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

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...

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Bibliographic Details
Published in:International journal of forensic mental health 2017-04, Vol.16 (2), p.161-171
Main Authors: Dickens, Geoffrey L., O'Shea, Laura E.
Format: Article
Language:English
Subjects:
Clinical significance
Forensic engineering
forensic mental health services
Forensic psychiatry
Forensic science
HoNOS-secure
Mental disorders
Mental health
Outcomes
Patients
reliable clinical change
Risk taking
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Summary: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.
ISSN:1499-9013
1932-9903
DOI:10.1080/14999013.2017.1286415