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Evaluating needs for care of psychiatric patients

Needs may be defined in terms of impairment, disability, or in terms of interventions. The fact that a need is defined does not mean that it can be met. For example, some needs may remain unmet because other problems take priority, because an effective method is not available locally, or because the person in need refuses treatment. A need may exist, as defined by a professional, even if the intervention is refused by a patient. Further, a needs assessment is not intended to endorse the status quo. It is important to define need in terms of the care/agent/setting required, not those already in place. At the same time, a proper needs assessment process should not lead to the imposition of expert solution upon patients. A professionally defined need remain unmet, and have to be replaced by one acceptable to the patients. The specification of an intervention, if accepted by the user following negotiation, leads to the choice of a key worker to provide the care (Mangen & Brewin, 1991). In addition, it is important to distinguish need from demand, provision and utilisation (Figure 1 from Stevens & Gabbay, 1991).