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


Guide for use:
HoNOS65+ is designed to be used by clinicians before and after interventions, so that changes attributable to interventions can be measured.

Health of the Nation Outcome Scale 65+ (HoNOS65+) is a clinical assessment tool used by mental health professionals to evaluate psychiatric symptoms and psychosocial functioning in an older patient.


Copyright in the Health of the Nation Outcome Scales (HoNOS) is owned by the Royal College of Psychiatrists.

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


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 HoNOS65+ total score (the sum of each individual scale item) will be a value between 0 and 48.


The Royal College of Psychiatrists. 1996. HoNOS65+ (Older Adults). The Royal College of Psychiatrists, London. Viewed 19 September 2012,

This content Based on Australian Institute of Health and Welfare material. Attribution provided as required under the AIHW CC-BY licence.

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