Individual unmet needs for care: are they sensitive as outcome criterion for the effectiveness of mental health services interventions?
(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)
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- author
- organization
- publishing date
- 2009
- 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
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Division of Nursing (Closed 2012) (013065000)
- id
- 531d71ec-f4f4-4ceb-8f69-09c28a48376a (old id 1399410)
- date added to LUP
- 2016-04-01 12:27:51
- date last changed
- 2022-03-13 18:16:44
@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}},
keywords = {{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}},
doi = {{10.1007/s00127-008-0432-z}},
volume = {{44}},
year = {{2009}},
}