Comparing needs assessed by staff and by service users: paternalism or partnership in mental health?

2002 ◽  
Vol 11 (3) ◽  
pp. 186-191 ◽  
Author(s):  
Graham Thornicroft ◽  
Mike Slade
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Service Users ◽  
Camberwell Assessment Of Need ◽  
Assessment Of Need

This paper examines two questions. Do staff and service users agree when rating the needs of those with severe mental illness? If not, what is the meaning of these differences? To put these questions in context, we shall define needs, examine one particular way in which needs can be measured in a standardised way, using the Camberwell Assessment of Need, and shall discuss three somewhat similar studies which have compared user and staff rated needs.

The Camberwell Assessment of Need: The Validity and Reliability of an Instrument to Assess the Needs of People with Severe Mental Illness

1995 ◽  
Vol 167 (5) ◽  
pp. 589-595 ◽  
Author(s):  
Michael Phelan ◽  
Mike Slade ◽  
Graham Thornicroft ◽  
Graham Dunn ◽  
Frank Holloway ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Service ◽  
Severe Mental Illness ◽  
Complete Agreement ◽  
Retest Reliability ◽  
New Instrument ◽  
Camberwell Assessment Of Need ◽  
Test Retest Reliability ◽  
Assessment Of Need

BackgroundPeople with severe mental illness often have a complex mixture of clinical and social needs. The Camberwell Assessment of Need (CAN) is a new instrument which has been designed to provide a comprehensive assessment of these needs. There are two versions of the instrument: the clinical version has been designed to be used by staff to plan patients' care; whereas the research version is primarily a mental health service evaluation tool. The CAN has been designed to assist local authorities to fulfil their statutory obligations under the National Health Service and Community Care Act 1990 to assess needs for community services.MethodA draft version of the instrument was designed by the authors. Modifications were made following comments from mental health experts and a patient survey. Patients (n = 49) and staff (n = 60) were then interviewed, using the amended version, to assess the inter-rater and test-retest reliability of the instrument.ResultsThe mean number of needs identified per patient ranged from 7.55 to 8.64. Correlations of the inter-rater and test-retest reliability of the total number of needs identified by staff were 0.99 and 0.78 respectively. The percentage of complete agreement on individual items ranged from 100–81.6% (inter-rater) and 100–58.1% (test-retest).ConclusionsThe study suggests that the CAN is a valid and reliable instrument for assessing the needs of people with severe mental illness. It is easily learnt by staff from a range of professional backgrounds, and a complete assessment took, on average, around 25 minutes.

scholarly journals Perceived Support for Recovery and Level of Functioning Among People With Severe Mental Illness in Central and Eastern Europe: An Observational Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Catharina Roth ◽  
Michel Wensing ◽  
Jan Koetsenruijter ◽  
Ana Istvanovic ◽  
Antoni Novotni ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Eastern Europe ◽  
Central And Eastern Europe ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Perceived Support ◽  
Service Users ◽  
Level Of Functioning

Background: Many people with severe mental illness experience limitations in personal and social functioning. Care delivered in a person's community that addresses needs and preferences and focuses on clinical and personal recovery can contribute to addressing the adverse impacts of severe mental illness. In Central and Eastern Europe, mental health care systems are transitioning from institutional-based care toward community-based care. The aim of this study is to document the level of functioning and perceived support for recovery in a large population of service users with severe mental illness in Central and Eastern Europe, and to explore associations between perceived support for recovery and the degree of functional limitations.Methods: The implementation of community mental health teams was conducted in five mental health centers in five countries in Central and Eastern Europe. The present study is based on trial data at baseline among service users across the five centers. Baseline data included sociodemographic, the World Health Organization Disability Assessment Schedule (WHODAS 2.0) for functional limitations, and the Recovery Support (INSPIRE) tool for perceived staff support toward recovery. We hypothesized that service users reporting higher levels of perceived support for their recovery would indicate lower levels of functional limitation.Results: Across all centers, the greatest functional limitations were related to participation in society (43.8%), followed by daily life activities (33.3%), and in education or work (35.6%). Service users (N = 931) indicated that they were satisfied overall with the support received from their mental health care provider for their social recovery (72.5%) and that they valued their relationship with their providers (80.3%). Service users who perceived the support they received from their provider as valuable (b = −0.10, p = 0.001) and who reported to have a meaningful relationship with them (b = −0.13, p = 0.003) had a lower degree of functional limitation.Conclusion: As hypothesized, the higher the degree of perceived mental health support from providers, the lower the score in functional limitations. The introduction of the community-based care services that increase contact with service users and consider needs and which incorporate recovery-oriented principles, may improve clinical recovery and functional outcomes of service users with severe mental illness.

scholarly journals Factor structure in the Camberwell Assessment of Need

2004 ◽  
Vol 185 (6) ◽  
pp. 505-510 ◽  
Author(s):  
Erik Wennström ◽  
Dag Sörbom ◽  
Frits-Axel Wiesel
Keyword(s):  
Mental Illness ◽  
Factor Analysis ◽  
Severe Mental Illness ◽  
Factor Structure ◽  
Functional Disability ◽  
Factor Model ◽  
Maximum Likelihood Factor Analysis ◽  
Emotional Loneliness ◽  
Camberwell Assessment Of Need ◽  
Assessment Of Need

BackgroundIn order to define needs for care of people with severe mental illness, the Camberwell Assessment of Need (CAN) is focused on measuring personal and social functioning. However, previous studies of the CAN have given inconsistent results in terms of what variables are actually being measured.AimsTo investigate the factor structure of the CAN.MethodAssessments of 741 out-patients (mean age 45.5 years, 50% females) with severe mental illness (68% schizophrenia or other psychotic disorder) were used in an exploratory maximum likelihood factor analysis.ResultsSupport was found for a three-factor model, comprising 13 of the 22 variables in the CAN, with the factors corresponding to functional disability (7 variables), social loneliness (3 variables) and emotional loneliness (3 variables). The remaining variables did not load on any factor.ConclusionsExploratory factor analysis revealed three homogeneous dimensions in the CAN that may represent functional disability and two aspects of social health.

scholarly journals Peer support for people with severe mental illness versus usual care: study protocol for a pragmatic multicentre randomised controlled trial (UPSIDES-RCT)

2020 ◽  
Author(s):  
Galia Sharon Moran ◽  
Jasmine Kalha ◽  
Annabel Mueller-Stierlin ◽  
Reinhold Kilian ◽  
Silvia Krumm ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cost Effectiveness ◽  
Severe Mental Illness ◽  
Peer Support ◽  
Social Inclusion ◽  
Controlled Trial ◽  
Service Users ◽  
Randomised Controlled

Abstract Background: Peer support is an established intervention involving a person in recovery from mental illness being engaged to offering support to others with mental illness. Peers are an under-used resource in global mental health. Building upon comprehensive formative research, this study will rigorously evaluate the impact of peer support at the levels of service users (psychosocial and clinical outcomes), peer support workers (work role, empowerment), services (cost-effectiveness, return on investment), and implementation (adoption, sustainability, organisational change). Methods: UPSIDES-RCT is a pragmatic parallel-group multi-centre randomised controlled trial assessing the effectiveness of UPSIDES at four measurement points over one year (baseline, 4-, 8-, and 12-month follow-up), and embedded process evaluation and cost-effectiveness analysis. Research will take place in a range of high-, middle- and low-income countries (Germany, United Kingdom, Israel, Uganda, Tanzania, India). The primary outcome is social inclusion of service users with severe mental illness (N= 558; N = 93 per site) at 8-month follow-up, measured with the Social Inclusion Scale. Secondary outcomes include empowerment (Empowerment Scale), hope (HOPE scale), recovery (Stages of Recovery), and health and social functioning (Health of the Nations Outcome Scales). Mixed-methods process evaluation will investigate mediators and moderators of effect, and implementation experiences of four UPSIDES stakeholder groups (service users, peer support workers, mental health workers, and policy makers). A cost-effectiveness analysis examining cost-utility and health budget impact will estimate the value for money of UPSIDES peer support. Discussion: By implementing and evaluating a manualized peer support intervention for people with severe mental illness across low-, middle-, and high-income countries, this study will contribute to harmonising core elements of peer support across different cultural and organisational dimensions. The UPSIDES-RCT will explore the essential components necessary to create a peer support model in mental health care, while providing the evidence required to sustain and eventually scale-up the intervention. Performance of mental health services will be maximised by actively involving and empowering service users, generating system changes towards user-centeredness, recovery orientation, community participation, and realising mental health as a human right. Trail registration: ISRCTN, ISRCTN26008944. Registered 30 October 2019, http://www.isrctn.com/ISRCTN26008944.

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