Health of the Nation Outcome Scales (HoNOS): Research and development
Abstract
Background: An instrument was required to quantify and thus potentially measure progress towards a Health of the Nation target, set by the Department of Health, “to improve significantly the health and social functioning of mentally ill people” Method: A first draft was created in consultation with experts and on the basis of literature review. This version was improved during four stages of testing: two preliminary stages, a large field trial involving 2706 patients (rated by 492 clinicians) and tests of the final Health of the Nation Outcome Scales (HoNOS), which included an independent study (n=197) of reliability and relationship to other instruments. Results: The resulting 12-item instrument is simple to use, covers clinical problems and social functioning with reasonable adequacy, has been generally acceptable to clinicians who have used it, is sensitive to change or the lack of it, showed good reliability in independent trials and compared reasonably well with equivalent items in the Brief Psychiatric Rating Scales and Role Functioning Scales. Conclusions: The key test for HoNOS is that clinicians should want to use it for their own purposes. In general, it has passed that test. A further possibility, that HoNOS data collected routinely as part of a minimum data set, for example for the Care Programme Approach, could also be useful in anonymised and aggregated form for public health purposes, is therefore testable but has not yet been tested.
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HoNOS is a 12-item scale originally developed to capture the health and social functioning of people with severe mental illness.
“In addition, the therapists fill in the Health of the Nation Outcome Scales (HoNOS; [77]), a 12-item scale originally developed to capture the health and social functioning of people with severe mental illness.”
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“In addition, the therapists fill in the Health of the Nation Outcome Scales (HoNOS; [77]), a 12-item scale originally developed to capture the health and social functioning of people with severe mental illness.”
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“For young people aged ≥ 18 years, additional secondary measures were: (i) Kessler Psychological Distress Scale (K10) (Andrews & Slade, 2001; Kessler et al., 2002) and (ii) Health of the Nations Outcome Scale (HoNOS) (Wing et al., 1998).”
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- Authors
- Wing, J. K., Beevor, A. S., Curtis, R. H., Park, S. G. B., Hadden, J., & Burns, A.
- Affiliations
- University of Nottingham (GB)
- Corresponding author
- Wing, J. K.
- ORCID
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 1998-01
- Volume
- 172
- Issue
- 1
- Pages
- 11-18
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W1983159214
- Cited by
- 1,203
- References
- 8
- Citations by year
- 2026: 40 · 2025: 56 · 2024: 50 · 2023: 42 · 2022: 60 · 2021: 74 · 2020: 53 · 2019: 43 · 2018: 61 · 2017: 43 · 2016: 58 · 2015: 45 · 2014: 45 · 2013: 59 · 2012: 57
- FWCI
- 33.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- Health of the Nation Outcome Scales, mental illness, social functioning, outcome measurement, scale development, reliability statistics, sensitivity to change, Care Programme Approach, Minimum Data Set, public health monitoring, Brief Psychiatric Rating Scale
- MeSH terms
- United Kingdom, Health Policy, Humans, Mental Health, Mental Health Services, Sensitivity and Specificity, Outcome Assessment, Health Care
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