Use of Health of the Nation Outcome Scales in psychiatry

Delaffon, Vijay; Anwar, Zarina; Noushad, Fabida; Ahmed, Ayesha S.; Brugha, Traolach

doi:10.1192/apt.bp.110.008029

Cited by 23 publications

(21 citation statements)

References 29 publications

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“…Clinicians rate consumers on a 12-item scale (0 = no severity , 4 = high severity ), which is designed to measure change in response to an intervention. Internal consistency has been moderate (α = .59–.76) and it shows fair to moderate test–retest reliability [36]. …”

Section: Methodsmentioning

confidence: 99%

How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy

Egeland

Ruud

Ogden

et al. 2017

Int J Ment Health Syst

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BackgroundThe purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway.MethodsA total of 9 clinical leaders, 31 clinicians, and 44 consumers at 9 service settings participated in the implementation of IMR. Implementation was conducted by an external team of researchers and an experienced trainer. Data were gathered on fidelity to the intervention and implementation strategy, feasibility, and consumer outcomes.ResultsAlthough the majority of clinicians scored within the acceptable range of high intervention fidelity, their participation in the implementation strategy appeared to moderate anticipated future use of IMR. No service settings reached high intervention fidelity scores for organizational quality improvement after 12 months of implementation. IMR implementation seemed feasible, albeit with some challenges. Consumer outcomes indicated significant improvements in illness self-management, severity of problems, functioning, and hope. There were nonsignificant positive changes in symptoms and quality of life.ConclusionsThe implementation strategy appeared adequate to build clinician competence over time, enabling clinicians to provide treatment that increased functioning and hope for consumers. Additional efficient strategies should be incorporated to facilitate organizational change and thus secure the sustainability of the implemented practice. Trial registration ClinicalTrials.gov NCT02077829. Registered 25 February 2014

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Section: Methodsmentioning

confidence: 99%

How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy

Egeland

Ruud

Ogden

et al. 2017

Int J Ment Health Syst

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“…In the mental health and forensic mental health contexts, Ellwood's grand vision has had limited impact. In the UK, there have reportedly been problems with the HoNOS' data quality despite mandated reporting (Delaffon, Anwar, Noushad, Ahmed, & Brugha, 2012). In Australia, however, outcomes measurement with the HoNOS has been more robust (Pirkis, Burgess, Coombs, Clarke, Jones-Ellis, & Dickson, 2005).…”

Section: Introductionmentioning

confidence: 99%

Reliable and Clinically Significant Change in Outcomes for Forensic Mental Health Inpatients: Use of the HoNOS-Secure

Dickens

2017

International Journal of Forensic Mental Health

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Secure mental health service outcomes are commonly derived from post-discharge recidivism, readmission and mortality rates. Information about less rare behavioural, functional, and symptom-related outcomes across the sometimes lengthy span of admission is scant. We aimed to determine whether patients underwent reliable and clinically significant change in risk-related need, behaviour, functioning, and symptoms during admission from analysis of routinely collected HoNOS-Secure data. Outcomes (N=418) were examined to determine between-group differences in baseline scores and rates of change, the proportion of patients for whom change was reliable, and, of those, the proportion whose scores fell during treatment by a clinically significant margin. Reliable change was demonstrated for just 4.8% and 5.7% of patients on the HoNOS-Secure scale and security scale respectively, and was rarely clinically significant. In a context in which services rarely report routinely collected data for a range of outcomes, this study found that HoNOS-Secure captured little of any clinical change that may have occurred. Further research is needed to determine whether the HoNOS-Secure is the most suitable tool for routine outcomes reporting, but, in any event, patients, clinicians, and the public should reasonably expect services to routinely demonstrate their effectiveness.

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“…Conceptually HoNOS has been criticized as having a low relevance to clinical decision-making, not refl ecting the priorities of people with mental illness, being staff-rated, and having a focus on defi cits (Slade, 2012). In addition, overall scores have better psychometric properties than some of the individual items (Delaffon et al, 2012;Pirkis et al, 2005).…”

Section: Honos and Other Outcome Measuresmentioning

confidence: 97%

Routine outcome measures in Canada

Kisely

Adair

Lin

et al. 2015

International Review of Psychiatry

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Canada is a federal country of 10 provinces and three territories. High level information on mental health conditions and service use has mostly been generated from administrative data collected by provinces and territories. These include four major types - hospital admissions and discharges, physician billings, ambulatory care services, and drug databases. At the national level, the Canadian Institute for Health Information brings together this information to produce indicators of outcome. Although these data provide information on patient and health system characteristics, they do not capture the full spectrum of formal and informal mental healthcare. These include changes in health status, functioning, community integration and quality of life. As a result, some jurisdictions have begun to implement more standardized measures of outcome such as the clinician-rated Health of the Nation Outcome Scales or the inpatient Resident Assessment Instrument - Mental Health. In this paper we provide an overview of mental-health-related data sources in Canada, highlight some of the more progressive practices beginning to emerge, and conclude with some thoughts about how the routine measurement and reporting of mental health outcomes in Canada might be advanced including efforts at engaging both clinicians and decision-makers.

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Use of Health of the Nation Outcome Scales in psychiatry

Cited by 23 publications

References 29 publications

How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy

How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy

Reliable and Clinically Significant Change in Outcomes for Forensic Mental Health Inpatients: Use of the HoNOS-Secure

Routine outcome measures in Canada

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