Sources of information when rating the Health of the Nation Outcome Scales

Mental health nurses will play an important role in the administration of the routine outcome measures currently being implemented across Australia, including the Health of the Nation Outcome Scales (HoNOS). Prior research has implied that sources of information may be responsible in part for the mixed reliability and validity of the HoNOS. This study examines which sources of information clinicians use when making a HoNOS rating. Twenty-one mental health clinicians that had been using the HoNOS routinely for 2 years were surveyed to determine the sources of information they used when making a rating. In addition, 12 specific HoNOS ratings were reviewed to obtain data about 'actual' sources utilized. More than half of all information used when completing a HoNOS rating was obtained from interviewing the client or from direct observation of the client. The main secondary sources used included medical records and consulting with family and carers and other staff. Collateral information from general practitioners and police was used in only a small percentage of cases. There was high variability amongst clinicians with regard to how much each source was used. Training mental health workers in routine use of the HoNOS should encourage clinicians to use a range of sources of information when making a rating.