Factors associated with changing patient needs in an assertive outreach team

Area of Science:

• Mental Health Services Research
• Clinical Psychology
• Psychiatry

Background:

• Clinical use of needs assessment tools is widespread, but evidence for their longitudinal value is limited.
• Assertive outreach (AO) teams manage complex caseloads requiring ongoing needs evaluation.
• Understanding factors influencing changing needs is crucial for effective long-term care.

Purpose of the Study:

• To identify factors associated with changes in patient needs within an AO team's caseload over a six-month period.
• To evaluate the effectiveness of needs assessment in guiding care planning and addressing unmet needs.
• To examine changes in patient engagement with services over time.

Main Methods:

• The Camberwell Assessment of Needs Short Appraisal Schedule (CANSAS) and Engagement Measure (EM) were administered to patients in an AO team.
• Patients were reassessed at a six-month follow-up to track changes in needs and engagement.
• Care planning decisions were informed by identified unmet needs.

Main Results:

• Patient-rated unmet needs significantly reduced over six months, while staff-rated unmet needs did not.
• Patient-rated met needs increased significantly, but staff-rated met needs did not change.
• Patient engagement levels remained unchanged; needs varied across physical, social, and psychological domains.
• Accommodation type and diagnosis were independently associated with changes in patient-rated met and unmet needs, respectively.

Conclusions:

• Routine use of the CANSAS in an AO team setting correlated with a significant reduction in patient-rated unmet needs.
• Formal needs assessment appears to aid in effectively targeting care planning for complex mental health populations.
• Accommodation and diagnosis may be key factors influencing the successful resolution of patient needs, warranting further investigation in larger studies.