Self-reported needs of people living with psychotic disorders: Results from the Australian national psychosis survey

Abstract

Person-centered care is a collaborative approach to health care. To provide effective, person-centered care to people living with severe mental illness, it is necessary to understand how people view their own needs. The Perceived Need for Care Questionnaire (PNCQ) was used in the Australian National Survey of High Impact Psychosis (SHIP) to deepen understanding and evaluate, at a population level, the needs of Australian adults living with psychotic illness. SHIP participants were 1,825 adults, aged 18–65 years, living with psychotic illness and in contact with public specialized mental health services across Australia in 2010. The survey package included demographic and clinical items, and various scales including the PNCQ appraising a comprehensive range of life domains. Logistic regressions measured the impact that various demographic, clinical and psychosocial independent variables (e.g., loneliness, health-related quality of life, disability, accommodation type) had on the likelihood of inadequately met PNCQ domain-related need. Over two-thirds of people living with psychosis reported at least two areas of unmet need for care despite most being in contact with mental health services. Work or using one's time and socializing, counseling, and self-care domains had the largest proportion of inadequately met needs (range between 49 and 57%). Feelings of loneliness and/or social isolation were significantly associated with unmet needs across all PNCQ domains, except for financial needs. Health-related quality of life was significantly associated with unmet needs across all domains, except for housing needs. Disability was significantly associated with unmet social, occupation (work or time use), housing and medication-related needs. Consumers view their needs for care as unmet across many life areas despite being in contact with mental health services. Loneliness, unmet psychosocial needs, and health-related quality of life appear strongly interconnected and warrant greater attention in the delivery of person-centered care for people living with psychosis. Support to address social, work or time use and housing related needs among people living with psychosis appears less well targeted toward those with disability. Results underscore the link between quality of life, recovery and needs. These inter-relationships should be considered in mental health services research and evaluation.

A longitudinal study of the impacts of a stay in a Prevention and Recovery Care service in Victoria, Australia

“…Nevertheless, one in four reported an inadequately met need for medication, which is consistent with previously reported survey findings by Morgan et al (2017) , in which the vast majority of people living with psychoses were taking medication but also indicated their treatment with medication was suboptimal. Similarly, the pattern of unmet needs in our study is very similar to other findings about people living with psychosis ( Migliorini et al, 2022 ). PNCQ results indicate that other perceived psychosocial needs are not adequately addressed over time in the specific areas of social connection (company), self-care, and work and time use.…”

Supports that help me to live well in the community: experiences of people living with schizophrenia

“…Environmental‐focused support included access to financial and accommodation security and engaging with a community of choice. These findings emphasise the multifaceted nature of support required by people living with schizophrenia, aligning with findings from previous investigations (Migliorini et al, 2022; Morgan et al, 2017).…”

“…The needs of Australians living with psychosis are multifaceted (Migliorini et al, 2022; Morgan et al, 2017), and can be mapped to the person‐environment‐occupation structure commonly found in occupational therapy conceptual models as follows (Turpin & García, 2021). Insufficient personal needs imply support to manage their mental and physical illness effectively; unmet environmental needs such as financial and accommodation securities; and unmet occupational needs such as meaningful use of time and social activities (Migliorini et al, 2022; Morgan et al, 2017; New South Wales Governmnet, 2011; NSW Mental Health Commission, 2014). While these studies reported people's views of their unmet needs, they have neither examined which supports were helpful nor the specific supports that people themselves identified as assisting them to live in the community and avoid re‐hospitalisation.…”

Predictors of length of time in service: Characteristics of people in intensive case management for longer than 5 years.

“…People with diagnoses of psychosis have reported that most of the help and support they receive for their mental health is from mental health practitioners rather than primary health care or informal services (Migliorini et al, 2022). Their greatest areas of unmet need are counseling and social support.…”