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Discharge from public community mental health services has proven difficult for mental health workers and managers. Mental illness can often be long term, with ongoing disability, requiring a need for corresponding long-term care. Community mental health services are now becoming recovery focused and are recognising the need for alternative management arrangements for individuals with long-term care needs. There are, however few tools to assist in the decision making about discharge or transfer of care between community mental health teams. This article describes a quality improvement project to develop a flag for mental health workers to prompt decisions regarding discharge and transfer using the Health of the Nation Outcome Scales (HoNOS). Relevant literature and HoNOS data collected as part of routine clinical practice were reviewed to develop the flag. The implementation process is described along with plans for future developments.

The use of the Health of the Nation Outcome Scales (HoNOS) to inform discharge and transfer decisions in community mental health services