Met and Unmet Needs in an Inpatient Psychiatry Setting in Spain

Abstract

Purpose Patients with severe mental disorder have health and social needs that require care. The aim of the study was to determine the main areas of perceived needs among inpatients with severe mental disorders and to identify risk factors of the group of patients with the greatest unmet needs. Patients and Methods A total of 150 patients with severe mental illness were assessed during admission prior to discharge from the hospital. Camberwell Assessment of Needs was used as evaluation measure, in addition to clinical status (The Brief Psychiatric Rating Scale), social functioning (Personal and Social Performance) and sociodemographic variables. A descriptive and a multivariate logistic regression analysis were used to analyse variables related to the group of patients with the highest number of unmet needs (≥3). Results Mean number of needs was 7.93, being 4.61 the mean number of needs met and 3.32 the needs unmet. The highest proportion of unmet needs were intimate relationships (44.0%), company (40.7%) and daytime activities (38.7%). A relationship was also found between the presence of three or more unmet needs and the following variables: Brief Psychiatric Rating Scale score (p=0.004), Personal and Social Performance score (p = 0.013), marital status (p=0.018), employment status (p=0.009) and voluntary admission (p=0.032). The multivariate model explained 29.5% of the variance (Nagelkerke’s R 2 : 0.295). Conclusion Treatments aimed at improving social relationships and daytime activities could be a good option for inpatients with many unmet needs.

Evaluation of Met and Unmet Needs in Patients with Severe Psychiatric Disorders and its Relation to the Quality of Life: A Cross-Sectional Study

“…However, studies with outpatient participants and less illness severity reported fewer needs ( 25 , 26 ). Identical to our results, numerous studies have reported high unmet patient needs for intimate relationships, sexual expression, information on condition and treatment, psychological distress, and psychotic symptoms ( 12 , 27 , 28 ).…”

“…However, due to the differences in the studies in terms of study design, symptom severity, mental health care systems, and socioeconomic status, the number of needs cannot be compared precisely. Still, in general, studies that evaluate more severe and inpatient participants reported a more significant number of needs ( 12 , 24 ). However, studies with outpatient participants and less illness severity reported fewer needs ( 25 , 26 ).…”

“…However, the number of total and unmet needs was higher in patients with schizophrenia. They mentioned that sociocultural factors influence needs more than the disorder type ( 12 ).…”

“…Also, in another study on the population of patients with schizophrenia and schizoaffective disorder, it was shown that more unmet needs were associated with lower quality of life, more severe illness, and more severe psychological distress ( 34 ). In the sample of psychiatric patients in Spain, ≥3 unmet needs were associated with higher severity of the disorder ( 12 ). In assessing the needs of patients with schizophrenia in India, there was a significant relationship between unmet needs and positive and negative symptoms, as well as general psychopathology ( 25 ).…”

“…Since then, numerous studies evaluated psychiatric patient needs and factors that influence them in many countries. More unmet needs were related to illness severity ( 12 ), socioeconomic status ( 13 ), lower quality of life ( 3 ), and more emergency department visits ( 14 ). Also, needs profiles were different among different countries and cultures ( 15 ).…”