Priorities for long-term care: comments from board-and-care residents

In these times of shrinking human services resources, establishing clear service priorities becomes all the more necessary. This is particularly true for the care of chronically mentally ill persons, whose many needs place high service demands on the care system. As a group these patients rarely have a say in the establishment of service priorities. To obtain a better idea of their perceived needs, we asked 278 randomly selected, mentally disabled residents in 30 Los Angeles board-and-care homes about their current life conditions and problems. Their responses to open-ended questions about recent sources of unhappiness and desired changes were compared with quantitative measures of life satisfaction in several life areas. Unemployment, poverty, and housing were the areas in which patients most consistently expressed dissatisfaction and desire for change. Also, mental health problems, including interpersonal and family difficulties, caused frequent day-to-day unhappiness for them. These findings underscore the need for social service programs that adequately address patients' problems of living, in addition to continuing efforts to meet their mental health needs.