Background. Staff and severely mentally ill patients differ in their assessments of need. This study compares staff and patient assessments of need for people suffering from psychotic disorders.

Method. The needs of an epidemiologically representative sample of 137 patients from a catchment area psychiatric service in South London who had an ICD-10 diagnosis of a functional psychotic disorder were assessed cross-sectionally by patients and staff, using the Camberwell Assessment of Need.

Results. Staff rated patients to have on average 6·1 needs, and patients rated 6·7 needs (t=2·58, df=136, P=0·011). This difference was accounted for by the staff rating of 1·2 unmet needs and the patient rating of 1·8 unmet needs (t=3·58, df=136, P<0·001). There was no difference in rating of total number of met needs. There was no difference in ratings in relation to any patient sociodemographic characteristics. There was moderate or better agreement on the presence of a need for 13 of the 22 domains in the Camberwell Assessment of Need.

Conclusions. Staff and patients moderately agree about met needs, but agree less often on unmet needs.