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<p>Socioeconomic disadvantage is associated with poor mental health outcomes. However, whether it also influences treatment outcomes is unclear. The objectives of this study were (1) To measure the impact of mental health services on change in Health of the Nation Outcome Scale [HoNOS] scores between service entry and the last available assessment (median follow-up 24 months; IQR 10–49), (2) To examine if minority or indigenous status influenced change in HoNOS scores and (3) To explore associations between neighbourhood-level and individual-level measures of socioeconomic status [SES] and changes in HoNOS scores. Electronic medical records of 246 adult clients (mean age 36.6 years, 55% male) were analysed from four mental health services of Northern Health in Melbourne, Australia. Exploratory factor analysis (KMO = 0.54; Bartlett’s <i>p</i>&lt;.01) identified two individual-level SES measures (individual economic capital and household stability and support). Linear mixed modelling (random intercept) tested associations between individual-level SES and HoNOS, controlling for baseline age, sex, new-consumer status, indigenous status, language and neighbourhood SES indices. Among 246 clients, mean HoNOS scores improved from 11.27 (<i>SE</i> = 0.41) at service entry to 9.95 (<i>SE</i> = 0.43) at last available follow-up (β = -1.32, <i>p</i> &lt; .01). Neither indigenous status nor non-English language predicted change (<i>p</i> &gt; .05), and neighbourhood-level SES indices showed no association with HoNOS scores (<i>p</i> &gt; .05). In contrast, higher individual economic capital (β = -0.63, <i>p</i> &lt; .01) and greater household stability and support (β = -0.85, <i>p</i> &lt; .01) were each independently linked to larger improvements in HoNOS scores. These findings indicate that individual-level socioeconomic factors drive improvements in HoNOS scores during engagement with community mental health services.</p>

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Individual Socioeconomic Measures and Change in HoNOS Scores among Persons Attending Adult Community Mental Health Services

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月11日

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  • Vinay Lakra,
  • Anton Isaacs,
  • Tim Powers,
  • Yang Yun,
  • Lokesh Sekharan,
  • Abel Thamby,
  • Veerappa Patil,
  • Srikanth Srikanth,
  • Madushi Senevirathne,
  • Achini Samaranayake,
  • Rachel Mulroy

摘要

Socioeconomic disadvantage is associated with poor mental health outcomes. However, whether it also influences treatment outcomes is unclear. The objectives of this study were (1) To measure the impact of mental health services on change in Health of the Nation Outcome Scale [HoNOS] scores between service entry and the last available assessment (median follow-up 24 months; IQR 10–49), (2) To examine if minority or indigenous status influenced change in HoNOS scores and (3) To explore associations between neighbourhood-level and individual-level measures of socioeconomic status [SES] and changes in HoNOS scores. Electronic medical records of 246 adult clients (mean age 36.6 years, 55% male) were analysed from four mental health services of Northern Health in Melbourne, Australia. Exploratory factor analysis (KMO = 0.54; Bartlett’s p<.01) identified two individual-level SES measures (individual economic capital and household stability and support). Linear mixed modelling (random intercept) tested associations between individual-level SES and HoNOS, controlling for baseline age, sex, new-consumer status, indigenous status, language and neighbourhood SES indices. Among 246 clients, mean HoNOS scores improved from 11.27 (SE = 0.41) at service entry to 9.95 (SE = 0.43) at last available follow-up (β = -1.32, p < .01). Neither indigenous status nor non-English language predicted change (p > .05), and neighbourhood-level SES indices showed no association with HoNOS scores (p > .05). In contrast, higher individual economic capital (β = -0.63, p < .01) and greater household stability and support (β = -0.85, p < .01) were each independently linked to larger improvements in HoNOS scores. These findings indicate that individual-level socioeconomic factors drive improvements in HoNOS scores during engagement with community mental health services.