Self-assessment of need for help in patients undergoing psychiatric treatment

Abstract

Needs assessment for patients in mental health care is an important tool. When used systematically, needs assessment can improve the quality of care and facilitate a process of ‘shared decision making’ in service provision. A self-report questionnaire, the Needs Assessment Scale (NAS), was developed for use in larger survey samples. The perceived problems of patients and their associated need for help were assessed in 22 life areas similar to those of the Camberwell Assessment of Need (CAN) interview. In this article, we explore the validity and utility of the NAS. For this purpose 305 psychiatric patients completed the NAS in a postal survey. The factor structure of the scale shows four subscales. Two domains are measured: problem assessment and needs assessment. Patients reported a mean number of 4.0 (S.D. 3.5) problem areas and a mean number of 2.4 (S.D. 3.6) unmet need areas. Differences between various subgroups (e.g. diagnostic categories, treatment setting) and concurrent validity with the CAN are discussed. The NAS seems to be sensitive to the perceived needs of patients, although those with psychotic disorders tend to under-report unmet need. We conclude that the NAS is a useful and feasible instrument in the assessment of patients' need for help at a population level.