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Clients with long-term mental disabilities in a Swedish county—conditions of life, needs of support and unmet needs of service provided by the public health and social service sectors

Published online by Cambridge University Press:  16 April 2020

Lennart Jansson ,
Karin Sonnander  and
Frits-Axel Wiesel
Lennart Jansson*
Affiliation:
Department of Neuroscience, Psychiatry, Ulleråker, Uppsala University Hospital, 750 17Uppsala, Sweden
Karin Sonnander
Affiliation:
Department of Neuroscience, Psychiatry, Ulleråker, Uppsala University Hospital, 750 17Uppsala, Sweden
Frits-Axel Wiesel
Affiliation:
Department of Neuroscience, Psychiatry, Ulleråker, Uppsala University Hospital, 750 17Uppsala, Sweden
*
*Corresponding author. E-mail address: lennart.jansson@neuro.uu.se (L. Jansson).
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Abstract

Objective

The purpose of the study was to identify and describe conditions of life and needs of support and public service for clients with a mental disability in a Swedish county population.

Methods

Public health care and social service providers identified clients and completed a questionnaire concerning the clients’ conditions of life and their special needs. A consecutively recruited sample of clients completed a similar questionnaire.

Results

Totally, 1261 clients were identified. The prevalence of clients with mental disabilities was in the urban and rural areas, 6.4/1000 inhabitants and 4.5/1000 inhabitants, respectively. The most prevalent unmet need (42.9%) was to participate in social and scheduled activities. Almost half of the group was reported to need support in activities of daily living. Clients living in urban settings more often needed support with activities of daily living (P < 0.001), whereas clients living in rural settings more often needed support with job training (P < 0.001) or finding work (P < 0.01). Clients and psychiatric care providers reported the needs of the clients in the same areas; however, clients reported a fewer number of needs than did the care providers.

Conclusions

By using both psychiatric care and social service providers, effective case findings of clients with a mental disability were possible to achieve. In general, there was high agreement between psychiatric care providers and clients regarding the clients’ number of needs of support and their unmet needs of service. However, at the individual level, the agreement between client and psychiatric care providers was lower.

Keywords

EpidemiologyCommunity mental health servicesNeeds assessmentMental disabilityRuralUrban
Type
Original article
Information
European Psychiatry , Volume 18 , Issue 6 , October 2003 , pp. 296 - 305
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2003

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References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington (DC): APA; 1994.Google Scholar
Anthony, WA, Liberman, RP. The practice of psychiatric rehabilitation: historical, conceptual, and research base. Schizophr Bull 1986;12:542-59.CrossRefGoogle ScholarPubMed
Bachrach, L. Deinstitutionalisation: promises, problems and prospects. In: Knudsen, H, Thornicroft, G, editors. Mental health service evaluation. Cambridge: University Press; 1996. p. 3-18.CrossRefGoogle Scholar
Blazer, D, George, LK, Landerman, R, Pennybacker, M, Melville, ML, Woodbury, M, et al. Psychiatric disorders. A rural/urban comparison. Arch Gen Psychiatry 1985;42:651-6.CrossRefGoogle ScholarPubMed
Bollini, P, Mollica, RF. Surviving without the asylum. An overview of the studies on the Italian reform movement. J Nerv Ment Dis 1989;177:607-15.CrossRefGoogle ScholarPubMed
Borgå, P, Widerlöv, B, Stefansson, CG, Cullberg, J. Social conditions in a total population with long-term functional psychosis in three different areas of Stockholm County. Acta Psychiatr Scand 1992;85:465-73.CrossRefGoogle Scholar
Cohen, J. A coefficient of agreement for normal scales. Educational Psychol Measur 1960;20:37-46.CrossRefGoogle Scholar
Committee on Psychiatric Care. Welfare and freedom of choice [Välfärd och valfrihet. Service, stöd och vård för psykiskt störda]. Stockholm: Allmänna förlaget; 1992 [SOU 1992: 73].Google Scholar
Corrigan, PW, Buican, B, McCracken, S. Can severely mentally ill adults reliably report their needs?. J Nerv Ment Dis 1996;184:523-9.CrossRefGoogle ScholarPubMed
Crane-Ross, D, Roth, D, Lauber, BG. Consumers’ and case managers’ perceptions of mental health and community support service needs. Community Ment Health J 2000;36:161-78.CrossRefGoogle ScholarPubMed
Dottl, SL, Greenley, JR. Rural-urban differences in psychiatric status and functioning among clients with severe mental illness. Community Ment Health J 1997;33:311-21.CrossRefGoogle ScholarPubMed
Feinstein, AR, Cicchetti, DV. High agreement but low kappa: I. The problems of two paradoxes. J Clin Epidemiol 1990;43:543-9.CrossRefGoogle ScholarPubMed
Ford, J, Young, D, Perez, BC, Obermeyer, RL, Rohner, DG. Needs assessment for persons with severe mental illness: what services are needed for successful community living?. Community Ment Health J 1992;28:491-503.CrossRefGoogle ScholarPubMed
Freeman, H, Alpert, M. Prevalence of schizophrenia in an urban population. Br J Psychiatry 1986;149:603-11.CrossRefGoogle Scholar
Halldin, J. Prevalence of mental disorder in an urban population in central Sweden. Acta Psychiatr Scand 1984;69:503-18.CrossRefGoogle Scholar
Hansson, L, Vinding, HR, Mackeprang, T, Sourander, A, Werdelin, G, Bengtsson-Tops, A, et al. Comparison of key worker and patient assessment of needs in schizophrenic patients living in the community: a Nordic multicentre study. Acta Psychiatr Scand 2001;103:45-51.CrossRefGoogle ScholarPubMed
Jablensky, A. Epidemiology of schizophrenia: a European perspective. Schizophr Bull 1986;12:52-73.CrossRefGoogle ScholarPubMed
Katschnig, H. Schizophrenia and quality of life. Acta Psychiatr Scand 2000;102(Suppl 407):33-7.CrossRefGoogle Scholar
Lasalvia, A, Ruggeri, M, Mazzi, MA, Dall’Agnola, RB. The perception of needs for care in staff and patients in community-based mental health services. Acta Psychiatr Scand 2000;102:366-75 The South-Verona Outcome Project 3.CrossRefGoogle ScholarPubMed
Lockwood, A, Marshall, M. Can a standardized needs assessment be used to improve the care of people with severe mental disorders? A pilot study of ‘needs feedback’. J Adv Nurs 1999;30:1408-15.CrossRefGoogle ScholarPubMed
MacCarthy, B, Benson, J, Brewin, CR. Task motivation and problem appraisal in long-term psychiatric patients. Psychol Med 1986;16:431-8.CrossRefGoogle ScholarPubMed
Middelboe, T, Mackeprang, T, Hansson, L, Werdelin, G, Karlsson, H, Bjarnason, O, et al. The Nordic study on schizophrenic patients living in the community. Subjective needs and perceived help. Eur Psychiatry 2001;16:207-14.CrossRefGoogle Scholar
Middelboe, T, Mackeprang, T, Thalsgaard, A, Christiansen, PB. A housing support programme for the mentally ill: need profile and satisfaction among users. Acta Psychiatr Scand 1998;98:321-7.CrossRefGoogle ScholarPubMed
Nordentoft, M, Knudsen, HC, Schulsinger, F. Housing conditions and residential needs of psychiatric patients in Copenhagen. Acta Psychiatr Scand 1992;85:385-9.CrossRefGoogle ScholarPubMed
Phelan, M, Slade, M, Thornicroft, G, Dunn, G, Hollowa, F, Wykes, T, et al. The Camberwell Assessment of Need: the validity and reliability of an instrument to assess the needs of people with severe mental illness. Br J Psychiatry 1995;167:589-95.CrossRefGoogle ScholarPubMed
Slade, M, Phelan, M, Thornicroft, G. A comparison of needs assessed by staff and by an epidemiologically representative sample of patients with psychosis. Psychol Med 1998;28:543-50.CrossRefGoogle ScholarPubMed
Slade, M, Phelan, M, Thornicroft, G, Parkman, S. The Camberwell Assessment of Need (CAN): comparison of assessments by staff and patients of the needs of the severely mentally ill. Soc Psychiatry Psychiatr Epidemiol 1996;31:109-13.CrossRefGoogle ScholarPubMed
Slade, M, Leese, M, Taylor, R, Thornicroft, G. The association between needs and quality of life in an epidemiologically representative sample of people with psychosis. Acta Psychiatr Scand 1999;100:149-57.CrossRefGoogle Scholar
Sommers, I. Geographic location and mental health services utilization among the chronically mentally ill. Community Ment Health J 1989;25:132-44.CrossRefGoogle ScholarPubMed
Swedish government bill 1993/94:218. Stockholm: Allmänna förlaget; 1994 [Psykiskt stördas villkor.]Google Scholar
Torrey, EF. Prevalence studies in schizophrenia. Br J Psychiatry 1987;150:598-608.CrossRefGoogle Scholar
Widerlöv, B, Borgå, P, Cullberg, J, Stefansson, CG, Lindqvist, G. Epidemiology of long-term functional psychosis in three different areas in Stockholm county. Acta Psychiatr Scand 1989;80:40-6.CrossRefGoogle ScholarPubMed
Widerlöv, B, Lindström, E, von Knorring, L. One-year prevalence of long-term functional psychosis in three different areas of Uppsala. Acta Psychiatr Scand 1997;96:452-8.CrossRefGoogle ScholarPubMed
Wiersma, D, Nienhuis, FJ, Giel, R, Slooff, CJ. Stability and change in needs of patients with schizophrenic disorders: a 15- and 17-year follow-up from first onset of psychosis, and a comparison between ‘objective’ and ‘subjective’ assessments of needs for care. Soc Psychiatry Psychiatr Epidemiol 1998;33:49-56.CrossRefGoogle Scholar
World Health Organization. Manual of international statistical classification of diseases [ninth revision] Geneva. 1977.Google Scholar
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