Health of the Nation Outcome Scale 65+

Identifying and definitional attributes

Metadata item type:Glossary Item
Synonymous names:HoNOS65+
METeOR identifier:730842
Registration status:Health, Standard 23/12/2020

An assessment of psychiatric symptoms and psychosocial functioning in an older patient.


Health of the Nation Outcome Scale 65+ (HoNOS 65+) is a clinical assessment tool used by mental health professionals to evaluate psychiatric symptoms and psychosocial functioning in an older patient.

Collection and usage attributes

Guide for use:

HoNOS 65+ is designed to be used by clinicians before and after interventions, so that changes attributable to interventions can be measured.


Twelve scales are used to rate older mental health service users. The scales include:

  • Behavioural disturbance
  • Non-accidental self injury
  • Problem drinking or drug use
  • Cognitive problems
  • Problems related to physical illness or disability
  • Problems associated with hallucinations and delusions
  • Problems associated with depressive symptoms
  • Other mental and behavioural problems
  • Problems with social or supportive relationships
  • Problems with activities of daily living
  • Overall problems with living conditions
  • Problems with work and leisure activities and the quality of the day time environment

Together, the scales rate various aspects of mental and social health, each on a scale of 0 to 4.

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

A HoNOS 65+ total score (the sum of each individual scale item) will be a value between 0 and 48.

Source and reference attributes

Submitting organisation:

Independent Hospital Pricing Authority


Health of the Nation Outcome Scales (HoNOS) © Royal College of Psychiatrists 1996.

Reference documents:

The Royal College of Psychiatrists 2019. HoNOS 65+ (Older Adults). The Royal College of Psychiatrists, London. Viewed 14 July 2020,

Relational attributes

Related metadata references:

Supersedes Health of the Nation Outcome Scale 65+ Health, Superseded 23/12/2020

Metadata items which use this glossary item:

Activity based funding: Mental health care NBEDS 2021–22 Health, Standard 23/12/2020

Person—level of psychiatric symptom severity, Health of the Nation Outcome Scale 65+ score code N Health, Standard 23/12/2020