Needs assessment of outpatients with psychotic disorders in Brazilian community mental health services

INTRODUCTION:  Needs assessment among patients with severe mental disorders have been one of the most used measures in planning and monitoring of mental health services. However, no study has described the needs of psychiatric patients in Brazil, even following the recent expansion of community services. This research is aimed to fill such gap.

METHODS: This cross-sectional study comprises a probabilistic sample of 401 patients with psychotic disorders seen in all 5 public mental health community services of the Brazilian city of Santos in the one-year period preceding the survey. Needs were assessed in direct interviews with patients using the Camberwell Assessment of Needs (CAN) which investigates the presence of 22 different needs and whether they are met or unmet. Symptoms severity was assessed with the Positive and Negative Symptoms Scale (PANSS). Descriptive statistical analysis were used, with percentiles, means and standard deviations.

RESULTS: Mean scores of PANSS positive, negative and general psychopathology scales were respectively 13.9 (+-5.1), 18.54 (+-7.82) and 33.0 (+-10.4). The mean number of needs was 5.8 (+-3.1). The most often reported needs were psychotic symptoms (67.0%), information needs (55.0%), psychological distress (41.8%), money (41.5%), food (36.6%), activities (35.0%), physical health (34.8%), looking after the home (33.8%) and transportation (33.5%). In addition, the most frequently met needs among the patients who presented with them included: physical health (77.5%), food (69.7%), psychotic symptoms (66.3%), looking after the home (64.9%) and self-care (60.5%).

CONCLUSIONS: The sample consisted mostly of patients with low levels of psychotic symptoms and high levels of general psychopathology. The mean number of needs was consistent with the results of international studies. Finally, both clinical and basic needs, which were the most present, were also the most frequently met, with some exceptions, such as information and emotional distress. This may indicate the need for further psychosocial interventions.