Multiple perspectives on mental health outcome: needs for care and service satisfaction assessed by staff, patients and family members

Community-based mental health care requires the involvement of staff, patients, and their family members when both planning
intervention programmes and evaluating mental health outcomes. The present study aimed to compare the perceptions of these
three groups on two important subjective mental health outcome measures—needs for care and service satisfaction—to identify
potential areas of discrepancy.

The sample consisted of patients with a DSM diagnosis of psychosis and attending either outpatient or day centres operating
in a community-based care system. Staff, patients and family members were assessed by using the CAN and the VSSS to evaluate,
respectively, needs for care and service satisfaction. Kappa statistics were computed to assess agreement in the three groups.

Patients identified significantly fewer basic (e.g. daytime activities, food, accommodation) and functioning needs (e.g. self-care,
looking after home, etc.) than staff or family members. Only fair levels of agreement were found in the three groups (average
kappa was 0.48 for staff and patients, 0.54 for staff and family members, and 0.45 for patients and relatives), with patients
and family members showing more areas of discrepancies in both needs and service satisfaction.

These findings provide further support for the idea that mental health services should routinely involve patients and their
relatives when planning and evaluating psychiatric intervention and that this policy is a premise for developing a partnership
care model.