Identification, screening and assessment

Screening tools: Mental health

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HoNOSCA - Health of the Nation Outcome Scales for Children and Adolescents

An assessment and outcome measurement tool intended to be used routinely to score the behaviour, impairments, symptoms and social functioning of children and young people with mental health problems.

Section A – re child

  1. Disruptive, anti-social or aggressive behaviour
  2. Over-activity, attention and concentration
  3. Non-accidental self-injury
  4. Alcohol, drug, solvent misuse
  5. Scholastic or language skills
  6. Physical illness or disability
  7. Hallucinations and delusions
  8. Non-organic somatic symptoms
  9. Emotional and related symptoms
  10. Peer relationships
  11. Self-care and independence
  12. Family life and relationships
  13. Poor school attendance

Section B - re access to services

  1. Lack of knowledge – about nature of difficulties
  2. Lack of information – about services and/or management

Description of tool
A 15-item questionnaire, to be completed by practitioner, to indicate severity of each problem, on scale of 0-4. 13 items relate to child and 2 relate to parental access to services. Child and parent self-rate versions are also available, each as a single A4 sheet.

Time to administer
10 minutes

Has tool been validated?
The tools have a reasonable level of validity although some divergence in view has been observed between self rating and practitioner views. Practitioner and parent tool for ages 5-18. Self-rate tool for ages 13-18.

Should be delivered by a health specialist.

Comments and how to access tool
Free to download from the University of Liverpool HoNOSCA website.

An instructional video and other materials can be purchased – follow the link from the web page, above.

The tool screens for severity of difficulty (need) in each area and, when repeated, indicates any change in severity (outcome). It should not be used as a risk assessment tool. It includes some questions about language skills and physical illness.

Gowers, S.G., Harrington, R.C., Whitton, A., Lelliott, P., Wing, J., Beevor, A. and Jezzard, R. (1999a) A Brief Scale for measuring the outcomes of emotional and behavioural disorders in children: HoNOSCA. British Journal of Psychiatry, 174, 413-416.

SQIfA - Screening Questionnaire Interview for Adolescents (Mental Health)

The questions cover:

  • ADHD
  • Psychosis
  • Risk of suicide and self harm
  • Depression
  • Drug and alcohol use
  • Traumatic experiences
  • Anxiety and excessive worries.

Description of tool
A sheet with 15 questions to be answered (yes/no) by the young person, and 4 questions answered by the interviewer, based on their observation or knowledge held by others.

Time to administer
10 – 20 minutes

Has tool been validated?

Does not need to be delivered by a health specialist.

Comments and how to access tool
Does not cover learning disability or speech, language and communication needs.

SDQ - Strengths and Difficulties Questionnaire

The questions screen for:

  • Emotional symptoms
  • Conduct problems
  • Hyperactivity/inattention
  • Peer relationship problems
  • Pro-social behaviour.

Description of tool
A4 questionnaire with 25 items about behaviour (choose response true, not true, partially true).

Different versions for young person, parent and teacher to complete

Time to administer
10 – 15 minutes

Has tool been validated?
Self-report validated for young people aged 11-17.

Parent and teacher form validated for scoring for children aged 4-16.

No specialist training required.

Comments and how to access tool
Available in over 70 languages.

Repeating the tool can indicate whether improvement occurs over time. A follow-up version asks if the intervention has reduced problems and helped in other ways.

Used increasingly by child and adolescent mental health service (CAMHS) and for children looked after by the local authority.

MAYSI-2 Massachusetts Youth Screening Instrument – Second version

The tool covers 7 areas:

  • Alcohol/drug use
  • Angry-irritable
  • Depressed-anxious
  • Somatic complaints
  • Suicide ideation
  • Thought disturbance
  • Traumatic experiences.

Description of tool
52-item questionnaire (yes/no response), covering the 7 areas.

Time to administer
15 minutes

Has tool been validated?
Validated for age 12- 17.

No specialist training required.

Comments and how to access tool
A tool from the USA.

For purchase (nominal amount).

Initially used in custody and now also used at first point of entry to the youth justice system (YJS).

Each scale has 2 suggested cut-off scores:

  • warning – indicating high risk (above 90% of norm)
  • caution – indicating clinically-significant symptoms.

Grisso, T. and Barnum, R. (2006) Massachusetts Youth Screening Instrument-Version 2: User's Manual and Technical Report. Sarasota, FL: Professional Resource Press.

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