Further reliability and validity studies of a procedure to assess the needs for care of the chronically mentally ill

1994 ◽  
Vol 24 (1) ◽  
pp. 215-222 ◽  
Author(s):  
I. Van Haaster ◽  
A. D. Lesage ◽  
M. Cyr ◽  
J. Toupin
Keyword(s):  
Mentally Ill ◽  
Cultural Context ◽  
Reliability And Validity ◽  
Practical Experience ◽  
Needs For Care ◽  
Severely Mentally Ill ◽  
Care Assessment ◽  
Patient Groups ◽  
Validity Studies

SynopsisThe Needs for Care Assessment Schedule (NFCAS; Brewin et al. 1987) is an itemized and systematic procedure that aims to evaluate the needs for care of long-term mentally ill patients. The present study pursues reliability and validity related issues with the NFCAS in a different cultural context applying the procedure to 98 severely mentally ill patients belonging to different patient groups: short-term, long-term, in-patient and out-patient.Inter-rater reliability was found to be excellent. The results suggest that a clinician with little practical experience and adequate training may effectively use the procedure. The assessment of clinical relevance suggested that the procedure is both applicable and pertinent to all the patients in the study. Additional guidelines were developed for its use with long-term in-patients.

Principles and practice of measuring needs in the long-term mentally ill: the MRC Needs for Care Assessment

1987 ◽  
Vol 17 (4) ◽  
pp. 971-981 ◽  
Author(s):  
C. R. Brewin ◽  
J. K. Wing ◽  
S. P. Mangen ◽  
T. S. Brugha ◽  
B. MacCarthy
Keyword(s):  
Social Functioning ◽  
Mentally Ill ◽  
Preliminary Data ◽  
Decision Rules ◽  
Unmet Need ◽  
Reliability And Validity ◽  
Needs For Care ◽  
Care Assessment ◽  
Potential Applications

SynopsisWe report the development of a new procedure for assessing the needs for treatment and care of the long-term mentally ill. This procedure covers 21 areas of clinical and social functioning, and in each of these specifies appropriate interventions. Decision rules are described which permit problems in functioning to be primarily classified as a met need, an unmet need, or as involving no need, and which allow the identification of various secondary needs. We report preliminary data on the reliability and validity of this procedure and discuss its potential applications in the care of the long-term mentally ill.

Counselling the Relatives of the Long-Term Adult Mentally Ill

1989 ◽  
Vol 154 (6) ◽  
pp. 775-782 ◽  
Author(s):  
Liz Kuipers ◽  
Brigid MacCarthy ◽  
Jane Hurry ◽  
Rod Harper ◽  
Alain LeSage
Keyword(s):  
Family Relationships ◽  
Mentally Ill ◽  
Expressed Emotion ◽  
Realistic Model ◽  
Education Session ◽  
Term Care ◽  
Interactive Education ◽  
Severely Mentally Ill ◽  
Group Facilitators

A psychosocial intervention is described geared to the needs of carers of the long-term mentally ill, which is feasible for a busy clinical team to implement: relatives were not selected for the group by patient diagnosis or motivation and little extra staff input was required. An interactive education session at home was followed by a monthly relatives group which aimed to reduce components of expressed emotion (EE) and to alleviate burden. The group facilitators adopted a directive but non-judgemental style, and constructive coping efforts were encouraged. The intervention was effective at reducing EE and improving family relationships. The study offers a realistic model of how to offer support to people providing long-term care for the severely mentally ill.

Can we measure need in the homeless mentally ill? Using the MRC Needs for Care Assessment in hostels for the homeless

1992 ◽  
Vol 22 (4) ◽  
pp. 1027-1034 ◽  
Author(s):  
Lorna I. Hogg ◽  
Max Marshall
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Standardized Assessment ◽  
Rehabilitation Services ◽  
Chronic Mental Illness ◽  
Needs For Care ◽  
Homeless Mentally Ill ◽  
Care Assessment

SynopsisHostels for the homeless contain many who are disabled by chronic mental illness but have little access to rehabilitation services. One approach to solving this problem might be to measure the needs of hostel residents in a standardized way and use this information as a basis for planning interventions. This study attempted to use the MRC Needs for Care Assessment Schedule to measure the needs of 46 mentally ill residents of Oxford hostels. It aimed to determine if a standardized assessment could be used in these difficult settings and if the needs it identified could form a useful basis for planning future interventions. Although it was possible to use the schedule, and although the pattern of need identified appeared broadly to reflect conditions in the hostels, it was not felt that the information produced was of sufficient quality to assist in planning services. The authors postulate that underlying this deficiency is the failure of the schedule to take sufficient account of the views of staff and residents.

scholarly journals A cross-sectional evaluation of a community-orientated mental health service

1995 ◽  
Vol 19 (3) ◽  
pp. 151-154
Author(s):  
Jon Spear ◽  
Andrew Cole ◽  
Jan Scott
Keyword(s):  
Mental Health ◽  
Mentally Ill ◽  
Community Mental Health Services ◽  
Cross Sectional ◽  
Neurotic Disorders ◽  
Community Psychiatric ◽  
Severely Mentally Ill ◽  
Acute Distress ◽  
To Receive

Community mental health services have been criticised for seeing those with minor psychiatric disorders at the expense of those with severe and long-term illness. We report a cross-sectional evaluation of a UK service based entirely within the community. Most patients in contact with the service (66%) had a psychotic disorder or an affective disorder. Patients with greater impairment were likely to receive more intensive treatment. Only 20% of the community psychiatric nurse (CPN) case load focused on acute distress and neurotic disorders. Within this service careful operational planning and maintaining CPNs within the secondary care system appear to be critical factors in achieving the goal of giving priority to the severely mentally ill.

The Cardinal Needs Schedule – a modified version of the MRC Needs for Care Assessment Schedule

1995 ◽  
Vol 25 (3) ◽  
pp. 605-617 ◽  
Author(s):  
M. Marshall ◽  
L. I. Hogg ◽  
D. H. Gath ◽  
A. Lockwood
Keyword(s):  
Social Services ◽  
Care Management ◽  
Social Care ◽  
Community Care ◽  
Reliability And Validity ◽  
Systematic Account ◽  
Needs For Care ◽  
Care Assessment ◽  
Modified Schedule ◽  
Assessment Of Need

SYNOPSISThis paper describes a modified version of the MRC Needs for Care Schedule (the Cardinal Needs Schedule), for measuring needs for psychiatric and social care amongst patients with severe psychiatric disorders. The modified schedule has three new features: (i) it is quick and easy to use; (ii) it takes systematic account of the views of patients and their carers; (iii) it defines and identifies need in a way that is concise and easy to interpret. The paper describes why the three new features were considered necessary, and then gives an overview of the structure of the Cardinal Needs Schedule, together with a description of how the three new features were developed. During a study of social services care management the practicality of the modified schedule was investigated and further data were obtained on the reliability and validity of the standardized approach to measuring need, in domains not previously investigated. Because of its speed and simplicity, the Cardinal Needs Schedule offers a new choice to researchers who wish to use a standardized and practical assessment of need in evaluative studies of community care. Examples of the usage of the modified schedule are given in an Appendix.

Suicidality of Chronic Schizophrenic Patients in Long-Term Community Care

Crisis ◽  
2004 ◽  
Vol 25 (2) ◽  
pp. 54-64 ◽  
Author(s):  
Thomas W. Kallert ◽  
Matthias Leisse ◽  
Peter Winiecki
Keyword(s):  
Suicidal Behavior ◽  
Community Care ◽  
Quality Standard ◽  
Community Services ◽  
Index Hospitalization ◽  
Chronic Schizophrenic ◽  
Needs For Care ◽  
Care Assessment ◽  
Schizophrenic Patients

Summary: In the provision of mental health care for chronic schizophrenic patients, the specific problems and requirements of long-term community care of suicidal behavior is an area of research not yet fully explored. This study focuses on a 4 ½-year prospective assessment of normative and subjective needs for care related to this specific area for a cohort living in the Dresden region (Germany). One significant result of this study shows the constant high level of needs for care in the area of suicidal behavior imposed on community services by 30-40% of this diagnostic group. Furthermore, the study identified a special high-risk subgroup for suicides as well as specific needs for care. This subgroup is characterized by clinical reasons for the index hospitalization (suicidal risk or attempt) as well as by psychopathological features (suicidal thoughts and higher levels of anxiety/depression) 1 month after release from index hospitalization. Four items of care were rated as potentially effective for addressing suicidality in the community setting: clinical assessment, increased supervision or systematic recording of (suicidal) behavior, medication, and a sheltered environment. Because these care measures are provided, the percentage of unmet normative needs for the area of suicidal behavior was rather low. Due to limitations of the instrument used for assessment of normative needs, the Needs for Care Assessment (NFCAS), the care measures most frequently provided do not define a quality standard of community care for this problem. A subjective needs assessment differing from the normative approach has to be integrated in establishing guidelines for effective community care.

A Brief Mental Health Outcome Scale

1995 ◽  
Vol 166 (5) ◽  
pp. 654-659 ◽  
Author(s):  
Steven H. Jones ◽  
Graham Thornicroft ◽  
Michael Coffey ◽  
Graham Dunn
Keyword(s):  
Antipsychotic Medication ◽  
Mentally Ill ◽  
Training Session ◽  
Reliability And Validity ◽  
Support Needs ◽  
Psychiatric Disturbance ◽  
Psychological Disturbance ◽  
Brief Training ◽  
Severely Mentally Ill ◽  
Gaf Scores

BackgroundThe Global Assessment of Functioning (GAF) is a quick and simple measure of overall psychological disturbance. However, there is little research on the reliability and validity of this measure in severely mentally ill populations.MethodMultidisciplinary keyworkers assessed 103 patients at monthly intervals over a 6-month period. Overall GAF scores were obtained, with additional separate ratings for symptoms and disability. These were compared with changes in antipsychotic medication and support needs over the same period.ResultsSatisfactory reliability was obtained for total GAF score and for symptom and disability measures, in spite of raters having only one brief training session. All GAF scores were associated with current support needs of patients. Symptom and disability scores were associated with changes in antipsychotic medication in the previous month. Only symptom score was associated with increases in antipsychotic medication at time of rating.ConclusionAF proved to be a reliable and, within the limits of the indicators used, a valid measure of psychiatric disturbance in our sample of the severely mentally ill. Differences in relationships between the three GAF scores and medication/support needs indicate the usefulness of obtaining all three scores for monitoring levels and type of psychiatric disturbance in this population.

Assertive Community Treatment of the Mentally Ill: Service Model and Effectiveness

2005 ◽  
Vol 13 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Adaobi Udechuku ◽  
James Olver ◽  
Karen Hallam ◽  
Frances Blyth ◽  
Melissa Leslie ◽  
...  
Keyword(s):  
Assertive Community Treatment ◽  
Mentally Ill ◽  
Psychiatric Inpatient ◽  
Community Treatment ◽  
Inpatient Service ◽  
Clinical Environment ◽  
Global Assessment Of Functioning ◽  
Severely Mentally Ill ◽  
Before And After

Objective: To provide a description of the service delivery model of an assertive community treatment (ACT) team in the management of a group of severely mentally ill patients and examine the effectiveness of this team in reducing readmissions to a psychiatric inpatient service. Method: A clinical case audit was performed on a single day in September 2001. Admission episodes and duration were collected for patients registered with the team in the 12 month period prior to ACT and for a period of 12 months ending on the day of the audit. Forty-three patients were registered with the team at the time of data collection. The majority (79%) were diagnosed with schizophrenia and there were high rates of comorbidity (76%) and disability (mean Global Assessment of Functioning score 45.9). The main outcome measures were the number of readmissions and readmission days before and after the institution of ACT. Results: The mean number of readmission days reduced from 70.9 to 10.2 (p < 0.05) following the institution of ACT. Conclusion: Assertive community treatment conducted in a naturalistic clinical environment is effective in signi?cantly reducing the number of readmission days in a group of patients suffering from long-term and persistent severe mental illness.

Counselling the Relatives of the Long-Term Adult Mentally Ill

1989 ◽  
Vol 154 (6) ◽  
pp. 768-775 ◽  
Author(s):  
Brigid MacCarthy ◽  
Liz Kuipers ◽  
Jane Hurry ◽  
Rod Harper ◽  
Alain LeSage
Keyword(s):  
Family Relationships ◽  
Mentally Ill ◽  
Day Care ◽  
Expressed Emotion ◽  
Care Facility ◽  
Term Care ◽  
Interactive Education ◽  
Severely Mentally Ill

The efficacy of implementing a clinically feasible psychosocial intervention which addresses the needs of carers of the long-term mentally ill is reported. All the relatives of patients in continuous high contact with one clinical team in a local day-care facility were offered the intervention. An interactive education session at home was followed by a monthly relatives group which aimed to reduce components of expressed emotion and to alleviate burden. Patients and relatives were assessed. The controls were the patients in contact with the other teams in the day-care facility, and their relatives. The intervention was effective at reducing EE and improving family relationships. Offering this kind of support to people who are providing long-term care for the severely mentally ill can contribute significantly to the quality of life of both supporters and patients.

scholarly journals Neglect of the long-term severely mentally ill

1987 ◽  
Vol 11 (9) ◽  
pp. 316-316
Author(s):  
P. Abbot
Keyword(s):  
Mentally Ill ◽  
Severely Mentally Ill
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