Handover | Issue 36 – October 2016 – Information alive

Child and adolescent mental health services have been collecting outcomes information since 2008, along with considerable activity data.

HoNOSCA (Health of the Nation Outcome Scales for Children and Adolescents) is a simple 15 item outcome measure, clinician rated from 0 meaning ‘no problem’ to 4 meaning ‘serious problem.’ The measure can be used in a whole variety of ways: to assist with care planning, goal setting, allocation of referrals, benchmarking and research, to name just a few. The 15 items are indicated right.

What is the information saying?

The graph below is informing us about how many service users at admission and discharge were scoring in the clinical range (that is 2 or more on HoNOSCA) during a one year period for all people seen by community child and adolescent mental health services.

As one would expect, people are more distressed on admission and on discharge are showing signs of recovery. Of particular note are emotional, peer and family relationships, all of which show significant improvements by discharge.

Limitations of the information

As with any information, the reliability of HoNOSCA information depends on how reliably clinicians do the ratings. This will depend on several criteria, in particular using the HoNOSCA glossary, being trained in HoNOSCA and having some practice with doing ratings. However we know that outcome measures have quite high levels of inter-rater reliability – higher than for diagnosis – providing these criteria are met.

Percentage of collections in clinical range on each HoNOSCA item, Community, New Zealand, Apr 2015 - Mar 2016

Percentage of collections in clinical range on each HoNOSCA item, Community, New Zealand, Apr 2015 - Mar 2016

Notes:

  • Percentage of service users in the clinical range (2, 3, or 4) for each HoNOSCA items.
  • Community discharge does not include discharges to an inpatient unit.
  • Source: Ministry of Health, PRIMHD extract 8 July 2016, analysed and formatted by Te Pou.