HoNOS: a cautionary tale of their use in a rehabilitation service

Abstract

Aims and methodHealth of the Nation Outcome Scales (HoNOS) were piloted in 248 patients with serious persistent mental health problems. Staff were trained by a cascade approach and rated patient outcome after six months.ResultsThere was poor interrater reliability between nurses and psychiatrists/psychologists. Outcome measured by HoNOS often contrasted with clinical experience.Clinical implicationsHoNOS were not a reliable or valid measure of outcome. The scales are now completed only under supervision.