Where HoNOS comes from
HoNOS was developed in the 1990s by the Royal College of Psychiatrists in the United Kingdom to measure outcomes in mental health services. It was designed to be quick, so busy clinicians could complete it as part of normal care.
In Australia it is part of the Mental Health National Outcomes and Casemix Collection, the set of measures public mental health services collect. That means many people who have used public mental health services already have HoNOS ratings in their records.
The 12 items
The scales cover four broad areas. Each item asks the clinician to rate the most severe problem in the period being rated, usually the past two weeks.
- Behaviour: overactive or aggressive behaviour, self harm, problem drinking or drug use
- Impairment: problems with memory and thinking, physical illness or disability
- Symptoms: hallucinations and delusions, depressed mood, other mental health symptoms such as anxiety
- Social functioning: relationships, activities of daily living, living conditions, and work, study or leisure activities
How it is scored
Each item is scored from 0 to 4, where 0 means no problem and 4 means a severe to very severe problem. The total ranges from 0 to 48, and higher scores mean more difficulty. Clinicians use a glossary that describes each point on the scale, so different raters reach similar scores.
There are versions for different age groups: HoNOSCA for children and adolescents, and HoNOS 65+ for older adults. Your clinician will use the one that fits your age.
How the NDIA uses HoNOS
For psychosocial disability, the NDIA asks for evidence from a treating health professional, plus a functional assessment. Its preferred tools, in order, are the LSP-16, HoNOS and the WHODAS 2.0.
HoNOS mixes symptoms with function, so it works best when the report also explains in plain words how the ratings show up in your life: what you cannot do on a bad day, what help you need, and how often. Repeat HoNOS ratings can also show change over time at a plan reassessment.
Who can complete it
HoNOS is completed by a clinician, not by you. It is commonly rated by psychiatrists, mental health nurses, psychologists, occupational therapists and social workers in mental health services. The NDIA also accepts evidence from mental health staff trained through the Australian Mental Health Outcomes and Classification Network.
If you are already a participant, a functional assessment that includes HoNOS is usually paid from your Capacity Building budget. Psychology has a 2026/27 price limit of $252.99 an hour and occupational therapy $193.99 an hour in most of Australia. If you see a public mental health service, ask whether a recent HoNOS rating is already on file.
Tips for a useful HoNOS
- Ask a clinician who knows you well and has seen you over time
- Tell them about hard periods, not just how you are on the day
- Mention help from family that hides your difficulties, such as reminders, cooking or cleaning
- Ask for the ratings to be explained in the report
- Keep a copy so you can compare at your next reassessment