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

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ABSTRACT Outcomes measures are commonly derived from post-discharge recidivism, readmission, and mortality rates but information about common outcomes across admission is scant. We determined whether reliable and clinically significant change… Click to show full abstract

ABSTRACT Outcomes measures are commonly derived from post-discharge recidivism, readmission, and mortality rates but information about common outcomes across admission is scant. We determined whether reliable and clinically significant change in risk-related need, behavior, functioning, and symptoms occurred during admission by analysing routinely collected HoNOS-secure data (N = 418). We calculated 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 by a clinically significant margin. Reliable change was demonstrated for 4.8% and 5.7% of patients on the HoNOS-secure scale and security scale respectively, and that change was rarely clinically significant. In a context in which services rarely report on routinely collected data for a range of outcomes, we found that HoNOS-secure captured little of any clinical change that may have occurred. Further research should determine whether the HoNOS-secure is a suitable tool for routine outcomes reporting.

Keywords: significant change; honos secure; reliable clinically; clinically significant

Journal Title: International Journal of Forensic Mental Health
Year Published: 2017

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