[HoNOS norms for SMI-patients in acute and long-term clinical care and in FACT care]

In the Netherlands the Health of the Nation Outcome Scale (HoNOS) has been used for over 20 years, but norms for the HoNOS have not been updated since 2004.

To establish metropolitan HoNOS norm scores for patients with a severe mental illness (SMI) in various types of care.

Anonymized data from a large cohort (n = 7566) from the years 2012-2021 of patients with SMI in acute clinical care (n = 4309), long-term clinical care (n = 822) and in care at flexible assertive community treatment (FACT; n = 2435) were used to establish norms for the index (total) score as well as the scores for clinically meaningful and serious problem areas.

There were significant differences in HoNOS scores between the three types of care: patients in acute clinical care had higher scores, long-term clinical care patients scored intermediate, and FACT patients had lower scores. Legal status did not influence the HoNOS score in a meaningful way. Norm tables with raw scores, normalised T-scores and percentile scores were created.

The new norms enable clinicians to estimate the severity of psychopathology and level of functioning in individual patients compared to appropriate reference groups.