Background: The Health of the Nation Outcome Scales (HoNOS) have been developed for assessing the effectiveness of mental health services.
Aims: To investigate the validity and reliability of the HoNOS in patients in contact with mental health services.
Method: Subjects (age range 19-64) came from day hospitals, acute in-patient units and out-patient clinics in general practice. We obtained the opinions of experienced professionals, advocacy groups and patient groups to evaluate consensual and content validity.
Results: One hundred patients were assessed using the package of rating scales. Interrater and test-retest reliability were good for some items and poor for others. The HoNOS had good criterion validity: acute in-patients had higher scores than day patients and out-patients. HoNOS also had good concurrent validity, correlating well with other scales. Comments suggested that the HoNOS was a useful and suitable scale for this population but psychotic symptoms and certain social factors were not sufficiently covered.
Conclusion: The HoNOS had good validity but variable reliability. It may be better than existing scales because of the wide range of areas which it covers.