Aims – To clarify the acceptability, reliability and factorial validity of a new Italian version of the HoNOS called HoNOS-Rome. Its main innovations are both in design and in contents. Methods – Face validity was assessed by surveying 3 focus groups. Reliability was assessed in 8 different pairs of raters on a sample of 24 patients; construct validity was analysed by factor analysis using a sample of 187 patients at 6 day centres. Acceptability was investigated by means an anonymous questionnaire filled by professionals that were using the instrument. Results – Time of completion was low (range 4–12 minutes), the tool proved very acceptable and the reliability was good (weighted kappa ≥ 0.71 for all items). Factor analysis was consistent with the division of HoNOS–Rome into four sensible factors accounting for 52% of the total variance. Conclusions – The findings indicate that HoNOS–Rome has a satisfactory degree of acceptability, construct validity and reliability, and may promote the routine evaluation of outcomes in mental health services.

Declaration of Interest: the authors declare that the study was supported by grant no. 96/Q/T41 of the Italian National Mental Health Project – Istituto Superiore di Sanità – Sub-project: Development and validation of tools for outcome evaluation of mental health services, Italy (Professor P. Morosini).