Health of the Nation Outcome Scales - Results of the Victorian field trial

Background InVictoria, Australia. systematic assessment of outcomes in mental health services are being instituted. Aims To carry out a farge-scale field trial of the Health of the Nation Outcome Scales (HoNOS). Method 2137 clients were rated by mental health workers on the HoNOS, and about half were rated again within a few months. Results While interrater reliability of the total score was satisfactory, that of some-individual items was unacceptable. Significant associations with age and gender were found, and clients with nonpsychotic disorders obtained higher (i.e. worse) ratings than those with psychotic disorders. There were relationships between service use and HoNOS total score. For the group as a whole, total scores had not changed at the second rating; but admissions and discharges; were associated with increases and decreases in total score. Among clients in the community, there was no relationship between change in Ho NOS total score and frequency of contacts. Conclusions Certain items, notably II and 12, were unreliable. The absence of evidence of sensitivity to change may be due to the short re-rating interval, little real change in the clients, or the characteristics of the scale itself. Declaration of interest: None.