Urgent need for a need assessment scale in monitoring social support - A validation study on the Swedish version of the Camberwell Assessment of need

In the aftermath of the desinstitutionalization process the social needs of patients with severe mental illness have been put on the agenda both for policy makers and professional groups working in this field. To be able to develop carefully designed monitoring systems to attend to this group of patients, there is an urgent need for assessment tools in this work. The Camberwell Assessment of Need is a form for a comprehensive assessment of the needs of people with a severe mental illness. The content and construct validity of the Swedish CAN Version was tried out on a group of 45 patients from the Department of Psychiatric Rehabilitation at the County Hospital of Jonkoping, Sweden, using in interviews a survey of need areas, the GAF functioning scale, and a quality of life scale (QLS-100). The overall result shows a rather weak correlation between assessment made by the GAF scale and assessment by key workers with the CAN. However, when the data are broken down, some interesting correspondences are found. Using the chi-square test the need areas accommodation, self-care, and daytime activities correspond with high and low GAF score, respectively. Somewhat surprisingly, the QLS-100 scores and the patient scores of the CAN show an even poorer correspondence. We interpret this as showing that where the QLS-100 invites to judgements on a desired quality of life, CAN judgements are more directed toward assessing factual circumstances in the individual's everyday life. We advocate further validity and reliability studies, since continuous changes in the support systems call for careful reasoning in addressing the difficult question of the relation between support and need.