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Name
Health of the Nation Outcome Scale
Description
Clinical score based on 12 simple scales on which service users with severe mental illness are rated by clinical staff.
Comment
Also known as the HoNOS.
Keywords
HoNOS assessment score mental health health of the nation index
Purpose
Records the Health of the Nation Outcome Scale score as a simple, repeatable method to document the service user's health or social status at a specific point in time, say at the start or end of an episode of care, after a course of treatment or some other intervention.
Use
The use of HoNOS is recommended by the English National Service Framework for Mental Health and by the working group to the Department of Health on outcome indicators for severe mental illnesses.
HoNOS is the most widely used routine clinical outcome measure used by English mental health services.

The 12 scales that are scored are:
1. Overactive, aggressive, disruptive or agitated behaviour
2. Non-accidental self-injury
3. Problem drinking or drug-taking
4. Cognitive problems
5. Physical illness or disability problems
6. Problems associated with hallucinations and delusions
7. Problems with depressed mood
8. Other mental and behavioural problems
9. Problems with relationships
10. Problems with activities of daily living
11. Problems with living conditions
12. Problems with occupation and activities

All scales follow the format:
0 = No problem
1 = Minor problem requiring no action
2 = Mild problem but definitely present
3 = Moderately severe problem
4 = Severe to very severe problem

Each scale is rated in order from 1 to 12. Do not include information rated in an earlier item except for item 10 which is an overall rating. The rating is made on the basis of all information available to the rater (whatever the source) and is based on the most severe problem that occurred during the period rated (usually the two weeks leading up to the point of rating).

The HoNOS system is not a standardised clinical assessment and cannot be a substitute for one.

The minimum required is that a rating is made at the start of each episode of care and at the end. Most services using HoNOS also require ratings at any regular review (like the English Care Programme Approach review), when there is a major change in the patient's status (for instance, an admission to or discharge from hospital) HoNOS Score is a copyrighted assessment score: Health of the Nation Outcome Scales (HoNOS) © Royal College of Psychiatrists 1996.
Please note, from RACP copyright guidance:
- "The RCPsych allows without express permission the free use, copy and reproduction of HoNOS scoresheets for use in NHS-funded care. Use, copy or reproduction of HoNOS scoresheets for any other purpose should be with the explicit permission of the RCPsych."
- "The RCPsych allows without express permission NHS organisations and other providers of NHS funded care to include HoNOS scoresheets in electronic healthcare records and other computerised clinical systems."
(http://www.rcpsych.ac.uk/traininpsychiatry/conferencestraining/resources/honos/copyright.aspx)and, for long episodes of care, at every 6 months or so.
Misuse
Users of the HoNOS Score archetype must ensure that they comply with the terms of use of the Royal College of Psychiatrists who own the copyright as per http://www.rcpsych.ac.uk/traininpsychiatry/conferencestraining/resources/honos/copyright.aspx. It should not be used outside the terms of the copyright.
References
http://www.rcpsych.ac.uk/traininpsychiatry/conferencestraining/resources/honos/whatishonos.aspx.
http://www.rcpsych.ac.uk/traininpsychiatry/conferencestraining/resources/honos/generalinformation/faq.aspx.
Archetype Id
openEHR-EHR-OBSERVATION.honos.v0
Copyright
© openEHR Foundation
Licencing
This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/.
Original Author
Kate Bryan
Stalis Ltd
Date Originally Authored
Records the Health of the Nation Outcome Scale score as a simple, repeatable method to document the service user's health or social status at a specific point in time, say at the start or end of an episode of care, after a course of treatment or some other intervention.
Name Card Type Description
Overactive, aggressive, disruptive or agitated behaviour
0..1 DV_ORDINAL Observation of the service user's behaviour.
Constraint for DV_ORDINAL
  • 0 : No problem
  • 1 : Minor problem requiring no action
  • 2 : Mild problem but definitely present
  • 3 : Moderately severe problem.
  • 4 : Severe to very severe problem
Non-accidental self-injury
0..1 DV_ORDINAL Observation of any non-accidental self-injuries.
Constraint for DV_ORDINAL
  • 0 : No problem
  • 1 : Minor problem requiring no action
  • 2 : Mild problem but definitely present
  • 3 : Moderately severe problem
  • 4 : Severe to very severe problem
Problem drinking or drug-taking
0..1 DV_ORDINAL Problem drinking or drug-taking.
Constraint for DV_ORDINAL
  • 0 : No problem
  • 1 : Minor problem requiring no action
  • 2 : Mild problem but definitely present
  • 3 : Moderately severe problem.
  • 4 : Severe to very severe problem
Cognitive problems
0..1 DV_ORDINAL Cognitive problems.
Constraint for DV_ORDINAL
  • 0 : No problem
  • 1 : Minor problem requiring no action
  • 2 : Mild problem but definitely present
  • 3 : Moderately severe problem.
  • 4 : Severe to very severe problem
Physical illness or disability problems
0..1 DV_ORDINAL Physical illness or disability problems.
Constraint for DV_ORDINAL
  • 0 : No problem
  • 1 : Minor problem requiring no action
  • 2 : Mild problem but definitely present
  • 3 : Moderately severe problem.
  • 4 : Severe to very severe problem
Problems associated with hallucinations and delusions
0..1 DV_ORDINAL Problems associated with hallucinations and delusions.
Constraint for DV_ORDINAL
  • 0 : No problem
  • 1 : Minor problem requiring no action
  • 2 : Mild problem but definitely present
  • 3 : Moderately severe problem.
  • 4 : Severe to very severe problem
Problems with depressed mood
0..1 DV_ORDINAL Problems with depressed mood.
Constraint for DV_ORDINAL
  • 0 : No problem
  • 1 : Minor problem requiring no action
  • 2 : Mild problem but definitely present
  • 3 : Moderately severe problem.
  • 4 : Severe to very severe problem
Other mental and behavioural problems
0..1 DV_ORDINAL Other mental and behavioural problems.
Constraint for DV_ORDINAL
  • 0 : No problem
  • 1 : Minor problem requiring no action
  • 2 : Mild problem but definitely present
  • 3 : Moderately severe problem.
  • 4 : Severe to very severe problem
Problems with relationships
0..1 DV_ORDINAL Problems with relationships.
Constraint for DV_ORDINAL
  • 0 : No problem
  • 1 : Minor problem requiring no action
  • 2 : Mild problem but definitely present
  • 3 : Moderately severe problem.
  • 4 : Severe to very severe problem
Problems with activities of daily living
0..1 DV_ORDINAL Problems with activities of daily living.
Constraint for DV_ORDINAL
  • 0 : No problem
  • 1 : Minor problem requiring no action
  • 2 : Mild problem but definitely present
  • 3 : Moderately severe problem.
  • 4 : Severe to very severe problem
Problems with living conditions
0..1 DV_ORDINAL Problems with living conditions.
Constraint for DV_ORDINAL
  • 0 : No problem
  • 1 : Minor problem requiring no action
  • 2 : Mild problem but definitely present
  • 3 : Moderately severe problem.
  • 4 : Severe to very severe problem
Problems with occupation and activities
0..1 DV_ORDINAL Problems with occupation and activities.
Constraint for DV_ORDINAL
  • 0 : No problem
  • 1 : Minor problem requiring no action
  • 2 : Mild problem but definitely present
  • 3 : Moderately severe problem.
  • 4 : Severe to very severe problem 
archetype (adl_version=1.4; uid=0bc353a0-345f-4b4c-8f4e-f39c4e925a53)
	openEHR-EHR-OBSERVATION.honos.v0

concept
	[at0000]	-- Health of the Nation Outcome Scale
language
	original_language = <[ISO_639-1::en]>
description
	original_author = <
		["name"] = <"Kate Bryan">
		["organisation"] = <"Stalis Ltd">
		["email"] = <"kate.b@stalis.com">
		["date"] = <"2015-11-13">
	>
	details = <
		["en"] = <
			language = <[ISO_639-1::en]>
			purpose = <"Records the Health of the Nation Outcome Scale score as a simple, repeatable method to document the service user's health or social status at a specific point in time, say at the start or end of an episode of care, after a course of treatment or some other intervention.">
			use = <"The use of HoNOS is recommended by the English National Service Framework for Mental Health and by the working group to the Department of Health on outcome indicators for severe mental illnesses.
HoNOS is the most widely used routine clinical outcome measure used by English mental health services.

The 12 scales that are scored are:
1. Overactive, aggressive, disruptive or agitated behaviour
2. Non-accidental self-injury
3. Problem drinking or drug-taking
4. Cognitive problems
5. Physical illness or disability problems
6. Problems associated with hallucinations and delusions
7. Problems with depressed mood
8. Other mental and behavioural problems
9. Problems with relationships
10. Problems with activities of daily living
11. Problems with living conditions
12. Problems with occupation and activities

All scales follow the format:
0 = No problem
1 = Minor problem requiring no action
2 = Mild problem but definitely present
3 = Moderately severe problem
4 = Severe to very severe problem 

Each scale is rated in order from 1 to 12. Do not include information rated in an earlier item except for item 10 which is an overall rating. The rating is made on the basis of all information available to the rater (whatever the source) and is based on the most severe problem that occurred during the period rated (usually the two weeks leading up to the point of rating).

The HoNOS system is not a standardised clinical assessment and cannot be a substitute for one.

The minimum required is that a rating is made at the start of each episode of care and at the end. Most services using HoNOS also require ratings at any regular review (like the English Care Programme Approach review), when there is a major change in the patient's status (for instance, an admission to or discharge from hospital) HoNOS Score is a copyrighted assessment score: Health of the Nation Outcome Scales (HoNOS) © Royal College of Psychiatrists 1996.
Please note, from RACP copyright guidance: 
- \"The RCPsych allows without express permission the free use, copy and reproduction of HoNOS scoresheets for use in NHS-funded care. Use, copy or reproduction of HoNOS scoresheets for any other purpose should be with the explicit permission of the RCPsych.\"
- \"The RCPsych allows without express permission NHS organisations and other providers of NHS funded care to include HoNOS scoresheets in electronic healthcare records and other computerised clinical systems.\"
 (http://www.rcpsych.ac.uk/traininpsychiatry/conferencestraining/resources/honos/copyright.aspx)and, for long episodes of care, at every 6 months or so.">
			keywords = <"HoNOS", "assessment", "score", "mental health", "health of the nation", "index">
			misuse = <"Users of the HoNOS Score archetype must ensure that they comply with the terms of use of the Royal College of Psychiatrists who own the copyright as per http://www.rcpsych.ac.uk/traininpsychiatry/conferencestraining/resources/honos/copyright.aspx. It should not be used outside the terms of the copyright.">
			copyright = <"© openEHR Foundation">
		>
	>
	lifecycle_state = <"in_development">
	other_contributors = <>
	other_details = <
		["licence"] = <"This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/.">
		["custodian_organisation"] = <"openEHR Foundation">
		["references"] = <"http://www.rcpsych.ac.uk/traininpsychiatry/conferencestraining/resources/honos/whatishonos.aspx.

http://www.rcpsych.ac.uk/traininpsychiatry/conferencestraining/resources/honos/generalinformation/faq.aspx.">
		["original_namespace"] = <"org.openehr">
		["original_publisher"] = <"openEHR Foundation">
		["custodian_namespace"] = <"org.openehr">
		["MD5-CAM-1.0.1"] = <"1D0C91F9815F9FD99F6C950F9552B828">
		["build_uid"] = <"ad71093a-ce36-4661-bf4d-9b3f640499c1">
		["revision"] = <"0.0.1-alpha">
	>

definition
	OBSERVATION[at0000] matches {	-- Health of the Nation Outcome Scale
		data matches {
			HISTORY[at0001] matches {	-- Event Series
				events cardinality matches {1..*; unordered} matches {
					POINT_EVENT[at0076] occurrences matches {0..1} matches {	-- Start of episode of care
						data matches {
							ITEM_TREE[at0003] matches {	-- Tree
								items cardinality matches {0..*; unordered} matches {
									ELEMENT[at0004] occurrences matches {0..1} matches {	-- Overactive, aggressive, disruptive or agitated behaviour
										value matches {
											0|[local::at0005], 	-- No problem
											1|[local::at0006], 	-- Minor problem requiring no action
											2|[local::at0007], 	-- Mild problem but definitely present
											3|[local::at0008], 	-- Moderately severe problem.
											4|[local::at0009]  	-- Severe to very severe problem
										}
									}
									ELEMENT[at0010] occurrences matches {0..1} matches {	-- Non-accidental self-injury
										value matches {
											0|[local::at0011], 	-- No problem
											1|[local::at0012], 	-- Minor problem requiring no action
											2|[local::at0013], 	-- Mild problem but definitely present
											3|[local::at0054], 	-- Moderately severe problem
											4|[local::at0055]  	-- Severe to very severe problem
										}
									}
									ELEMENT[at0014] occurrences matches {0..1} matches {	-- Problem drinking or drug-taking
										value matches {
											0|[local::at0024], 	-- No problem
											1|[local::at0034], 	-- Minor problem requiring no action
											2|[local::at0044], 	-- Mild problem but definitely present
											3|[local::at0056], 	-- Moderately severe problem.
											4|[local::at0066]  	-- Severe to very severe problem
										}
									}
									ELEMENT[at0015] occurrences matches {0..1} matches {	-- Cognitive problems
										value matches {
											0|[local::at0025], 	-- No problem
											1|[local::at0035], 	-- Minor problem requiring no action
											2|[local::at0045], 	-- Mild problem but definitely present
											3|[local::at0057], 	-- Moderately severe problem.
											4|[local::at0067]  	-- Severe to very severe problem
										}
									}
									ELEMENT[at0016] occurrences matches {0..1} matches {	-- Physical illness or disability problems
										value matches {
											0|[local::at0026], 	-- No problem
											1|[local::at0036], 	-- Minor problem requiring no action
											2|[local::at0046], 	-- Mild problem but definitely present
											3|[local::at0058], 	-- Moderately severe problem.
											4|[local::at0068]  	-- Severe to very severe problem
										}
									}
									ELEMENT[at0017] occurrences matches {0..1} matches {	-- Problems associated with hallucinations and delusions
										value matches {
											0|[local::at0027], 	-- No problem
											1|[local::at0037], 	-- Minor problem requiring no action
											2|[local::at0047], 	-- Mild problem but definitely present
											3|[local::at0059], 	-- Moderately severe problem.
											4|[local::at0069]  	-- Severe to very severe problem
										}
									}
									ELEMENT[at0018] occurrences matches {0..1} matches {	-- Problems with depressed mood
										value matches {
											0|[local::at0028], 	-- No problem
											1|[local::at0038], 	-- Minor problem requiring no action
											2|[local::at0048], 	-- Mild problem but definitely present
											3|[local::at0060], 	-- Moderately severe problem.
											4|[local::at0070]  	-- Severe to very severe problem
										}
									}
									ELEMENT[at0019] occurrences matches {0..1} matches {	-- Other mental and behavioural problems
										value matches {
											0|[local::at0029], 	-- No problem
											1|[local::at0039], 	-- Minor problem requiring no action
											2|[local::at0049], 	-- Mild problem but definitely present
											3|[local::at0061], 	-- Moderately severe problem.
											4|[local::at0071]  	-- Severe to very severe problem
										}
									}
									ELEMENT[at0020] occurrences matches {0..1} matches {	-- Problems with relationships
										value matches {
											0|[local::at0030], 	-- No problem
											1|[local::at0040], 	-- Minor problem requiring no action
											2|[local::at0050], 	-- Mild problem but definitely present
											3|[local::at0062], 	-- Moderately severe problem.
											4|[local::at0072]  	-- Severe to very severe problem
										}
									}
									ELEMENT[at0021] occurrences matches {0..1} matches {	-- Problems with activities of daily living
										value matches {
											0|[local::at0031], 	-- No problem
											1|[local::at0041], 	-- Minor problem requiring no action
											2|[local::at0051], 	-- Mild problem but definitely present
											3|[local::at0063], 	-- Moderately severe problem.
											4|[local::at0073]  	-- Severe to very severe problem
										}
									}
									ELEMENT[at0022] occurrences matches {0..1} matches {	-- Problems with living conditions
										value matches {
											0|[local::at0032], 	-- No problem
											1|[local::at0042], 	-- Minor problem requiring no action
											2|[local::at0052], 	-- Mild problem but definitely present
											3|[local::at0064], 	-- Moderately severe problem.
											4|[local::at0074]  	-- Severe to very severe problem
										}
									}
									ELEMENT[at0023] occurrences matches {0..1} matches {	-- Problems with occupation and activities
										value matches {
											0|[local::at0033], 	-- No problem
											1|[local::at0043], 	-- Minor problem requiring no action
											2|[local::at0053], 	-- Mild problem but definitely present
											3|[local::at0065], 	-- Moderately severe problem.
											4|[local::at0075]  	-- Severe to very severe problem
										}
									}
								}
							}
						}
					}
					POINT_EVENT[at0077] occurrences matches {0..1} matches {	-- End of episode of care
						data matches {
							use_node ITEM_TREE /data[at0001]/events[at0076]/data[at0003]	-- /data[Event Series]/events[Start of episode of care]/data[Tree]
						}
					}
					EVENT[at0002] occurrences matches {0..*} matches {	-- Any event
						data matches {
							use_node ITEM_TREE /data[at0001]/events[at0076]/data[at0003]	-- /data[Event Series]/events[Start of episode of care]/data[Tree]
						}
					}
				}
			}
		}
	}


ontology
	term_definitions = <
		["en"] = <
			items = <
				["at0000"] = <
					text = <"Health of the Nation Outcome Scale">
					description = <"Clinical score based on 12 simple scales on which service users with severe mental illness are rated by clinical staff.">
					comment = <"Also known as the HoNOS.">
				>
				["at0001"] = <
					text = <"Event Series">
					description = <"@ internal @">
				>
				["at0002"] = <
					text = <"Any event">
					description = <"Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.">
				>
				["at0003"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0004"] = <
					text = <"Overactive, aggressive, disruptive or agitated behaviour">
					description = <"Observation of the service user's behaviour.">
				>
				["at0005"] = <
					text = <"No problem">
					description = <"No problem.">
				>
				["at0006"] = <
					text = <"Minor problem requiring no action">
					description = <"Minor problem requiring no action.">
				>
				["at0007"] = <
					text = <"Mild problem but definitely present">
					description = <"Mild problem but definitely present.">
				>
				["at0008"] = <
					text = <"Moderately severe problem.">
					description = <"moderately severe problem.">
				>
				["at0009"] = <
					text = <"Severe to very severe problem">
					description = <"Severe to very severe problem.">
				>
				["at0010"] = <
					text = <"Non-accidental self-injury">
					description = <"Observation of any non-accidental self-injuries.">
				>
				["at0011"] = <
					text = <"No problem">
					description = <"No problem.">
				>
				["at0012"] = <
					text = <"Minor problem requiring no action">
					description = <"Minor problem requiring no action.">
				>
				["at0013"] = <
					text = <"Mild problem but definitely present">
					description = <"Mild problem but definitely present.">
				>
				["at0014"] = <
					text = <"Problem drinking or drug-taking">
					description = <"Problem drinking or drug-taking.">
				>
				["at0015"] = <
					text = <"Cognitive problems">
					description = <"Cognitive problems.">
				>
				["at0016"] = <
					text = <"Physical illness or disability problems">
					description = <"Physical illness or disability problems.">
				>
				["at0017"] = <
					text = <"Problems associated with hallucinations and delusions">
					description = <"Problems associated with hallucinations and delusions.">
				>
				["at0018"] = <
					text = <"Problems with depressed mood">
					description = <"Problems with depressed mood.">
				>
				["at0019"] = <
					text = <"Other mental and behavioural problems">
					description = <"Other mental and behavioural problems.">
				>
				["at0020"] = <
					text = <"Problems with relationships">
					description = <"Problems with relationships.">
				>
				["at0021"] = <
					text = <"Problems with activities of daily living">
					description = <"Problems with activities of daily living.">
				>
				["at0022"] = <
					text = <"Problems with living conditions">
					description = <"Problems with living conditions.">
				>
				["at0023"] = <
					text = <"Problems with occupation and activities">
					description = <"Problems with occupation and activities.">
				>
				["at0024"] = <
					text = <"No problem">
					description = <"No problem.">
				>
				["at0025"] = <
					text = <"No problem">
					description = <"No problem.">
				>
				["at0026"] = <
					text = <"No problem">
					description = <"No problem.">
				>
				["at0027"] = <
					text = <"No problem">
					description = <"No problem.">
				>
				["at0028"] = <
					text = <"No problem">
					description = <"No problem.">
				>
				["at0029"] = <
					text = <"No problem">
					description = <"No problem.">
				>
				["at0030"] = <
					text = <"No problem">
					description = <"No problem.">
				>
				["at0031"] = <
					text = <"No problem">
					description = <"No problem.">
				>
				["at0032"] = <
					text = <"No problem">
					description = <"No problem.">
				>
				["at0033"] = <
					text = <"No problem">
					description = <"No problem.">
				>
				["at0034"] = <
					text = <"Minor problem requiring no action">
					description = <"Minor problem requiring no action.">
				>
				["at0035"] = <
					text = <"Minor problem requiring no action">
					description = <"Minor problem requiring no action.">
				>
				["at0036"] = <
					text = <"Minor problem requiring no action">
					description = <"Minor problem requiring no action.">
				>
				["at0037"] = <
					text = <"Minor problem requiring no action">
					description = <"Minor problem requiring no action.">
				>
				["at0038"] = <
					text = <"Minor problem requiring no action">
					description = <"Minor problem requiring no action.">
				>
				["at0039"] = <
					text = <"Minor problem requiring no action">
					description = <"Minor problem requiring no action.">
				>
				["at0040"] = <
					text = <"Minor problem requiring no action">
					description = <"Minor problem requiring no action.">
				>
				["at0041"] = <
					text = <"Minor problem requiring no action">
					description = <"Minor problem requiring no action.">
				>
				["at0042"] = <
					text = <"Minor problem requiring no action">
					description = <"Minor problem requiring no action.">
				>
				["at0043"] = <
					text = <"Minor problem requiring no action">
					description = <"Minor problem requiring no action.">
				>
				["at0044"] = <
					text = <"Mild problem but definitely present">
					description = <"Mild problem but definitely present.">
				>
				["at0045"] = <
					text = <"Mild problem but definitely present">
					description = <"Mild problem but definitely present.">
				>
				["at0046"] = <
					text = <"Mild problem but definitely present">
					description = <"Mild problem but definitely present.">
				>
				["at0047"] = <
					text = <"Mild problem but definitely present">
					description = <"Mild problem but definitely present.">
				>
				["at0048"] = <
					text = <"Mild problem but definitely present">
					description = <"Mild problem but definitely present.">
				>
				["at0049"] = <
					text = <"Mild problem but definitely present">
					description = <"Mild problem but definitely present.">
				>
				["at0050"] = <
					text = <"Mild problem but definitely present">
					description = <"Mild problem but definitely present.">
				>
				["at0051"] = <
					text = <"Mild problem but definitely present">
					description = <"Mild problem but definitely present.">
				>
				["at0052"] = <
					text = <"Mild problem but definitely present">
					description = <"Mild problem but definitely present.">
				>
				["at0053"] = <
					text = <"Mild problem but definitely present">
					description = <"Mild problem but definitely present.">
				>
				["at0054"] = <
					text = <"Moderately severe problem">
					description = <"Moderately severe problem.">
				>
				["at0055"] = <
					text = <"Severe to very severe problem">
					description = <"Severe to very severe problem.">
				>
				["at0056"] = <
					text = <"Moderately severe problem.">
					description = <"Moderately severe problem.">
				>
				["at0057"] = <
					text = <"Moderately severe problem.">
					description = <"Moderately severe problem.">
				>
				["at0058"] = <
					text = <"Moderately severe problem.">
					description = <"Moderately severe problem.">
				>
				["at0059"] = <
					text = <"Moderately severe problem.">
					description = <"Moderately severe problem.">
				>
				["at0060"] = <
					text = <"Moderately severe problem.">
					description = <"Moderately severe problem.">
				>
				["at0061"] = <
					text = <"Moderately severe problem.">
					description = <"Moderately severe problem.">
				>
				["at0062"] = <
					text = <"Moderately severe problem.">
					description = <"Moderately severe problem.">
				>
				["at0063"] = <
					text = <"Moderately severe problem.">
					description = <"Moderately severe problem.">
				>
				["at0064"] = <
					text = <"Moderately severe problem.">
					description = <"Moderately severe problem.">
				>
				["at0065"] = <
					text = <"Moderately severe problem.">
					description = <"Moderately severe problem.">
				>
				["at0066"] = <
					text = <"Severe to very severe problem">
					description = <"Severe to very severe problem.">
				>
				["at0067"] = <
					text = <"Severe to very severe problem">
					description = <"Severe to very severe problem.">
				>
				["at0068"] = <
					text = <"Severe to very severe problem">
					description = <"Severe to very severe problem.">
				>
				["at0069"] = <
					text = <"Severe to very severe problem">
					description = <"Severe to very severe problem.">
				>
				["at0070"] = <
					text = <"Severe to very severe problem">
					description = <"Severe to very severe problem.">
				>
				["at0071"] = <
					text = <"Severe to very severe problem">
					description = <"Severe to very severe problem.">
				>
				["at0072"] = <
					text = <"Severe to very severe problem">
					description = <"Severe to very severe problem.">
				>
				["at0073"] = <
					text = <"Severe to very severe problem">
					description = <"Severe to very severe problem.">
				>
				["at0074"] = <
					text = <"Severe to very severe problem">
					description = <"Severe to very severe problem.">
				>
				["at0075"] = <
					text = <"Severe to very severe problem">
					description = <"Severe to very severe problem.">
				>
				["at0076"] = <
					text = <"Start of episode of care">
					description = <"HoNOS score at start of episode of care.">
				>
				["at0077"] = <
					text = <"End of episode of care">
					description = <"HoNOS score at end of episode of care.">
				>
			>
		>
	>