Health Needs Assessment

Health Needs Assessment



Health Needs Assessment

Introduction

Primary care plays a fundamental role in the provision of services for people with mental health care needs, and in the promotion of mental health and well-being. It also works closely with mental health services and refers service users for assessment, treatment and care when this is appropriate. The extent of primary mental health care service provision can be seen from the following.

One in four people in the community have mental health care needs.

30% of people who see their GP have a mental health component to their condition.

90% of people with mental health care needs are cared for entirely within primary care (Koro Carol 2002).

About 40% of people with severe and/or enduring mental health care needs are not in contact with specialist mental health services2.

Despite these facts, most mental health needs assessment focuses on those in contact with specialist mental health services. This needs assessment chapter focuses on the needs of individuals aged 16-64 years, who have severe and/or enduring mental health care needs who are not in contact with specialist mental health services but who are registered with primary care.

EPIDEMIOLOGY

Definition

It is widely accepted that people with severe and/or enduring mental health care needs are no longer simply defined by diagnosis5,6. In addition to diagnosis, the key factors in defining severe and/or enduring mental health care needs for this study were: the risk people pose to themselves and others, the level of care required, the level of disability, the distress people experience and the duration of the care needs.

Prevalence

Data provided by the Improving Mental Health Information Programme estimates that 5020 people in Lanarkshire have severe and/or enduring mental health care needs. Of these, 11 (0.2%) are under 16 years of age, 1345 (27%) are aged 16-39, 2302 (46%) are aged 40-64 and 1360 (27%) are aged 65 or over. The figures suggest a Lanarkshire prevalence rate for the 16-64 age group of 9.3 people per 1000, ranging from 7.8 per 1000 in East Kilbride to 11.5 per 1000 in Coatbridge (Table 1).

(Table 1): Prevalence of people with severe and/or enduring mental health care needs aged 16-64 years by LHCC, number and rate per 1000 population

LHCC area

Population aged 16-64 years

Number

Rate per 1000

Airdrie

Coatbridge

Cumbernauld

Motherwell

Wishaw

Clydesdale

East Kilbride

Hamilton

36140

32150

47000

52600

43300

39100

58600

72600

370

370

400

480

440

380

460

720

10.2

11.5

8.5

9.1

10.2

9.7

7.8

9.9

Lanarkshire

390800

3650

9.3

NEEDS OF USERS

Methods

Through co-operation with the Cumbernauld & Kilsyth and Clydesdale LHCCs, nine GP practices self-nominated to take part in the study, four in Clydesdale and five in Cumbernauld. Service users with severe and/or enduring mental health care needs were identified via primary care information systems, local Scottish Morbidity Record data and key informant information provided by local statutory and non-statutory mental health services. The approach was fully compliant with the Data Protection Act, NHS Caldicott Guidelines and was approved by NHS Lanarkshire Research Ethics Committee(Hennessy Sean 2002).

A clinician with research experience used a validated assessment tool, the Cardinal Needs Schedule8, to interview a stratified random sample of service users who were not in contact with specialist mental health services. When available the carers of service users were also ...