Person—level of psychiatric symptom severity, Health of the Nation Outcome Scale for Children and Adolescents score code N

Identifying and definitional attributes
Metadata item type:	Data Element
Short name:	Level of psychiatric symptom severity (HoNOSCA score)
METEOR identifier:	575043
Registration status:	Independent Hospital Pricing Authority, Standard 15/10/2014
Definition:	An assessment of the severity of a person's psychiatric symptoms, as represented by a HoNOSCA score-based code.
Context:	Psychiatric symptom severity, persons aged 17 years and under.
Data Element Concept:	Person—level of psychiatric symptom severity
Value Domain:	Health of the Nation Outcome Scale for Children and Adolescents score code N

Value domain attributes
Representational attributes
Representation class:	Code
Data type:	Number
Format:	N
Maximum character length:	1
	Value	Meaning
Permissible values:	0	No problems within the period stated
	1	Minor problem requiring no action
	2	Mild problem but definitely present
	3	Moderately severe problem
	4	Severe to very severe problem

Collection and usage attributes
Guide for use:	The Health of the Nation Outcome Scale for children and adolescents (HoNOSCA) is used to rate child and adolescent mental health service users. Together, the scales rate various aspects of mental and social health. HoNOSCA is answered on an item-specific anchored 4-point scale with higher scores indicating more problems. Each scale is assigned a value of between 0 and 4. The fifteen scales are as follows: Disruptive, antisocial or aggressive behaviour Overactivity attention and concentration Non-accidental self injury Alcohol, substance/solvent misuse Scholastic or language skills Physical illness or disability problems Hallucinations and delusions Non-organic somatic symptoms Emotional and related symptoms Peer relationships Self care and independence Family life and relationships Poor school attendance Lack of knowledge - nature of difficulties Lack of information - services/management The sum of the individual scores of each of the scales from 1 to 13 represents the total HoNOSCA score. The total HoNOSCA score represents the overall severity of an individual's psychiatric symptoms.

Collection and usage attributes

Guide for use:

The Health of the Nation Outcome Scale for children and adolescents (HoNOSCA) is used to rate child and adolescent mental health service users. Together, the scales rate various aspects of mental and social health.

HoNOSCA is answered on an item-specific anchored 4-point scale with higher scores indicating more problems. Each scale is assigned a value of between 0 and 4. The fifteen scales are as follows:

Disruptive, antisocial or aggressive behaviour
Overactivity attention and concentration
Non-accidental self injury
Alcohol, substance/solvent misuse
Scholastic or language skills
Physical illness or disability problems
Hallucinations and delusions
Non-organic somatic symptoms
Emotional and related symptoms
Peer relationships
Self care and independence
Family life and relationships
Poor school attendance
Lack of knowledge - nature of difficulties
Lack of information - services/management

The sum of the individual scores of each of the scales from 1 to 13 represents the total HoNOSCA score. The total HoNOSCA score represents the overall severity of an individual's psychiatric symptoms.

Source and reference attributes
Submitting organisation:	Independent Hospital Pricing Authority

Data element attributes
Source and reference attributes
Submitting organisation:	Independent Hospital Pricing Authority
Reference documents:	Health of the Nation Outcome Scales (HoNOS), Royal College of Psychiatrists 1996. Viewed 22 May 2014, http://www.rcpsych.ac.uk/training/honos/whatishonos.aspx
Relational attributes
Related metadata references:	Has been superseded by Person—level of psychiatric symptom severity, Health of the Nation Outcome Scale for Children and Adolescents score code N Health, Superseded 25/01/2018 See also Person—level of psychiatric symptom severity, Health of the Nation Outcome Scale score code N Independent Hospital Pricing Authority, Standard 15/10/2014
Implementation in Data Set Specifications: All attributes +	Activity based funding: Mental health care DSS 2016-17 Independent Hospital Pricing Authority, Superseded 28/02/2017 DSS specific attributes + Implementation start date: 01/07/2016 Implementation end date: 30/06/2017 Conditional obligation: Reporting of the HoNOSCA at the commencement of mental health phase of care is mandatory for patients in all settings. Reporting of the HoNOSCA is not mandatory if mental health phase of care is reported as Assessment Only. The HoNOSCA should only be reported for patients aged 17 years and younger. Admitted patient mental health care cluster Independent Hospital Pricing Authority, Standard 15/10/2014 DSS specific attributes + Conditional obligation: Reporting of the HoNOSCA at admission and discharge is mandatory for admitted patients in psychiatric hospitals or designated psychiatric units in acute hospitals. Reporting is optional for admitted patients in non-designated hospitals or units. The HoNOSCA should only be reported for patients aged 17 years and under. The HoNOSCA discharge rating is not required if the episode of admitted care had a length of stay of 3 days or less. Ambulatory patient mental health care cluster Independent Hospital Pricing Authority, Standard 15/10/2014 DSS specific attributes + Conditional obligation: For the purposes of this DSS, an ambulatory episode is defined as a period of continuous contact between a consumer and a mental health service within an ambulatory service setting. This is consistent with the definition in the National Outcomes and Casemix Collection. Reporting of the HoNOSCA is mandatory for the first and last service contacts of an ambulatory mental health care episode provided by a specialised mental health service. Reporting is optional for service contacts provided by specialised mental health services from non-government organisations that receive state or territory government funding. Reporting is optional for service events provided by non-specialised mental health services. The HoNOSCA should only be reported for patients aged 17 years and under. DSS specific information: The HoNOSCA for the first service contact may be derived from the HoNOSCA admission rating submitted for the patient's ambulatory care episode as part of the National Outcomes and Casemix Collection reporting requirements. The HoNOSCA for the last service contact may be derived from the HoNOSCA discharge rating submitted for the patient's ambulatory care episode as part of the National Outcomes and Casemix Collection reporting requirements. Residential patient mental health care cluster Independent Hospital Pricing Authority, Standard 15/10/2014 DSS specific attributes + Conditional obligation: Reporting of HoNOSCA at admission and separation is mandatory for residential mental health care services that are included in the General list of in-scope public hospital services, which have been developed under the National Health Reform Agreement (2011). Reporting is optional for episodes of residential mental health care provided by government-funded, non-government operated services. The HoNOSCA should only be reported for patients aged 17 years and under.
Implementation in Indicators:	Used as Numerator KPIs for Australian Public Mental Health Services: PI 01J – Change in consumer's clinical outcomes, 2015 Health, Superseded 11/05/2016 KPIs for Australian Public Mental Health Services: PI 01J – Change in consumer's clinical outcomes, 2016 Health, Superseded 14/06/2017

Person—level of psychiatric symptom severity, Health of the Nation Outcome Scale for Children and Adolescents score code N

Identifying and definitional attributes

Value domain attributes

Representational attributes

Collection and usage attributes

Source and reference attributes

Data element attributes

Source and reference attributes

Relational attributes

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Person—level of psychiatric symptom severity, Health of the Nation Outcome Scale for Children and Adolescents score code N

Data Element Attributes

Identifying and definitional attributes

Value domain attributes

Representational attributes

Collection and usage attributes

Source and reference attributes

Data element attributes

Source and reference attributes

Relational attributes

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