A statewide survey of high-support services for people with chronic mental illness: assessment of needs for care, level of functioning and satisfaction

Objective: The primary aim of this study was to describe high support accommodation services available for patients with chronic mental illness living in New South Wales (NSW). The second aim was to ask patients in these facilities about their needs and satisfaction with services and to assess their level of functioning. Method: Non-inpatient services matching NSW Health's definition for high support, very high support and residential rehabilitation were sent a survey regarding type of service, criteria for acceptance, choice of housing options, patient demographics, evaluation methods and staff details. The Camberwell Assessment of Need was used to assess needs and the Life Skills Profile-16 was used to assess level of functioning. Comparisons were made between services operated by NSW Health and non-government organizations (NGOs), rural and urban services and services providing 24-hour support and those with less intensive staffing. Results: Forty of the 42 identified services were included in the survey (95% response rate) of which 25 were operated by NGOs. There were 753 residential beds and 1132 patients lived in these facilities over the financial year 2001/2002. Interviews were completed at 25 locations across the state with 159 patients. Seventy-four percent were male and the mean age was 43 years. Patients had on average 7.6 needs of which 2.2 were unmet and their mean LSP-16 total score was 16.8. Almost half the patients responded that they were homeless at one time because they could not find appropriate housing. Conclusions: There were no significant differences in the number of needs expressed by patients residing in government or non-government operated services, those living in rural or urban areas and those in 24-hour services compared to patients in less intensively staffed services. Existing services are doing a good job of meeting patients' needs for practical assistance, but social and psychological needs remain unmet for a significant proportion.