Routine clinical outcome measures for patients with severe mental illness: CANSAS and HoNOS

Background Two recently developed measures intended for clinical use are HoNOS (Health of the Nation Outcome Scales), measuring social functioning. and CANSAS (Camberwell Assessment of Need Short Appraisal Schedule), for measuring need. Aims We investigated the association between CANSAS and HoNOS. Results For some domains there were substantial associations, with high HoNOS rating correlated with CANSAS rating of the presence of a need. For other areas the agreement was less than might be expected. Seven factors were identified within the 22 CANSAS domains, and the presence of needs in the Drug/alcohol and Activities of daily living factors was associated with high scores in the related HoNOS domains. Conclusions CANSAS and HoNOS assessments differ. HoNOS can track changes in social functioning over time, but may be less useful for treatment planning, and should not be used to infer the level of morbidity in a case-load. CANSAS indicates when treatment should be commenced or continued; it can also be used as a-case-load measure, but may be insufficiently sensitive to be used as an outcome measure at the individual level. Declaration of interest Of the two studies on which this investigation was based, Study I was funded by the Department of Health, and Study 2 was funded by Croydon Health Authority.