Introduction.
This thesis examines self-reported need in people who have a long-term mental illness. The context is recent mental health policy in The United Kingdom which emphasises that the assessment of an individual's expressed need be undertaken in addition to a normative assessment of need. The main issue addressed concerns testing the proposition that people with a long-term mental illness can reliably and validly report their own needs.
Methodology.
The thesis is split into three stages. Stage 1 represents the piloting of client and keyworker assessment of need schedules. Stage 2 concerns refinement of the schedules based on the results of Stage 1. Stage 3 represents an examination of the reliability and validity of client's self-reported need. The basic methodology used includes the use of key-worker needs data to help verify the reliability and validity of client needs data and the use of client mental state data to help examine factors related to self-report need measures.
Results.
Results provide a) evidence that under-reporting of need by people with a long-term mental illness is more probable than over-reporting of need compared to key-workers; and b) evidence to reflect a complex interaction between client and key-worker perspectives.
Conclusions.
Overall it appears that the ability of people with a long-term mental illness to self-report need in a needs assessment situation is multi-factorial. Factors include psychiatric symptomatology, insight, cognitive deficits, motivational processes and a social desirability bias. The implication for the policy and practice of self-reported need is that people with a long-term mental illness require a thorough assessment of their mental state and verification of their needs with key-workers.