Desperately seeking outcomes: quantifying the effectiveness of community mental healthcare using Health of the Nation Outcome Scales

BACKGROUND: Community mental health services in the UK have struggled to measure the clinical effectiveness of their services. AIMS: To measure clinical outcomes for different diagnostic clusters. METHOD: Clinicians measure the clinical status of patients by the Health of the Nation Outcome Scales (HoNOS), and HoNOS scores should be recorded annually after treatment. Clinical outcomes were measured by changes in HoNOS for diagnostic clusters. RESULTS: In two time periods (2014 and 2016), the health of patients with mild to moderate common mental disorders deteriorated after intervention. Patients with severe common mental disorders and psychoses improved in their clinical status. CONCLUSIONS: British community mental health teams may be effective in improving the clinical status of people with severe mental illness, but may have a negative effect on people with mild to moderate illnesses. These teams need to focus on the severely mentally ill and build on this demonstrable effectiveness. DECLARATION OF INTEREST: None.