scholarly journals Systematic assessments of need and care planning in severe mental illness

2004 ◽  
Vol 185 (2) ◽  
pp. 163-168 ◽  
Author(s):  
M. Marshall ◽  
A. Lockwood ◽  
G. Green ◽  
G. Zajac-Roles ◽  
C. Roberts ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Needs Assessment ◽  
Randomised Trial ◽  
Care Planning ◽  
Care Programme ◽  
Cluster Randomised ◽  
Care Coordinators ◽  
To Receive ◽  
Assessment Of Need

BackgroundSurveys have shown high levels of unmet need in representative samples of people with severe mental illness. Introducing standardised needs assessment into the care planning process might reduce these needs and improve outcome.AimsTo determine whether feedback from a standardised assessment of need enhances the effectiveness of care planning and whether exposing care coordinators to feedback on some patients improves their care of other patients.MethodA single-blind, cluster-randomised trial involving a within-cluster individually randomised arm: patients' needs were evaluated using the Cardinal Needs Schedule and the findings were fed back to their care coordinators under the care programme approach. Atotal of 304 patients were recruited from 72 care coordinators and 242 patients (79.6%) were reassessed at 12 months.ResultsThe only significant effect of the intervention was on patient satisfaction. Patients cluster-randomised to receive feedback were more satisfied than controls, but patients individually randomised to receive feedback were not.ConclusionsStandardised needs assessment did not substantially enhance care planning in this trial. However, giving care coordinators some experience of feedback from a standardised assessment of need could improve satisfaction.

scholarly journals Reforming care without bureaucracy

2018 ◽  
Vol 43 (3) ◽  
pp. 104-105
Author(s):  
Peter Tyrer
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Good Practice ◽  
Care Programme ◽  
The Future ◽  
Discharge From Hospital ◽  
Intangible Benefit

The Care Programme Approach was a valiant attempt to improve the aftercare of people with severe mental illness after discharge from hospital. It was introduced as a response to a scandal, not an advance in knowledge, and has always suffered by being a reaction to events rather than a trailblazer for the future. It may have dragged the worst of care upwards, but at the expense of creating a bureaucratic monstrosity that has hindered good practice by excessive attention to risk, and vastly increased paperwork with intangible benefit. It needs to be simplified to allow practitioners greater scope for collaborative solutions, less minatory oversight and better use of strained resources.Declaration of interestNone.

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 User involvement in care planning

1999 ◽  
Vol 23 (9) ◽  
pp. 539-541 ◽  
Author(s):  
Mike Lawson ◽  
Chrissie Strickland ◽  
Paul Wolfson
Keyword(s):  
Needs Assessment ◽  
User Involvement ◽  
Information Provision ◽  
Limited Resources ◽  
Clinical Implications ◽  
Care Planning ◽  
Structured Interviews ◽  
Care Programme ◽  
Information Pack ◽  
Quota Sampling

Aims and methodTo assess the extent of user involvement in care planning, from the users' perspective. Fifty Care Programme Approach (CPA) meetings across five consultant teams were included using quota sampling. Data concerning user involvement was collected by direct observation, semi-structured interviews with users and keyworkers and a review of CPA documentation.ResultsUser involvement in needs assessment and decision-making was poor, as was knowledge of care planning and information provision to users.Clinical implicationsLimited resources and conflict resulting from the more containing aspects of the CPA remain obstacles for user involvement. Possible improvements include user led needs assessment, information pack provision and limiting attendance at CPA meetings.

scholarly journals Severe mental illness and palliative care: patient semistructured interviews

2020 ◽  
pp. bmjspcare-2019-002122
Author(s):  
Inge Knippenberg ◽  
Nasira Zaghouli ◽  
Yvonne Engels ◽  
Kris C P Vissers ◽  
Marieke M Groot
Keyword(s):  
Mental Illness ◽  
Palliative Care ◽  
Severe Mental Illness ◽  
End Of Life ◽  
Current Situation ◽  
Care Planning ◽  
Health Issues ◽  
Starting Point ◽  
Semistructured Interviews ◽  
Death Wishes

ObjectivesTo explore perceptions, experiences and expectations with respect to palliative care of patients with severe mental illness (SMI) and an incurable, life-limiting chronic illness.MethodsFace-to-face semistructured interviews were conducted with 12 patients (10 of them living in a mental healthcare institution) with severe mental and physical health issues in the Netherlands. A semistructured interview guide was used to elicit perceptions of, experiences with and expectations regarding palliative care. Data were analysed using inductive content analysis.ResultsAnalysis of the data revealed eight categories: perceptions on health and health issues, coping with illness and symptoms, experiences with and wishes for current healthcare, contact with relatives and coresidents, experiences with end of life of relatives and coresidents, willingness to discuss end of life and death, wishes and expectations regarding one’s own end of life and practical aspects relating to matters after death. These categories were clustered into two separate themes: current situation and anticipation of end of life. Interviewees with SMI appeared not accustomed to communicate about end-of-life issues, death and dying due to their life-threatening illness. They tended to discuss only their current situation and, after further exploration of the researcher, the terminal phase of life. They seemed not engaged in their future palliative care planning.ConclusionsFindings of this study highlight inadequacies in advance care planning for patients with SMI. Results suggest using values, current and near wishes, and needs as a starting point for establishing a gradual discussion concerning goals and preferences for future medical and mental treatment and care.

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.

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