Component 2
Identifying Needs

CRM recognizes that unmet needs are a key source of motivation for mental health consumers and hence are important to identify. CRM adopts a negotiated approach to need, utilizing measures such as the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS, London Institute of Psychiatry, 1997; Phelan, Slade & Thornicroft, 1995) as part of needs assessment and as a precursor to collaborative goal setting.


Socially negotiated need


An approach to needs assessment which calls for collaboration between the views of clinicians and the demands of consumers has been referred to as “socially negotiated” (Carroll & Mortimer, 1998).

 

The Camberwell Assessment of Need


The Camberwell Assessment of Need (CAN) is a structured interview in which staff, consumer and carer views of need are recorded separately. Expressed need of the consumer is incorporated into the socially negotiated concept of need represented by the CAN and the shorter version, the CANSAS. Such an assessment instrument which records client-identified and clinician-rated needs separately can act as a catalyst for discussion (Slade et al., 1996).


Four principles shaped the development of the CAN

  1. Everyone has needs
  2. People with mental illness have multiple needs, which are not always recognised by mental health services
  3. Routine needs assessment should be an integral part of clinical practice and service evaluation
  4. Needs should not be defined by staff alone


All variations of the CAN assess 22 areas of need:

  1. Accommodation
  2. Food
  3. Looking after the home
  4. Self-care
  5. Daytime activities
  6. Physical Health
  7. Psychotic Symptoms
  8. Information on condition and treatment
  9. Psychological distress
  10. Safety to self
  11. Safety to others
  12. Alcohol
  13. Drugs
  14. Company
  15. Intimate relationships
  16. Sexual expression
  17. Child care
  18. Basic education (literacy)
  19. Telephone
  20. Transport
  21. Money
  22. Benefits

The interviewer can be a third person (eg researcher) who can interview a staff member, the consumer or the carer. The interviewer can also be the staff member, who can make their own rating, record the consumer’s rating and the carer’s rating.


The level of need is rated in several ways:
0 = no need
1 = met need
2 = unmet need
9 = not known

   

Media resources

Key references

Library resources