ASSESSMENT OF THE NEED FOR CARE 15 YEARS AFTER ONSET OF A DUTCH COHORT OF PATIENTS WITH SCHIZOPHRENIA, AND AN INTERNATIONAL COMPARISON

Assessment of needs for care is crucial in the evaluation of ongoing c hanges from institutional care to various forms of day- and outpatient treatment, Do patients really do better in the community and are they adequately cared for? The 15-year follow-up of a Dutch incidence coho rt of patients with schizophrenia and other functional non-affective p sychoses showed that 47 (out of 63) patients had positive ratings of s ymptoms and disabilities, They were assessed by means of the Needs for Care Assessment Schedule, which articulates the problems and correspo nding interventions resulting in a judgement of met or unmet need for treatment or assessment, There was a mean of 2.1 clinical problems and 2.1 social problems per patient, Few problems were considered to gene rate unmet needs: 14% of the clinical problems and only 7% of the soci al problems. Nevertheless, 32% of the patients had one or more unmet n eeds, These results were compared with data from six research centres ill the United Kingdom (Camberwell, Oxford and South Glamorgan), Canad a (Montreal): Italy (Verona) and Finland (Tampere). Despite difference s in health care settings in the four countries, the ratio of met to u nmet needs (about: 4-5 to 1) among chronic, mostly schizophrenic patie nts is more or less the same with the exception of an apparently under served hostel population in Oxford and the Finnish patient population probably due to high expectations with respect to independent communit y living.