Assessing perceived need for mental health care in a community survey: development of the Perceived Need for Care Questionnaire (PNCQ)

Background: The Perceived Need for Care Questionnaire (PNCQ) was designed f or the Australian National Survey of Mental Health and Wellbeing. The PNCQ complemented collection of data on diagnosis and disability with the survey participants' perceptions of their needs for mental health care and the me eting of those needs. The four-stage design of the PNCQ mimics a conversati onal exploration of the topic of perceived needs. Five categories of percei ved need are each assigned to one of four levels of perceived need (no need , unmet need, partially met need and met need). For unmet need and partiall y met need, information on barriers to care is collected, Methods: Inter-ra ter reliabilities of perceived needs assessed by the PNCQ were examined in a study of 145 anxiety clinic attenders. Construct validity of these items was tested, using a multi-trait multi-method approach and hypotheses regard ing extreme groups, in a study with a sample of 51 general practice and com munity psychiatric service patients. Results: The instrument is brief to ad minister and has proved feasible for use in various settings. Inter-rater r eliabilities for major categories, measured by the kappa statistic, exceede d 0.60 in most cases; for the summary category of all perceived needs, inte r-rater reliability was 0.62. The multi-trait multi-method approach lent su pport to the construct validity of the instrument, as did findings in extre me groups. Conclusions: The PNCQ shows acceptable feasibility, reliability and validity, adding to the range of assessment tools available for epidemi ological and health services research.