Health of the Nation Outcome Scales: A case study in general psychiatry

Abstract

BackgroundHealth of the Nation Outcome Scales (HoNOS) were incorporated in a data set recording the routine clinical activities of a mental health team in Liverpool.AimsTo evaluate the use of HoNOS in general adult psychiatry.MethodAll consecutive patients who came in contact with the mental health team were administered HoNOS by the consultant psychiatrist. A cohort (n=204) of patients was identified over a period of 8 months. All patients (n=156) who had a repeat HoNOS after an interval of 6 months were included in the study.ResultsThere was an overall reduction in HoNOS scores after an interval of 6 months, more so among patients with psychotic and affective disorders. Patients scoring on other disorders showed no change on HoNOS. The measured change in clinical state based on the Clinical Global Impression scale was broadly consistent with HoNOS scores.ConclusionsIt was feasible to administer HoNOS during routine assessments, but HoNOS data were of limited value in care-planning in day-today clinical practice. The widespread adoption of HoNOS for use in routine clinical practice would be premature.