Needs assessment and discharge: a Scottish perspective

Discharge from hospital remains a difficult area for health services and it is unclear how much impact policy directives have had on discharge outcomes. The recent National Service Framework for mental health has highlighted discharge as a key area with Standard Five indicating minimum requirements at discharge from hospital. In order to aid this process this paper discusses the findings of a needs assessment of patients following discharge from psychiatric inpatient care in Scotland. The needs and unmet needs as assessed by both patients and mental health community staff on the Camberwell Assessment of Need (CAN) are presented. The CAN seeks to identify needs in a range of domains addressing basic, health, social, functioning and service issues. The sample comprised 173 patients recently discharged from acute psychiatric units in eight health board areas of Scotland and 98 community staff identified as providing key support to 98 of the patient sample. The findings indicate that the needs of patients discharged from hospital are complex and that the targeting of mental health services according to diagnostic criteria may not be the best way of ensuring support reaches those in most need. The range of needs identified suggests that fully integrated multidisciplinary care is essential to meet needs at discharge. The period initially after hospital discharge is one of vulnerability and incorporating a needs assessment into the discharge planning could aid the care planning process required by the Framework.