Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-30T15:09:55.516Z Has data issue: false hasContentIssue false

The Camberwell Assessment of Need: The Validity and Reliability of an Instrument to Assess the Needs of People with Severe Mental Illness

Published online by Cambridge University Press:  02 January 2018

Michael Phelan*
Affiliation:
Department of Psychology, Institute of Psychiatry, London
Mike Slade
Affiliation:
Department of Psychology, Institute of Psychiatry, London
Graham Thornicroft
Affiliation:
Department of Psychology, Institute of Psychiatry, London
Graham Dunn
Affiliation:
Department of Psychology, Institute of Psychiatry, London
Frank Holloway
Affiliation:
Department of Psychology, Institute of Psychiatry, London
Til Wykes
Affiliation:
Department of Psychology, Institute of Psychiatry, London
Geraldine Strathdee
Affiliation:
Department of Psychology, Institute of Psychiatry, London
Linda Loftus
Affiliation:
Department of Psychology, Institute of Psychiatry, London
Paul McCrone
Affiliation:
Department of Psychology, Institute of Psychiatry, London
Peter Hayward
Affiliation:
Department of Psychology, Institute of Psychiatry, London
*
Dr Phelan, PRiSM, Institute of Psychiatry, De Crespigny Park, London SE5 8AF

Abstract

Background

People with severe mental illness often have a complex mixture of clinical and social needs. The Camberwell Assessment of Need (CAN) is a new instrument which has been designed to provide a comprehensive assessment of these needs. There are two versions of the instrument: the clinical version has been designed to be used by staff to plan patients' care; whereas the research version is primarily a mental health service evaluation tool. The CAN has been designed to assist local authorities to fulfil their statutory obligations under the National Health Service and Community Care Act 1990 to assess needs for community services.

Method

A draft version of the instrument was designed by the authors. Modifications were made following comments from mental health experts and a patient survey. Patients (n = 49) and staff (n = 60) were then interviewed, using the amended version, to assess the inter-rater and test-retest reliability of the instrument.

Results

The mean number of needs identified per patient ranged from 7.55 to 8.64. Correlations of the inter-rater and test-retest reliability of the total number of needs identified by staff were 0.99 and 0.78 respectively. The percentage of complete agreement on individual items ranged from 100–81.6% (inter-rater) and 100–58.1% (test-retest).

Conclusions

The study suggests that the CAN is a valid and reliable instrument for assessing the needs of people with severe mental illness. It is easily learnt by staff from a range of professional backgrounds, and a complete assessment took, on average, around 25 minutes.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.Google Scholar
Bradshaw, J. (1972) A taxonomy of social need. In Problems and Progress in Medical Care: Essays on Current Research (ed. McLachlan, G.) (7th series). London: Oxford University Press.Google Scholar
Brewin, C., Wing, J., Mangen, S., et al (1987) Principles and practice of measuring needs in the long-term mentally ill: the MRC Needs for Care Assessment. Psychological Medicine, 17, 971981.CrossRefGoogle ScholarPubMed
Brewin, C., & Wing, J., (1993) The MRC Needs for Care Assessment: progress and controversies. Psychological Medicine, 23, 837841.CrossRefGoogle ScholarPubMed
Cohen, J. A. (1960) A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 3746.CrossRefGoogle Scholar
Department of Health Social Services Inspectorate (1991) Care Management and Assessment: Summary of Practice Guidance. London: HMSO.Google Scholar
Feinstein, A. R. & Cicchetti, D. V. (1990) High agreement but low kappa: 1. The problems of two paradoxes. Journal of Clinical Epidemiology, 43, 543549.CrossRefGoogle Scholar
Gardner, S. B., Winter, P. D. & Gardner, M. J. (1991) CIA Confidence Interval Software. London: British Medical Journal.Google Scholar
Grammatik Software (1992) Grammatik 5 for Windows version 1.0. Essex: Reference Software International.Google Scholar
Hogg, L. I. & Marshall, M. (1992) Can we measure need in the homeless mentally ill? Using the MRC Needs for Care Assessment in hostels for the homeless. Psychological Medicine, 22, 10271034.CrossRefGoogle ScholarPubMed
Holloway, F. (1994) Need in community psychiatry: a consensus is required. Psychiatric Bulletin, 18, 321323.CrossRefGoogle Scholar
House of Commons (1990) The National Health Service and Community Care Act. London: HMSO.Google Scholar
Maslow, A. H. (1954) Motivation and Personality. New York: Harper & Row.Google Scholar
Phelan, M., Wykes, T. & Goldman, H. (1994) Global function scales. Social Psychiatry and Psychiatric Epidemiology, 29, 205211.CrossRefGoogle ScholarPubMed
Pryce, I. G., Griffiths, R. D., Gentry, R. M., et al (1993) How important is the assessment of social skills in current long-stay in-patients? British Journal of Psychiatry, 162, 498502.CrossRefGoogle ScholarPubMed
Slade, M. (1994) Needs assessment: who needs to assess? British Journal of Psychiatry, 165, 287292.Google Scholar
Slade, M., Phelan, M., Thornicroft, G., et al (1995) The Camberwell Assessment of Need (CAN): comparison of assessments by staff and patients of the needs of the severely mentally ill. Social Psychiatry and Psychiatric Epidemiology (in press).CrossRefGoogle Scholar
SPSS (1993) SPSS for Windows version 6.0. Statistical Package for the Social Sciences. Chicago: SPSS Inc.Google Scholar
Stevens, A. & Gabbay, J. (1991) Needs assessment needs assessment. Health Trends, 23, 2023.Google ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.