The meagre outcomes of HoNOS.

OBJECTIVE: To ask the Leginski question of an outcome measurement process. METHOD: Articles elicited by a literature search of 'HoNOS' are analysed for evidence of its value or cost effectiveness to consumers, clinicians or administrators. RESULTS: None of the 260 studies elicited by the search attempted to assess the cost of the use of Health of the Nation Outcome Scale (HoNOS). One study investigated the effect of routine outcome measurement, finding that it failed to result in the provision of evidence-based care. One study reported positive outcomes. CONCLUSIONS: The ability of HoNOS to improve the health and social functioning of mentally ill people has not been demonstrated. The widespread use of HoNOS as a routine outcome measure is not justified by the evidence.

Development of a psychiatric liaison service in Rawalpindi, Pakistan.

The paper reports a descriptive survey of the referrals received by a new psychiatric liaison service in Rawalpindi in the first 2 years. The survey showed a rapid increase in use of the service, particularly by the emergency department. There was a lower proportion of referrals for self-harm and substance misuse than occurs in similar services in high-income countries but a higher proportion of patients presenting with dissociative (conversion) disorders. The large proportion of patients who had abnormal findings on physical examination remains unexplained and warrants further investigation.