Health of the Nation Outcome Scales. Results of the Victorian field trial.
BACKGROUND
In Victoria, Australia, systematic assessment of outcomes in mental health services are being instituted.


OBJECTIVE
To carry out a large-scale field trial of the Health of the Nation Outcome Scales (HoNOS).


METHODS
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 non-psychotic 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 HoNOS total score and frequency of contacts.


CONCLUSIONS
Certain items, notably 11 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.
Trauer
T
T
Alfred Hospital, Monash University, Victoria, Australia.
Callaly
T
T
Hantz
P
P
Little
J
J
Shields
R
R
Smith
J
J
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards* / Q000706:statistics & numerical data; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D019984:Quality Indicators, Health Care; D017678:Sex Distribution; D014739:Victoria