Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-23T23:54:19.839Z Has data issue: false hasContentIssue false

Meeting the needs of people with schizophrenia living in the community: a report from a European collaboration

Published online by Cambridge University Press:  13 June 2014

Fiona Keogh
Affiliation:
formerly Health Research Board, 73, Lower Baggot Street, Dublin 2, Ireland
Aine Finnerty
Affiliation:
St. Loman's Hospital, Palmerstown, Dublin 20, Ireland
Anne O'Grady Walshe
Affiliation:
Psychiatric Unit, Tallaght Adelaide, Meath & National Children's Hospital, Tallaght, Dublin 24, Ireland
Ian Daly
Affiliation:
Psychiatric Unit, Tallaght Adelaide, Meath & National Children's Hospital, Tallaght, Dublin 24, Ireland
Denis Murphy
Affiliation:
Psychiatric Unit, Tallaght Adelaide, Meath & National Children's Hospital, Tallaght, Dublin 24, Ireland
Abbie Lane
Affiliation:
Dublin County Stress Clinic, Stillorgan, Co. Dublin, Ireland
Dermot Walsh
Affiliation:
Health Research Board, 73, Lower Baggot Street, Dublin 2, Ireland

Abstract

Objectives: This study was carried out as part of a collaborative European study, with the aim of assessing needs in a population with chronic schizophrenia in the context of a community service, and also to measure service use in this population.

Method: This is the first part of a 12 month follow-up study of a sample of persons with schizophrenia who were in contact with the psychiatric services. Seventy eight patients who matched the inclusion criteria were randomly selected and 64 (82%) were interviewed using the Schedules for Clinical Assessment in Neuro-Psychiatry (SCAN) and the Needs for Care Assessment Schedule (NCAS). Service use data for a 12 month period were collected prospectively using the Mannheim Service Recording Sheet (MSRS).

Results: The levels of clinical and social need were quite low at 2.1 and 2.6 respectively. Most needs were met; unmet need was 0.11 for clinical problems and 0.4 for social. Service use was high, with a total of 6,969 contacts with community services, a mean of 109 per patient per year. Total service use (including inpatient and hostel) was partly predictive of met need (R2 23.6). The levels of met and unmet need in Dublin compare favourably with that reported in Mannheim and Granada. Service use was similar to that in Mannheim, although there was a higher level of service provision in Mannheim.

Conclusions: This study has shown that there is a low level of clinical and social need in this sample of patients with schizophrenia living in the community, and a relatively high level of service use. There is good evidence that services are meeting the needs of this sample of patients.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Department of Health. Commission of inquiry on mental illness. Dublin: Stationery Office, 1966.Google Scholar
2.Daly, A, Walsh, D. Irish Psychiatric Services. Activities 1999. Health Research Board, 2000.Google Scholar
3.Department of Health. The Psychiatric Services – Planning for the future. Report of a study group on the development of the psychiatric services. Stationery Office, Dublin, 1984.Google Scholar
4.Department of Health. Green Paper on mental health. Dublin: Stationery Office, 1992.Google Scholar
5.Shepherd, G, Beadsmore, A, Moore, C, Hardy, P, Muijen, M. Relation between bed use, social deprivation and overall bed availability in acute psychiatric units and alternative residential options. BMJ 1997; 314: 262–6.CrossRefGoogle ScholarPubMed
6.Magi, M, Allender, E. Towards a theory of perceived and medically defined need. Sociology of Health and Illness 1981; 3: 4971.CrossRefGoogle ScholarPubMed
7.Brewin, CR, Wing, JK. MRC Needs for Care Assessment. Manual for version two. MRC Social Psychiatry Unit, 1989.Google Scholar
8.Slade, M, Loftus, L, Phelan, M, Thornicroft, G, Wykes, T. The Camberwell Assessment of Need. London: Gaskell, 1999.Google Scholar
9.Freeman, H, Henderson, JH. Evaluation of comprehensive care of the mentally ill. London: Gaskell, 1991.Google Scholar
10.Kovess, V, Wiersma, D, Caldas, de Almeida JMet al.Evolution of needs for schizophrenic patients in seven European countries. Psychiatric Networks 2000; 3: 2640.Google Scholar
11.World Health Organisation. Schedule for clinical assessment in neuropsychiatry (SCAN). Geneva: WHO, Division of Mental Health, 1992.Google Scholar
12.Wing, JK, Cooper, J, Sartorious, N. The measurement and classification of psychiatric illness. Cambridge: Cambridge University Press, 1974.Google Scholar
13.Salize, HJ, Rossler, W. Mannheim Service Recording Sheet. Mannheim: Mental Health Services Research Unit, Central Institute of Mental Health, 1994.Google Scholar
14.Angst, J. European long-term follow-up studies of schizophrenia. Schizophrenia Bulletin 1988; 14: 501–13.CrossRefGoogle ScholarPubMed
15.Finnerty, A, Keogh, F, O'Grady-Walshe, A, Walsh, D. A Fifteen Year Follow-up of Schizophrenia in Ireland. Ir J Psych Med (In press).Google Scholar
16.Hollander, D, Powell, RB. The 13 steps to community care. BMJ 1996; 312, 913.CrossRefGoogle ScholarPubMed
17.Tyrer, P. Cost-effective or profligate community psychiatry? Br J Psychiatry 1998; 172: 13.CrossRefGoogle ScholarPubMed
18.Salize, HJ, Kustner, BM, Torres-Gonzalez, Fet al.Needs for care and effectiveness of mental health care provision for schizophrenic patients in two European regions: a comparison between Gianada (Spain) and Mannheim (Germany). Acta Psychiat Scand 1999; 100:328–34.CrossRefGoogle ScholarPubMed
19.O'Shea, E. The costs of Caring for People with Dementia and Cognitive Impairments. National Council on Ageing and Older People, 2000.Google Scholar