Utility of the HoNOS in measuring change in a Community Mental Health Care population

Abstract

Background: Given that, for many community health care teams, the HoNOS is the audit tool of choice, further work is needed to establish the viability of using this instrument to assess health change.Aims: To assess the usefulness of the HoNOS in measuring change in a population on the caseloads of community mental health teams.Method: Key workers or care co-ordinators of 195 selected patients on the caseloads of a national sample of 10 generic community mental health teams rated patients on the HoNOS four times over a period of 4 – 6 months. Patients had previously received a primary diagnosis of anxiety, depression, psychosis, personality disorder, or substance misuse on the Manchester Audit Tool.Results: In this population, the HoNOS marginally discriminated amongst diagnoses, and was associated with severity and complexity but not chronicity. Scores on the HoNOS changed differentially over time according to diagnosis and severity.Conclusion: A change of 3 to 4 points on the HoNOS is small, but statistically significant, and may be a useful basis for tracking the clinical improvement of neurotic patients, and the clinical stability of those with psychosis.Declaration of interest: This study was supported by a grant from the UK Department of Health's Policy Research Branch, Human Resources and Effectiveness Programme, to Michael West, Simon Garrod, and David Shapiro.