Abstract
Objectives: The aim of this study was to compare the HoNOS-SR, BASIS-32 and MHI with respect to their acceptability to consumers, their perceived utility to clinicians, and the similarity of consumers' ratings of their mental health problems with those of their treating clinicians, using the HoNOS.
Methods: Clinicians were asked to offer the HoNOS-SR, BASIS-32 or MHI to consumers each time that the clinician routinely completed a HoNOS (usually at the 6-monthly team review). Each time a consumer accepted and returned a completed consumer rated outcome measure, that rating was sent to the clinician who compared it with their own HoNOS rating and completed a short questionnaire designed to capture their impression of the comparison. The clinician subsequently met with the consumer to discuss the two ratings. The consumers were asked to complete questions about the acceptability of each consumer rated outcome measure at the time they first completed it and again after they met with the clinician to discuss both ratings.
Results: The 50 consumers who completed a HoNOS-SR, the 50 who completed the BASIS-32 and the 28 who completed the MHI were comparable with respect to age, gender, case manager rated HoNOS scores and principal diagnosis.
More consumers reported taking a shorter time to complete the BASIS-32 than each of the other measures. All three consumer rated measures were judged to be easy or very easy to complete. There was no association between ease of completion and self-rated severity of disorder. Most consumers thought it would be a good idea that the consumer rated outcome measure be completed every 6 months. This endorsement was higher for the HoNOS-SR than for the other two scales.
Conclusions: The majority of clinicians believed that the consumers rating was broadly similar to their HoNOS rating completed at about the same time. Very few clinicians whose patients had completed the MHI or HoNOS-SR reported that, if there was a significant difference in their ratings, this had produced a major change in their management strategy. However 30% of clinicians whose patients had completed the BASIS-32 said the difference did lead to a major change in management strategy, compared to 5% and 8% for the HoNOS-SR and MHI respectively.
In a comparison between the HoNOS-SR and the clinician's HoNOS, there were low agreements between the clinicians perception of severity of problems and the consumers report for item 6 (hallucinations/delusions), item 7 (depressed mood), item 10 (activities of daily living) and item 11 (accommodation problems) with the consumers reporting a significantly higher rating on the last 3 items. There were moderately strong correlations between the total scores of the consumer self-rated scales and the total score of the HoNOS completed by the case manager.