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The assessment of need in patients presenting to psychiatrists in the general hospital

Published online by Cambridge University Press:  13 June 2014

Larkin Feeney ,
Annette Kavanagh ,
Mary Mooney  and
Stephen Browne
Larkin Feeney*
Affiliation:
Department of Psychiatry, St. Vincent's Hospital, Fairview, Dublin 3, Ireland
Annette Kavanagh
Affiliation:
Department of Psychiatry, St. Luke's Hospital, Kilkenny, Ireland
Mary Mooney
Affiliation:
Department of Psychiatry, St. Luke's Hospital, Kilkenny, Ireland
Stephen Browne
Affiliation:
Department of Psychiatry, Waterford Regional Hospital, Waterford, Ireland
*
Correspondence Email: [email protected]
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Abstract

Objective: The evaluation of psychosocial need is an important part of the assessment of any patient who presents to a psychiatrist. The Camberwell Assessment of Need (CAN) instrument was developed for the systematic assessment of need in people with severe and enduring mental illness. Variations of the CAN have been developed for forensic, elderly and learning disability populations. Patients presenting to psychiatrists in the general hospital may also have different needs to those presenting to psychiatrists in other settings. We set out to examine whether the CAN would be useful in identifying needs in patients referred to psychiatrists in the general hospital with self-harm or alcohol problems.

Method: Over a four-month period from September 2004 we prospectively assessed all patients with self-harm or alcohol problems referred to a liaison psychiatry service. We used the short version of the Camberwell Assessment of Need instrument (CANSAS) to assess psychosocial needs. Urgent referrals to a local psychiatric service of patients with severe enduring mental illness (SEMI) were assessed using identical methodology over the same time period and used as a comparison group.

Results: Over the study period 53 patients with self-harm, 42 with alcohol problems and 45 with SEMI were assessed. Patients presenting with self-harm and alcohol problems had significantly fewer needs than those with SEMI (4.40 vs 3.98 vs 7.96, p < 0.001). Looking after the home, self-care, daytime activity, psychotic symptoms, safety to others and sexual expression needs were significantly greater in the SEMI group than in either the DSH or alcohol groups. Only safety to self-needs in the DSH group and alcohol needs in the alcohol group were significantly higher than in the SEMI group. The proportion of needs that were unmet was similar in each group.

Conclusions: The CANSAS instrument identified some needs in deliberate self-harm and alcohol problem patients that might not have been identified during the course of a standard psychosocial assessment. It was easy to administer and as such was a useful addition to the assessment process. However the development of a more specific instrument for the assessment of need in these populations would be useful.

Keywords

Needs assessmentliaison psychiatryalcoholDSHgeneral hospitalsevere mental illness.
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 23 , Issue 3 , September 2006 , pp. 92 - 95
Copyright
Copyright © Cambridge University Press 2006

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References

1.Department of Health and Children. Quality and Fairness: A Health System For You. Dublin: The Stationery Office, 2001.Google Scholar
2.Stevens, A, Gabbay, J. Needs assessment needs assessment. Health Trends 1991; 23, 20–23.Google ScholarPubMed
3.Slade, M, Thornicroft, G, Loftus, L, Phelan, M, Wykes, T. CAN: Camberwell Assessment of Need. A comprehensive needs assessment tool for people with severe mental illness. Gaskell, London, 1999.Google Scholar
4.Thomas, S, Harty, MA, Parrott, J, McCrone, P, Slade, M, Thornicroft, G. Camberwell Assessment of Need – Forensic Version (CANFOR). Gaskell, London, 2003.Google Scholar
5.Orrell, M, Hancock, G. CANE: Camberwell Assessment of Need for the Elderly. Gaskell, London, 2004.Google Scholar
6.Xenitidis, K, Slade, M, Thornicroft, G, Bouras, N. CANDID: Camberwell Assessment of Need for Adults with Developmental and Intellectual Difficulties. Gaskell, London, 2003.Google Scholar
7.Kapur, N. Management of self-harm in adults: which way now? British Journal of Psychiatry 2005; 187, 497–499.Google Scholar
8.Phelan, M, Slade, M, Thornicroft, G, Dunn, G, Holloway, F, Wykes, T, Strathdee, G, Loftus, L, McCrone, P, Hayward, P. 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 1995; 167, 589–595.CrossRefGoogle ScholarPubMed
9.Gannon, M, Ryan, M, Kinsella, A. Assessment of need in patients attending an inner city psychiatric service. Ir J Psych Med 2000; 17, 25–28.CrossRefGoogle Scholar
10.Lehman, AF, Dixon, LB, Kernan, E, DeForge, BR, Postrado, LT. A randomised trial of assertive community treatment for homeless persons with severe mental illness. Arch Gen Psychiatry 1997; 54, 1038–1043.CrossRefGoogle ScholarPubMed
11.Feeney, L, Ryan, J, Moran, P. Parasuicide assessment in the emergency department. Irish Medical Journal 2005; 98, 113–115.Google ScholarPubMed
12.Wagner, LC, King, M. Existential needs of people with psychotic disorders in Porto Alegre, Brazil. Br J Psychiatry 2005; 186, 141–145.Google ScholarPubMed