems and is used around the world. This book includes three versions of CAN – the full clinical version (CAN-C), the short, one page version for routine clinical use (CANSAS) and the research version (CAN-R) – along with permission for unlimited use of the assessments, which are designed to be photocopied. There are also materials and instructions for a half-day CAN training session. The CAN is suitable for use in primary care settings, specialist mental health teams and social services.

By Mike Slade, Graham Thornicroft, Linda Loftus, Michael Phelan and Til Wykes. Published by Gaskell, an imprint of the Royal College of Psychiatrists.

To order online, visit:

CANDID: Camberwell Assessment of Need for Adults with
Developmental and Intellectual Disabilities

CANDID is a modification of the Camberwell Assessment of Need which assesses the needs of adults with mental health problems and learning disabilities. It allows the perspectives of staff, service users and carers to be assessed to fully inform the planning of care. The book contains CANDID-R, the full version for research use and CANDID-S, the short version for both clinical and research use, along with a training programme and full rating guidance. Both assessments can be photocopied.

By Kiriakos Xenitidis, Mike Slade, Graham Thornicroft and Nick Bouras. Published by Gaskell, an imprint of the Royal College of Psychiatrists.

To order online, visit:

CANFOR: Camberwell Assessment of Need – Forensic Version

Based on the Camberwell Assessment of Need, CANFOR is a tool for assessing the needs of people with mental health problems who are in contact with forensic services and is suitable for use in all forensic mental health and prison settings. The tool allows assessment in 25 areas of life covering health, social, clinical and functional domains. The book contains versions for research (CANFOR-R) and clinical use (CANFOR-C) as well as a short summary version (CANFOR-S) suitable for both. There are rating scales, descriptions of how they were developed and their psychometric properties, administration details, a full training programme, guidance on scoring and blank assessment forms for all three versions that can be photocopied.

By Stuart Thomas, Mari-Anne Harty, Janet Parrott, Paul McCrone, Mike Slade and Graham Thornicroft. Published by Gaskell, an imprint of the Royal College of Psychiatrist.

To order online, visit:

CAN-M: Camberwell Assessment of Need for Mothers

The Camberwell Assessment of Need for Mothers (CAN–M) is a tool for assessing the needs of pregnant women and mothers with severe mental illness. It is a modification of the Camberwell Assessment of Need, the most widely used needs assessment for people with severe mental health problems. The CAN–M has been designed to assess met and unmet needs in 26 areas, covering a full range of social, physical health and mental health domains. The perspectives of staff and service users are assessed so that care planning is fully informed. Comprehensive versions are included for research and for clinical use, as well as a short summary version suitable for both clinical and research use.

By Louise Howard, Katherine Hunt, Mike Slade, Veronica O'Keane, Trudi Seneviratne, Morven Leese, Graham Thornicroft and Michael Wiseman.

To order online, visit:

CANE: Camberwell Assessment of Need for the Elderly

Based on the Camberwell Assessment of Need, a widely used assessment tool for people with severe mental illness, CANE is a tool for assessing the needs of older people and particularly those with mental health problems. Needs are assessed in 24 areas of life and cover a broad range of health, social and psychological domains. Also included are two items that assess the needs of those who care for the older person.

Edited by Martin Orrell and Geraldine Hancock.

To order online, visit:

Measures relating to Stigma and Discrimination

Researchers in the Section of Community Mental Health (CMH) have developed seven measures relating to different aspects of stigma and discrimination.  These measures are freely available so long as you follow the conditions of use, including completing a short registration survey (this replaces the need to request for permission to use the measures).

Conditions of use
If you work or study in a university or health setting the scale is freely available for you subject to the conditions below. Otherwise please contact Professor Graham Thornicroft at

Permission to use the scale is granted on condition that:

  1. You complete our short scale user registration questionnaire.
  2. No changes are made to the wording or format of the scale.
  3. Translations into different languages are done using Back Translation (e.g. as detailed in this translation guidance).
  4. You are willing to share any translated versions(s) with others who may wish to use it / them.
  5. The copyright information in the footer of the scale is included when the scale is used.
  6. The full reference to the key paper describing the scale is included in the footer when it is used and is cited in any publication using the measure.
  7. The scale is not passed on to a third party (instead please direct them to this website).
  8. You make no financial charge for your version of our scales.

Access the measures here:

Discrimination and Stigma (DISC) scale
The DISC is an interview-based scale which measures experiences of mental health-related discrimination ('being treated unfairly’) in key areas of everyday life and social participation, including work, marriage, parenting, housing, leisure, and religious activities. It has 21 questions. The DISC was designed to be completed by people who have a mental health problem. It is a reliable and valid measure and has been widely used in many countries around the world.

DISC measure
DISC manual
DISC key paper - please click the link below:
Questionnaire on Anticipated Discrimination (QUAD)
The QUAD is a new measure of anticipated discrimination. It asks people how much they personally anticipate experiencing mental health-related discrimination across 14 areas of life. The QUAD is intended for use with people who have a mental health problem. Our research showed that the QUAD is an understandable, reliable and valid questionnaire.

QUAD measure
QUAD manual
QUAD key paper - please click link below:
Mental Illness Knowledge Scale (MAKS)
MAKS has been developed to measure mental health-related knowledge. The tool assesses and tracks stigma-related mental health knowledge among the general public and can be used to evaluate anti-stigma interventions. If used in combination with other assessment tools that measure attitudes and behaviour, MAKS can help researchers plan and develop interventions that effectively reduce stigma.

Download MAKS here:

MAKS measure
MAKS instructions
MAKS key paper


MAKS (1-6) Cantonese

Reported and Intended Behaviour Scales (RIBS)

RIBS has been designed to assess and track mental health related behavioural discrimination among the general public. Several studies have demonstrated the significance and high prevalence of discrimination experienced by service users, emphasising the importance of assessing and documenting behavioural tends.

Download RIBS here:

RIBS measure

RIBS instructions

RIBS key paper

RIBS Cantonese

Mental Illness: Clinicians’ Attitudes (MICA) scale (v2 and v4)
The Mental Illness Clinicians’ Attitudes scale (MICA-2) was created for use with medical students. It was found to be reliable, valid and responsive to change. An amended version (MICA-4) was validated with a sample of nursing students and may be suitable for staff and students from a wide range of health professions. The MICA has 16 questions and has been widely used around the world.

MICA v2 measure
MICA v4 measure
MICA manual
MICA v2 key paper - click the link:

MICA v4 key paper – click the link:
Costs of Discrimination Assessment (CODA)
The CODA has been developed to measure the economic costs than can arise due to the stigma and discrimination which people with mental health problems often face. The content of the CODA was based on a systematic review of the topic and on focus groups. The main sections of the CODA cover employment, health care use and avoidance, and leisure activities.

CODA measure
Barriers to Accessing Care Evaluation (BACE)

The BACE measures barriers to accessing mental health care. It asks about 30 different barriers to care, and has a special focus on stigma-related barriers. It has a ‘treatment stigma’ subscale to assess to what extent the stigma associated with mental health care has been a barrier for an individual. It has good psychometric properties and is also being used in several studies around the world.

BACE measure
BACE manual
BACE key paper – click the link:

Conceal or Reveal: A guide to telling employers about a mental health condition (CORAL)

 A guide for anyone who has experienced a mental health condition and is unsure of issues related to telling a potential or current employer about this. The CORAL booklet aims to help aid decision making by considering your needs and values and helps you to think about when to disclose and who to disclose to.

Further reference:

Henderson C, Brohan E, Clement S, Williams P, Lassman F, Schauman O, Dockery L, Simone Farrelly S, Murray J, Murphy C, Slade M, Thornicroft G. Randomised controlled trial of a decision aid on disclosure of mental health status to an employer: feasibility and outcomes. British Journal of Psychiatry, 203: 350-357, 2013, doi:10.1192/bjp.bp.113.128470.

Brohan E, Henderson C, Slade M, Thornicroft G. Development and preliminary evaluation of a decision aid for disclosure of mental illness to employers. Patient Education and Counselling, 94 (2):238–242, 2014.

CORAL booklet

CORAL Dutch language translation

For advice on using the Dutch language translation of CORAL in the Netherlands, please contact: Prof.dr. Jaap van Weeghel, Directeur Wetenschap Kenniscentrum Phrenos,Postbus 1203, 3500 BE Utrecht

tel. 030-2931626


If you have a query about any of these scales you may find the answer in the manuals/instructions. If not, please contact Dr Sara Evans-Lacko:

Two measures (MAKS and RIBS) were developed as part of the evaluation of England’s national Time to Change Evaluation and the remainder were developed as part of the SAPPHIRE Programme on Stigma and Discrimination in Mental Health.

For more information click the links:

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