Needs assessment in mental health services: the DISC framework

People with mental health problems have a range of health and social care needs that result in both illness and disability (effects of the illness on social functioning and citizenship). If service development is to be creative and innovative, needs assessment has to focus on the identification of actual need--rather than using the existing services as the basis of planning. To be valid, needs assessment must use the experience of users and their families, yet it can be highly frustrating for all concerned if there is not a clear framework to structure the wide-ranging information that will be collected through this sort of exercise. This paper proposes a framework for structuring needs assessment and discusses how it can be used for local mental health service development through a 'stakeholder' approach. The framework can be used to identify a comprehensive set of service functions, that is, what a service actually needs to be doing if the range of peoples' needs are to be met. The use of the framework to structure activity at different levels in the service system is discussed.