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Factors Associated with Needs of Users with Severe Mental Disorders

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Abstract

For persons suffering from severe mental disorders (SMD), better quantification of needs may facilitate services planning and evaluation, as well as patient recovery. This study aimed to assess associations of sociodemographic, socioeconomic, service utilization, life events, social support and clinical variables with the level of perceived needs of users with SMD globally and according to their factorial structure. A total of 351 adults with SMD from Montreal (Canada) were interviewed using the Montreal Assessment of Needs Questionnaire and seven other standardized instruments. Clinical records were also consulted. Eight variables were associated with levels of needs. Four factors were extracted from the factor analysis and labeled respectively: Helplessness, Social Integration, Functional Skills and Interpersonal Relationships. Models built from needs assessment factors are stronger than global needs and have a greater association with pertinent variables. Linear regression models based on factors show the importance of satisfaction with life domains and substance abuse in association with higher levels of perceived needs. The recognition of variables associated with each factor would optimize care planning and implementation.

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References

  1. Middleboe T, Mackeprang T, Hansson L, et al.: The Nordic Study on schizophrenic patients living in the community. Subjectives needs and perceived help. European Psychiatry 16(4):207–214, 2001

    Article  Google Scholar 

  2. Fakhoury WKH, Murray A, Shepherd G, et al.: Research in supported housing. Social Psychiatry and Psychiatric Epidemiology 37(7):301–315, 2002

    Article  PubMed  Google Scholar 

  3. Slade M, Leese M, Ruggeri M, et al.: Does meeting need improve quality of life? Psychotherapy and Psychosomatics 73(3):183–189, 2004

    Article  PubMed  Google Scholar 

  4. de Weert-van Oene GH, Havenaar JM, Schirjvers AJ: Self-assessment of need for help in patients undergoing psychiatric treatment. Psychiatry Research 167(3):221–230, 2009

    Article  PubMed  Google Scholar 

  5. Phelan M, Slade M, Thornicroft G, et al.: The Camberwell Assessment of Need: the validity and reliability of an instrument to assess the needs of people with severe mental illness. British Journal of Psychiatry 167(5):589–595, 1995

    Article  PubMed  CAS  Google Scholar 

  6. Slade M, Beck A, Bindman J, et al.: Routine clinical outcome measures for patients with severe mental illness: CANSAS and HoNOS. British Journal of Psychiatry 174:404–408, 1999

    Article  PubMed  CAS  Google Scholar 

  7. Joska J, Flisher AJ: The assessment of need for mental health services. Social Psychiatry and Psychiatric Epidemiology 40(7):529–539, 2005

    Article  PubMed  Google Scholar 

  8. Hansson L, Björkman T, Svensson B: The assessment of needs in psychiatric patients. Interrater reliability of the Swedish version of the Camberwell Assessment of Needs instrument and results from a cross-sectional study. Acta Psychiatrica Scandinavica 92(4):285–293, 1995

    Article  PubMed  CAS  Google Scholar 

  9. Kulhara P, Avashthi A, Grover S, et al.: Needs of Indian schizophrenia patients: an exploratory study from India. Social Psychiatry and Psychiatric Epidemiology 45(8):809–818, 2010

    Article  PubMed  Google Scholar 

  10. Hayward M, Slade M, Moran PA: Personality disorders and unmet needs among psychiatric inpatients. Psychiatric Services 57(4):538–543, 2006

    Article  PubMed  Google Scholar 

  11. Lasalvia A, Ruggeri M, Mazzi MA, et al.: The perception of needs for care in staff and patients in community-based mental health services. The South-Verona Outcome Project 3. Acta Psychiatrica Scandinavica 102(5):366–375, 2000

    Article  PubMed  CAS  Google Scholar 

  12. Gallagher J, Teesson M: Measuring disability, need and outcome in Australian community mental health services. Australian and New Zealand Journal of Psychiatry 34(5):850–855, 2000

    Article  PubMed  CAS  Google Scholar 

  13. Wiersma D: Needs of people with severe mental illness. Acta Psychiatrica Scandinavica. Supplementum 429:115–119, 2006

    Article  PubMed  Google Scholar 

  14. Ochoa S, Haro JM, Autonell J, et al.: Met and unmet needs of schizophrenia patients in a Spanish sample. Schizophrenia Bulletin 29(2):201–210, 2003

    Article  PubMed  CAS  Google Scholar 

  15. Broadbent E, Kydd R, Sanders D, et al.: Unmet needs and treatment seeking in high users of mental health services: role of illness perceptions. Australian and New Zealand Journal of Psychiatry 42(2):147–153, 2008

    Article  PubMed  Google Scholar 

  16. Hansson L, Sandlund M, Bengtsson-Topps A, et al.: The relationship of needs and quality of life in persons with schizophrenia living in the community. A Nordic multic-center study. Nordic Journal of Psychiatry 57(1):5–11, 2003

    Article  PubMed  Google Scholar 

  17. Van Busschbach J, Wiersma D: Does rehabilitation meet the needs of care and improve the quality of life of patients with schizophrenia or other chronic mental disorders? Community Mental Health Journal 38(1):61–70, 2002

    Article  PubMed  Google Scholar 

  18. Wiersma D, van Busschbach J: Are needs and satisfaction of care associated with quality of life? An epidemiological survey among the severely mentally ill in the Netherlands. European Archives of Psychiatry and Clinical Neuroscience 251(5):239–246, 2001

    Article  PubMed  CAS  Google Scholar 

  19. Bengtsson-Topps A, Hansson L: Clinical and social needs of schizophrenic outpatients living in the community: the relationship between needs and subjective quality of life. Social Psychiatry and Psychiatric Epidemiology 34(10):513–518, 1999

    Article  Google Scholar 

  20. Kirmayer LJ, Weinfeld M, Burgos G, et al.: Use of health care services for psychological distress by immigrants in an urban multicultural milieu. Canadian Journal of Psychiatry 52(5):295–304, 2007

    Google Scholar 

  21. Stockdale SE, Wells KB, Tang L, et al.: The importance of social context; neighborhood stressors, stress-buffering mechanisms, and alcohol drug, and mental health disorders. Social Science & Medicine 65(9):1867–1881, 2007

    Article  Google Scholar 

  22. Latkin CA, Curry AD: Stressful neighborhoods and depression: a prospective study of the impact of neighborhood disorder. Journal of Health and Social Behavior 44(1):34–44, 2003

    Article  PubMed  Google Scholar 

  23. Howard KI, Cornille TA, Lyons JS, et al.: Patterns of Mental Health Service Utilization. Archives of General Psychiatry 53(8):696–703, 1996

    Article  PubMed  CAS  Google Scholar 

  24. Wennström E, Sörbom D, Wiesel FA: Factor Structure in the Camberwell Assessment of Need. British Journal of Psychiatry 185:505–510, 2004

    Article  PubMed  Google Scholar 

  25. Korkeila J, Heikkilä J, Hansson L, et al.: Structure of needs among persons with schizophrenia. Social Psychiatry and Psychiatric Epidemiology 40(3):233–239, 2005

    Article  PubMed  Google Scholar 

  26. Fleury MJ, Piat M, Grenier G, et al.: Components associated with adequacy of help for consumers with severe mental disorders. Administration and Policy in Mental Health and Mental Health Services Research 37(6):497–508, 2010

    Article  PubMed  Google Scholar 

  27. McCrone P, Leese M, Thornicroft G, et al.: Reliability of the Camberwell Assessment of Need- European Version. EPSILON Study 6. European Psychiatric Services: Inputs linked to outcome domains and needs. British Journal of Psychiatry Suppl 39:s34-s40., 2000

    Article  Google Scholar 

  28. Pruessner M, Iyer SN, Faridi K, et al.: Stress and protective factors in individuals at ultra-high risk for psychosis, first episode psychosis and healthy controls. Schizophrenia Research 129(1):29–35, 2011

    Article  PubMed  Google Scholar 

  29. Corbière M, Zaniboni S, Lecomte T, et al.: Job acquisition for people with severe mental illness enrolled in supported employment programs: a theoerically grounded empirical study. Journal of Occupational Rehabilitation 21(3):342–354, 2011

    Article  PubMed  Google Scholar 

  30. Schulze B, Angermeyer MC: Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals. Social Science & Medicine 56(2):299–312, 2003

    Article  Google Scholar 

  31. Stuart H: Stigma and the daily news: evaluation of a newspaper intervention. Canadian Journal of Psychiatry 48(10):651–656, 2003

    Google Scholar 

  32. Piat M, Sabetti J, Bloom D: The transformation of mental health services to a recovery-oriented system of care: Canadian decision maker perspectives. International Journal of Social Psychiatry 56(2):168–177, 2010

    Article  PubMed  Google Scholar 

  33. Accietto C: La validation d’une version française du questionnaire A.U.D.I.T. “Alcohol Use Identification Test”, Thèse de doctorat. Genève, Université de Genève, 2003

    Google Scholar 

  34. Carey KB, Carey MP, Chandra PS: Psychometric evaluation of the alcohol use disorders identification test and short drug abuse screening test with psychiatric patients in India. Journal of Clinical Psychiatry 64(7):767–774, 2003

    Article  PubMed  Google Scholar 

  35. Caron J: L’Échelle de provisions sociales : une validation québécoise. Santé Mentale au Québec 21(2):158–180, 1996

    Article  PubMed  CAS  Google Scholar 

  36. Caron J, Mercier C, Tempier R: Une validation québécoise du Satisfaction with Life Domains Scale. Santé Mentale au Québec 17(2):195–218, 1997

    Article  Google Scholar 

  37. Durbin J, Goering P, Streiner DL, et al.: Continuity of care: Validation of a new self-report measure for individuals using mental health services. Journal of Behavorial Health Services & Research 31(3):279–296, 2004

    Google Scholar 

  38. Hendryx MS, Dyck DG, McBride D, et al.: A test of the reliability and validity of the Multnomah Community Ability Scale. Community Mental Health Journal 37(2):157–168, 2001

    Article  PubMed  CAS  Google Scholar 

  39. Slade M, Phelan M, Thornicroft G: A comparison of needs assessed by staff and by an epidemiologically representative sample of patients with psychosis. Psychological Medicine 28:543–550, 1998

    Article  PubMed  CAS  Google Scholar 

  40. Slade M, Leese M, Cahill S, et al.: Patient-rated mental health needs and quality of life improvement. British Journal of Psychiatry 187(3):256–261, 2005

    Article  PubMed  Google Scholar 

  41. McCrone P, Leese M, Thornicroft G, et al.: A comparison of needs of patients with schizophrenia in five European countries: the EPSILON Study. Acta Psychiatrica Scandinavica 103(5):370–379, 2001

    Article  PubMed  CAS  Google Scholar 

  42. Wiersma D, van den Brink R, Wolters K, et al.: Individual unmet needs for care: are they sensitive as outcome criterion for the effectiveness of mental health services interventions? Social Psychiatry and Psychiatric Epidemiology 44(4):317–324, 2009

    Article  PubMed  Google Scholar 

  43. McCann E: The sexual and relationship needs of people who experience psychosis; quantitative findings of a UK study. Journal of Psychiatric and Mental Health Nursing 17(4):295–303, 2010

    Article  PubMed  CAS  Google Scholar 

  44. Slade M: Assessing the needs of the severely mentally ill: cultural and professional differences. International Journal of Social Psychiatry 42(1):1–9, 1996

    Article  PubMed  CAS  Google Scholar 

  45. Cummings SM, Kropf NP: Formal and informal support for older adults with severe mental illness. Aging & Mental Health 13(4):619–627, 2009

    Article  Google Scholar 

  46. Rush BR, Urbanoski KA, Bassani DG, et al.: The epidemiology of co-occurring substance use and other mental disorders in Canada: Prevalence, service use, and unmet needs. In: Cairney J, Streiner DL (Eds) Mental Disorder in Canada. An Epidemiological Perspective, Toronto, University of Toronto Press, 2010

    Google Scholar 

  47. De Graaf R, Bijl RV, Ten Have M, et al.: Pathways to comorbidity: the transition of pure mood, anxiety and substance use disorders into comorbid conditions in a longitudinal population-based study. Journal of Affective Disorders 82(3):461–467, 2004

    Article  PubMed  Google Scholar 

  48. Pirkola SP, Isometsä E, Suvisaari J, et al.: DSM-IV mood-, anxiety- and alcohol use disorders and their comorbidity in the Finnish general population. Result from the Health 2000 Study. Social Psychiatry and Psychiatric Epidemiology 40(1):1–10, 2005

    Article  PubMed  Google Scholar 

  49. Albert M, Becker T, McCrone P, et al.: Social networks and mental health service utilisation. A literature review. International Journal of Social Psychiatry 44(4):248–266, 1998

    Article  PubMed  CAS  Google Scholar 

  50. Lemming MR, Calsyn RJ: Utility of the behavioral model in predicting service utilization by individuals suffering from severe mental illness and homelessness. Community Mental Health Journal 40(4):347–364, 2004

    Article  PubMed  Google Scholar 

  51. Ross HE, Lin E, Cunningham J: Mental Health Service Use: A comparison of treated and untreated individuals with substance use disorders in Ontario. Canadian Journal of Psychiatry 44(4):570–577, 1999

    CAS  Google Scholar 

  52. Björkman T, Hansson L: Predictors of improvement in quality of life of long-term mentally ill individuals receiving case management. European Psychiatry 17(1):33–40, 2002

    Article  PubMed  Google Scholar 

  53. Ortega AN, Feldman JM, Canino G, et al.: Co-occurence of mental and physical illness in US Latinos. Social Psychiatry and Psychiatric Epidemiology 41(12):927–934, 2006

    Article  PubMed  Google Scholar 

  54. Wang PS, Berglund PA, Kessler RC: Patterns and correlates of contacting clergy for mental disorders in the United States. Health Services Research 38(2):647–673, 2003

    Article  PubMed  Google Scholar 

  55. Lipsky S, Caetano R, Roy-Byrne P: Triple jeopardy: impact of partner violence perpetration, mental health and substance abuse on perceived unmet for mental health care among men. Social Psychiatry and Psychiatric Epidemiology 46(9):843–852, 2010

    Article  PubMed  Google Scholar 

  56. Maslow A: Motivation and Personality, New York, Harper and Row, 1954

    Google Scholar 

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Acknowledgments

The study was funded by the Canadian Institute of Health Research (CIHR). We would like to thank this grant agency and all the users who participated in the research.

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Authors and Affiliations

  1. Douglas Hospital Research Centre, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada

    Marie-Josée Fleury & Jacques Tremblay

  2. Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montreal, QC, Canada

    Guy Grenier & Jean-Marie Bamvita

Authors
  1. Marie-Josée Fleury
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  2. Guy Grenier
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  4. Jacques Tremblay
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Correspondence to Marie-Josée Fleury.

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Fleury, MJ., Grenier, G., Bamvita, JM. et al. Factors Associated with Needs of Users with Severe Mental Disorders. Psychiatr Q 84, 363–379 (2013). https://doi.org/10.1007/s11126-012-9252-0

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  • DOI: https://doi.org/10.1007/s11126-012-9252-0

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