Advanced

Individual unmet needs for care: are they sensitive as outcome criterion for the effectiveness of mental health services interventions?

Wiersma, Durk; van den Brink, Rob; Wolters, Kerstin; McCabe, Rosemarie; Bullenkamp, Jens; Hansson, Lars LU ; Lauber, Christoph; Martinez-Leal, Rafael; Roessler, Wulf and Salize, Hans, et al. (2009) In Social Psychiatry and Psychiatric Epidemiology 44(4). p.317-324
Abstract
Background Mental health interventions should demonstrate an effect on patients' functioning as well as his/her needs, in particular on unmet needs whose assessment depends on the perspective of either the patient or the clinician. However, individual met and unmet needs appear to change over time, qualitatively and quantitatively, raising questions about their sensitivity to change and about the association between level of needs and treatment. Methods Data on baseline and follow-up need assessment in community mental health services in four European countries in the context of a cluster randomised trial on a novel mental health service intervention were used, which involved 102 clinicians with key worker roles and 320 patients with... (More)
Background Mental health interventions should demonstrate an effect on patients' functioning as well as his/her needs, in particular on unmet needs whose assessment depends on the perspective of either the patient or the clinician. However, individual met and unmet needs appear to change over time, qualitatively and quantitatively, raising questions about their sensitivity to change and about the association between level of needs and treatment. Methods Data on baseline and follow-up need assessment in community mental health services in four European countries in the context of a cluster randomised trial on a novel mental health service intervention were used, which involved 102 clinicians with key worker roles and 320 patients with schizophrenia or related psychotic disorders. Need assessment was performed with the Camberwell assessment of needs short appraisal schedule (CANSAS) among patients as well as clinicians. Focus is the sensitivity to change in unmet needs over time as well as the concordance between patient and clinician ratings and their relationship with treatment condition. Results At follow-up 294 patients (92%) had a full need assessment, while clinician rated needs were available for 302 patients (94%). Generally, the total number of met needs remained quite stable, but unmet needs decreased significantly over time, according to patients as well as to clinicians. Sensitivity to change of unmet needs is quite high: about two third of all unmet needs made a transition to no or met need, and more than half of all unmet needs at follow-up were new. Agreement between patient and clinician on unmet needs at baseline as well as follow-up was rather low, without any indication of a specific treatment effect. Conclusions Individual unmet needs appear to be quite sensitive to change over time but as yet less suitable as outcome criterion of treatment or specific interventions. (Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
routine outcome assessment, need for care, schizophrenia, mental health care, community
in
Social Psychiatry and Psychiatric Epidemiology
volume
44
issue
4
pages
317 - 324
publisher
Steinkopff
external identifiers
  • wos:000265399300009
  • scopus:63949088411
ISSN
0933-7954
DOI
10.1007/s00127-008-0432-z
language
English
LU publication?
yes
id
531d71ec-f4f4-4ceb-8f69-09c28a48376a (old id 1399410)
date added to LUP
2009-06-15 15:33:19
date last changed
2017-11-19 03:38:02
@article{531d71ec-f4f4-4ceb-8f69-09c28a48376a,
  abstract     = {Background Mental health interventions should demonstrate an effect on patients' functioning as well as his/her needs, in particular on unmet needs whose assessment depends on the perspective of either the patient or the clinician. However, individual met and unmet needs appear to change over time, qualitatively and quantitatively, raising questions about their sensitivity to change and about the association between level of needs and treatment. Methods Data on baseline and follow-up need assessment in community mental health services in four European countries in the context of a cluster randomised trial on a novel mental health service intervention were used, which involved 102 clinicians with key worker roles and 320 patients with schizophrenia or related psychotic disorders. Need assessment was performed with the Camberwell assessment of needs short appraisal schedule (CANSAS) among patients as well as clinicians. Focus is the sensitivity to change in unmet needs over time as well as the concordance between patient and clinician ratings and their relationship with treatment condition. Results At follow-up 294 patients (92%) had a full need assessment, while clinician rated needs were available for 302 patients (94%). Generally, the total number of met needs remained quite stable, but unmet needs decreased significantly over time, according to patients as well as to clinicians. Sensitivity to change of unmet needs is quite high: about two third of all unmet needs made a transition to no or met need, and more than half of all unmet needs at follow-up were new. Agreement between patient and clinician on unmet needs at baseline as well as follow-up was rather low, without any indication of a specific treatment effect. Conclusions Individual unmet needs appear to be quite sensitive to change over time but as yet less suitable as outcome criterion of treatment or specific interventions.},
  author       = {Wiersma, Durk and van den Brink, Rob and Wolters, Kerstin and McCabe, Rosemarie and Bullenkamp, Jens and Hansson, Lars and Lauber, Christoph and Martinez-Leal, Rafael and Roessler, Wulf and Salize, Hans and Björkman, Tommy and Torres-Gonzales, Francisco and Wright, Donna J. and Priebe, Stefan},
  issn         = {0933-7954},
  keyword      = {routine outcome assessment,need for care,schizophrenia,mental health care,community},
  language     = {eng},
  number       = {4},
  pages        = {317--324},
  publisher    = {Steinkopff},
  series       = {Social Psychiatry and Psychiatric Epidemiology},
  title        = {Individual unmet needs for care: are they sensitive as outcome criterion for the effectiveness of mental health services interventions?},
  url          = {http://dx.doi.org/10.1007/s00127-008-0432-z},
  volume       = {44},
  year         = {2009},
}