Skip to main content

Advertisement

Log in

Self-Rated Assessment of Needs for Mental Health Care: A Qualitative Analysis

  • Original paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

This study explored perceived mental health-related needs and barriers to meeting them in primary and mental health care settings. Fifty-one participants completed the Perceived Need for Care Questionnaire and an interview to qualitatively explore the meanings behind self-identified needs for medication, information, counselling, practical help, and skills development. Qualitative content analysis indicated perceived needs for care are multifaceted. Dissatisfaction with taking medication may coexist with perceiving medication needs as met; information needs predominantly concerned wanting to better understand one’s illness; and communication was the main perceived barrier to meeting these needs. Counselling-related needs included being listened to, supported or assisted with problem-solving, with service attitudes, staff expertise or cost seen as limiting access. Needs for practical help and skills development were described as unmet or addressed by family, and help-seeking for these needs constrained by efforts to self-manage, insufficient information, and affordability. Collaborative care and information-sharing appear important to better meet mental health-related perceived needs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Adams, J. R., & Drake, R. E. (2006). Shared decision-making and evidence-based practice. Community Mental Health Journal, 42(1), 87–105.

    Article  PubMed  Google Scholar 

  • Bebbington, P., Brewin, C. R., Marsden, L., & Lesage, A. (1996). Measuring the need for psychiatric treatment in the general population: The community version of the MRC needs for care assessment. Psychological Medicine, 26, 229–236.

    Article  PubMed  CAS  Google Scholar 

  • Bebbington, P. E., Marsden, L., & Brewin, C. (1997). The need for psychiatric treatment in the general population: The Camberwell needs for care survey. Psychological Medicine, 27, 821–834.

    Article  PubMed  CAS  Google Scholar 

  • Bick, P., Knoesen, N., & Castle, D. (2007). Clinical implications of CATIE schizophrenia trials: Day-to-day management lessons for Australasian psychiatrists. Australasian Psychiatry, 15(6), 465–469.

    Article  PubMed  Google Scholar 

  • Boardman, J., Henshaw, C., & Willmott, S. (2004). Needs for mental health treatment among general practice attenders. British Journal of Psychiatry, 185, 318–327.

    Article  PubMed  Google Scholar 

  • Brewin, C. R., Wing, J. K., Mangen, S. P., Brugha, T. S., & MacCarthy, B. (1987). Principles and practice of measuring needs in the long-term mentally ill: The MRC needs for care assessment. Psychological Medicine, 17, 971–981.

    Article  PubMed  CAS  Google Scholar 

  • Burgess, P., Pirkis, J. E., Slade, T. N., Johnston, A. K., Meadows, G. N., & Gunn, J. M. (2009). Service use for mental health problems: Findings from the 2007 NSMHWB. Australian and New Zealand Journal of Psychiatry, 43(7), 615–623.

    Article  PubMed  Google Scholar 

  • Cleary, M., Freeman, A., Hunt, G. E., & Walter, G. (2006). Patient and carer perceptions of need and associations with care-giving burden in an integrated adult mental health service. Social Psychiatry and Psychiatric Epidemiology, 41, 208–214.

    Article  PubMed  Google Scholar 

  • Crane-Ross, D., Roth, D., & Lauber, B. G. (2000). Consumers’ and case managers’ perceptions of mental health and community support service needs. Community Mental Health Journal, 36, 161–178.

    Article  PubMed  CAS  Google Scholar 

  • Deegan, P. E., & Drake, R. E. (2006). Shared decision making and medication management in the recovery process. Psychiatric Services, 57(11), 1636–1639.

    Article  PubMed  Google Scholar 

  • Drapalski, A. L., Marshall, T., Seybolt, D., Medoff, D., Peer, J., Leith, J., et al. (2008). Unmet needs of families of adults with mental illness and preferences regarding family services. Psychiatric Services, 59(6), 655–662.

    Article  PubMed  Google Scholar 

  • Fassaert, T., de Wit, M. A. S., Tuinebreijer, W. C., Verhoeff, A. P., Beekman, A. T. F., & Dekker, J. (2009). Perceived need for mental health care among non-western labour migrants. Social Psychiatry and Psychiatric Epidemiology, 44(3), 208–216.

    Article  PubMed  Google Scholar 

  • Fleury, M.-J., Grenier, G., Caron, J., & Lesage, A. (2008). Patients’ report of help provided by relatives and to meet their needs. Community Mental Health Journal, 44, 271–281.

    Article  PubMed  Google Scholar 

  • Fossey, E., Harvey, C., McDermott, F., & Davidson, L. (2002). Understanding and evaluating qualitative research. Australian and New Zealand Journal of Psychiatry, 36, 717–732.

    Article  PubMed  Google Scholar 

  • Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105–112.

    Article  PubMed  CAS  Google Scholar 

  • Happell, B., Manias, E., & Roper, C. (2004). Wanting to be heard: Mental health consumers’ experiences of information about medication. International Journal of Mental Health Nursing, 13, 242–248.

    Article  PubMed  Google Scholar 

  • Harvey, C., Fossey, E., Jackson, H., & Shimitras, L. (2006). Time use of people with schizophrenia living in North London: Predictors of participation in occupations and their implications for improving social inclusion. Journal of Mental Health, 15(1), 43–55.

    Article  Google Scholar 

  • Harvey, C. A., Jeffreys, S. E., McNaught, A. S., Blizard, R. A., & King, M. B. (2007). The Camden schizophrenia surveys III: Five-year outcome of a sample of individuals from a prevalence survey and the importance of social relationships. International Journal of Social Psychiatry, 53(4), 340–356.

    Article  PubMed  Google Scholar 

  • Herrman, H., & Harvey, C. (2005). Community care for people with psychosis. International Review of Psychiatry, 17(2), 89–95.

    Article  PubMed  Google Scholar 

  • Hsieh, H. F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277–1288.

    Article  PubMed  Google Scholar 

  • Institute of Medicine. (2006). Improving the quality of health care for mental and substance use conditions. Washington, DC: National Academies Press.

    Google Scholar 

  • Jablensky, A., McGrath, J., Herrman, H., Castle, D., Gureje, O., Evans, M., et al. (2000). Psychotic disorders in urban areas: An overview of the study on low prevalence disorders. Australian and New Zealand Journal of Psychiatry, 34, 221–236.

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  • Katz, S. J., Kessler, R. C., Frank, R. G., Leaf, P., Lin, E., & Edlund, M. (1997). The use of outpatient mental health services in the United States and Ontario: The impact of mental morbidity and perceived need for care. American Journal of Public Health, 87(7), 1136–1143.

    Article  PubMed  CAS  Google Scholar 

  • Killackey, E., Jorm, A., Alvarez-Jimenez, M., McCann, T., Hides, L., & Couineau, L. (2008). Do we do what we know works, and if not why not? Australian and New Zealand Journal of Psychiatry, 46(6), 439–444.

    Article  Google Scholar 

  • Macpherson, R., Jerrom, B., Alexander, M., Thompson, R., Edgar, K., & Hughes, K. (1998). A survey of patient and keyworker satisfaction with the Gloucester mental health rehabilitation service. Journal of Mental Health, 7(4), 367–374.

    Article  Google Scholar 

  • Macpherson, R., Varah, M., Summerfield, L., Foy, C., & Slade, M. (2003). Staff and patient assessments of need in an epidemiologically representative sample of patients with psychosis. Social Psychiatry and Psychiatric Epidemiology, 38(11), 662–667.

    Article  PubMed  Google Scholar 

  • Marshall, M., Hogg, L. I., Gath, D. H., & Lockwood, A. (1995). The Cardinal needs schedule—A modified version of the MRC needs for care assessment schedule. Psychological Medicine, 25, 605–617.

    Article  PubMed  CAS  Google Scholar 

  • Meadows, G. N., & Burgess, P. M. (2009). Perceived needs for mental health care: Findings from the 2007 Australian survey of mental health and wellbeing. Australian and New Zealand Journal of Psychiatry, 43(7), 624–634.

    Article  PubMed  Google Scholar 

  • Meadows, G., Burgess, P., Bobevski, I., Fossey, E., Harvey, C., & Liaw, S.-T. (2002). Perceived need for mental health care: Influences of diagnosis, demography and disability. Psychological Medicine, 32, 209–299.

    Article  Google Scholar 

  • Meadows, G., Burgess, P., Fossey, E., & Harvey, C. (2000a). Perceived need for mental health care, findings from the Australian National survey of mental health and well-being. Psychological Medicine, 30, 645–656.

    Article  PubMed  CAS  Google Scholar 

  • Meadows, G., Harvey, C., Fossey, E., & Burgess, P. (2000b). Assessing perceived need for mental health care in a community survey: Development of the Perceived Need for Care Questionnaire (PNCQ). Social Psychiatry and Psychiatric Epidemiology, 35(9), 427–435.

    Article  PubMed  CAS  Google Scholar 

  • Meadows, G. N., Harvey, C. A., Joubert, L., Barton, D., & Bedi, G. (2007). The Consultation-Liaison in primary-care psychiatry program: A structured approach to long-term collaboration. Psychiatric Services, 58(8), 1036–1038.

    Article  PubMed  Google Scholar 

  • Meadows, G., Liaw, T., Burgess, P., Bobevski, I., & Fossey, E. (2001). Australian general practice and the meeting of needs for mental health care. Social Psychiatry and Psychiatric Epidemiology, 36, 595–603.

    Article  PubMed  CAS  Google Scholar 

  • O’Day, B., Killeen, M. B., Sutton, J., & Iezzoni, L. I. (2005). Primary care experiences of people with psychiatric disabilities: Barriers to care and potential solutions. Psychiatric Rehabilitation Journal, 28(4), 339–345.

    Article  PubMed  Google Scholar 

  • Ojeda, V. D., & Bergstresser, S. M. (2008). Gender, race-ethnicity, and psychosocial barriers to mental health care: An examination of perceptions and attitudes among adults reporting unmet need. Journal of Health and Social Behaviour, 49, 317–334.

    Article  Google Scholar 

  • Phelan, M., Slade, M., Thornicroft, G., Dunn, G., Holloway, F., Wykes, T., et al. (1995). 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, 589–595.

    Article  PubMed  CAS  Google Scholar 

  • QSR International. (2002). NVivo 2. Melbourne: QSR International.

    Google Scholar 

  • Roe, D., Goldblatt, H., Baloush-Klienman, V., Swarbrick, M., & Davidson, L. (2009). Why and how people decide to stop taking prescribed psychiatric medication: Exploring the subjective process of choice. Psychiatric Rehabilitation Journal, 33(1), 38–46.

    Article  PubMed  Google Scholar 

  • Sareen, J., Cox, B. J., Afifi, T. O., Clara, I., & Yu, B. N. (2005). Perceived need for mental health treatment in a nationally representative Canadian sample. Canadian Journal of Psychiatry, 50, 643–651.

    Google Scholar 

  • Sareen, J., Cox, B. J., Afifi, T. O., Stein, M. B., Belik, S. L., Meadows, G., et al. (2007). Combat and peacekeeping operations in relation to prevalence of mental disorders and perceived need for mental health care: Findings from a large representative sample of military personnel. Archives in General Psychiatry, 64(7), 843–852.

    Article  Google Scholar 

  • Schauer, C., Everett, A., del Vecchio, P., & Anderson, L. (2007). Promoting the value of shared decision-making in mental health care. Psychiatric Rehabilitation Journal, 31(1), 54–61.

    Article  PubMed  Google Scholar 

  • Shera, W., Aviram, U., Healy, B., & Ramon, S. (2002). Mental health system reform: A multi country comparison. Social Work in Health Care, 35(1/2), 547–575.

    Article  PubMed  Google Scholar 

  • Slade, M., Leese, M., Cahill, S., Thornicroft, G., & Kuipers, E. (2005). Patient-rated mental health needs and quality of life improvement. British Journal of Psychiatry, 187, 256–261.

    Article  PubMed  Google Scholar 

  • Tanenbaum, S. J. (2008). Consumer perspectives on information and other inputs to decision-making: Implications for evidence-based practice. Community Mental Health Journal, 44(5), 331–335.

    Article  PubMed  Google Scholar 

  • Thornicroft, G. (2006). Shunned: Discrimination against people with mental illness. Oxford: Oxford University Press.

    Google Scholar 

  • Torrey, W. C., & Drake, R. E. (2010). Practicing shared decision making in the outpatient psychiatric care of adults with severe mental illnesses: Redesigning care for the future. Community Mental Health Journal, 46, 433–440.

    Article  PubMed  Google Scholar 

  • Trauer, T., Tobias, G., & Slade, M. (2008). Development and evaluation of a patient-rated version of the Camberwell assessment of need short appraisal schedule (CANSAS-P). Community Mental Health Journal, 44, 113–124.

    Article  PubMed  Google Scholar 

  • Tyreman, S. (2005). The expert patient: Outline of UK government paper. Medicine Health Care Philosophy, 8(2), 149–151.

    Article  Google Scholar 

  • Urbanoski, K. A., Cairney, J., Bassani, D. G., & Rush, B. R. (2008). Perceived unmet need for mental health care for Canadians with co-occurring mental and substance use disorders. Psychiatric Services, 59, 283–289.

    Article  PubMed  Google Scholar 

  • Whiteford, H., & Groves, A. (2009). Policy implications of the 2007 National survey of mental health and wellbeing. Australian and New Zealand Journal of Psychiatry, 43(7), 644–651.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors acknowledge funding from the Federal Government’s Department of Health and Aging; the contributions of Professor Phillip Burgess in the original working group on development of the Perceived Need for Care Questionnaire (PNCQ); and of Claire Lincoln and Vanessa Shardey, who completed the interviewing for this study. We also thank the participants for sharing their views, and making this work possible.

Conflict of interest

The authors declare that there are no known conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ellie Fossey.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fossey, E., Harvey, C., Mokhtari, M.R. et al. Self-Rated Assessment of Needs for Mental Health Care: A Qualitative Analysis. Community Ment Health J 48, 407–419 (2012). https://doi.org/10.1007/s10597-011-9433-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-011-9433-6

Keywords

Navigation