Meeting the needs of people with schizophrenia living in the community: a report from a European collaboration

Objectives: This study was carried out as part of a collaborative European study, with the aim of assessing needs in a population with chronic schizophrenia in the context of a community service, and also to measure service use in this population. Method: This is the first part of a 12 month follow-up study of a sample of persons with schizophrenia who were in contact with the psychiatric services. Seventy eight patients who matched the inclusion criteria were randomly selected and 64 (82%) were interviewed using the Schedules for Clinical Assessment in Neuro-Psychiatry (SCAN) and the Needs for Care Assessment Schedule (NCAS). Service use data for a 12 month period were collected prospectively using the Mannheim Service Recording Sheet (MSRS). Results: The levels of clinical and social need were quite low at 2.1 and 2.6 respectively. Most needs were met; unmet need was 0.11 for clinical problems and 0.4 for social. Service use was high, with a total of 6,969 contacts with community services, a mean of 109 per patient per year. Total service use (including inpatient and hostel) was partly predictive of met need (R-2 23.6). The levels of met and unmet need in Dublin compare favourably with that reported in Mannheim and Granada. Service use was similar to that in Mannheim, although there was a higher level of service provision in Mannheim. Conclusions: This study has shown that there is a low level of clinical and social need in this sample of patients with schizophrenia living in the community, and a relatively high level of service use. There is good evidence that services are meeting the needs of this sample of patients.