SynopsisWe report the development of a new procedure for assessing the needs for treatment and care of the long-term mentally ill. This procedure covers 21 areas of clinical and social functioning, and in each of these specifies appropriate interventions. Decision rules are described which permit problems in functioning to be primarily classified as a met need, an unmet need, or as involving no need, and which allow the identification of various secondary needs. We report preliminary data on the reliability and validity of this procedure and discuss its potential applications in the care of the long-term mentally ill.

This paper analyses the central concerns of selection and execution of cross-national qualitative research. Discussion is issue-driven , incorporating relevant publications on the basis of good practice. An assessment is made of the potential of the qualitative approach in cross-national settings, as well as its pitfalls. Questions of sampling and the attributes of specific methods are then addressed. The paper concludes with a brief review of the added value of qualitative data software packages.

SynopsisWe report the results of a survey of the needs for items of care of 145 long-term users of psychiatric day-hospitals and day-centres in Camberwell. The overall ratio of met to unmet need was almost exactly 5:1. Need was shown to vary according to chronicity, degree of participation, and placement in day-hospital or day-centre. Specific areas of functioning and specific types of care were identified in which there was significant overprovision or underprovision. The utility of our measures, and their ability to identify clinically significant unmet need, are discussed.

SynopsisWe report the results of a survey of the burdens and needs for items of care of 45 supporters of long-term users of psychiatric day care facilities in Camberwell. The supporters reported high levels of disturbed behaviour and low levels of self-care skills in the attenders. They were also subject to high levels of social and economic burden, not all of which could be attributed to the attenders' problems. The needs assessment identified a large number of unmet needs, although the supporters themselves were largely resigned to their situation and expressed little dissatisfaction with the services they were offered. The advantage of conducting this kind of assessment of supporters' needs as a routine part of clinical practice was discussed.