Reliable and clinically significant change in outcomes for forensic mental health inpatients: use of the HoNOS-Secure

Geoffrey L. Dickens*, Laura E. O'Shea

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Citations (Scopus)
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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.
Original languageEnglish
Pages (from-to)161–171
Number of pages11
JournalInternational Journal of Forensic Mental Health
Issue number2
Early online date10 Mar 2017
Publication statusPublished - 10 Mar 2017


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