ABSTRACT
Mental health services engagement in routine outcome measurement has created a demand for a coherent infrastructure. Two clinician instruments for adolescents (HoNOSCA) and adults (HONOS) are used across many countries. However, the increasing emphasis on youth suggests protocols with historically driven age divisions may obscure outcomes. The current study examines these instruments' congruence with regard to youth mental health. Members of national mental health expert panels rated four vignettes before discussing perceived strengths and weaknesses. The instruments were strongly correlated and HoNOSCA resulted in more severe symptom scores. Most subscales and scales correlated as predicted with some important exceptions. 'Problems with family relationships', tracked by HoNOSCA, did not correlate with its HoNOS counterpart. Qualitative feedback indicated using the HoNOSCA scale 'School attendance' for vocational attendance would improve its applicability to young people. The instruments have a strong relationship. While either could be used, HoNOS will underestimate symptom severity in youth. The importance of family relationships for young people suggests that HoNOSCA is preferable. While sited in the Australian context, these findings should be applicable to other countries using these instruments, and should interest services considering the continuity of youth presentations and their outcomes.