Items of Assessment

Introduction to the Items:

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The NiRA is a 38-item assessment tool, designed to initiate discussions about a broad array of needs that may be experienced by people recovering from a first episode of mental illness.

The items of need included in the NiRA1 have been divided into six categories to facilitate a systematic approach to assessment. These categories reflect the broader needs that have been identified in academic literature and by service users and mental health clinicians involved in developing and evaluating the NiRA.

Whilst items have been allocated to categories in this assessment, it is important to recognise that some needs are inter-related and may cross two or more categories. For example, the item “reducing or abstaining from alcohol or other substance use” has been placed in the physical needs category. Needs relating to this item are likely to also involve psychological and emotional items that may be important to discuss within the context of a needs assessment.

 

 

1-1. Davies, EL, Gordon, AL, Pelentsov, LJ, Hooper, KJ & Esterman, AJ, 2018:
‘Needs of individuals recovering from a first episode of mental illness: a scoping review’. International Journal of Mental Health Nursing vol. 27, pp. 1326-1343
1-2. Davies, EL, Pelentsov, LJ, Hooper, KJ, Gordon, AL & Esterman, AJ, 2019:
‘Needs of individuals recovering from a first-episode of mental illness: a qualitative descriptive analysis of focus group discussions’, Issues in Mental Health Nursing vol. 40, no. 9, pp. 737-746.
1-3. Davies, EL, Hooper, KJ, Pelentsov, LJ, Gordon, AL & Esterman, AJ, 2020:
‘Development and validation of the Needs in Recovery Assessment (NiRA): a clinical tool for assessing the needs of individuals recovering from a first-episode of mental illness’ International Journal of Mental Health Nursing, early view.

Identifying unmet needs.

Practical needs

Needs relating to the resources required for maintaining an acceptable* level of quality of life, social independence and safety, such as safe and stable accommodation, adequate food and income.

  • Safe accommodation
  • Stable accommodation
  • Method to contact people (e.g. phone, internet)
  • Sufficient income
  • Support interacting with social services (e.g. housing trust, welfare services, child support, legal aid)

Daily activity needs

Needs relating to developing or applying skills that enable individuals to live with an acceptable* level of quality of life and social independence.

  • Preparing or getting meals
  • Shopping for household goods (e.g. food, clothing)
  • Cleaning and maintenance of your home
  • Managing income
  • Self-care (e.g. hygiene, appearance)
  • Transportation (e.g. to & from school, work, appointments)
  • Attending place of work or study
  • Performing well at place of work or study
  • Attending appointments
  • Knowing what to do during the day (e.g. having a routine, creative outlet, plan for education or employment)
  • Care of dependent(s) (e.g. children, other relatives, pets)

Physical health needs

Needs relating to the maintenance of physical health and the treatment and management of physical illness, including side-effects from medications.

  • Managing physical health or illness
  • Managing side-effects of medications
  • Maintaining a healthy body weight
  • Maintaining healthy eating habits
  • Maintaining healthy sleeping patterns
  • Attending regular GP appointments (e.g. review of physical & sexual health, medication reviews)
  • Reducing/abstaining from alcohol/substance use

Informational needs

Needs relating to the provision and reception of information relating to diagnosis, prognosis, symptoms, treatment and support services.

Understanding your:
  • diagnosis
  • treatment plan
  • medications
  • recovery and how this could be enhanced

Emotional and psychological needs

Needs relating to the understanding, expression and management of one’s feelings, such as anger, hope, fear and happiness and; needs relating to coping with experiences and thoughts, exploring and expressing identity, the desire to be understood and to belong, and the management of psychological symptoms.

  • Understanding, expressing and managing your emotions
  • Understanding, expressing and managing your thoughts
  • Managing psychological symptoms
  • Feeling safe when you experience thoughts of self-harm
  • Feeling safe when you experience thoughts of suicide
  • Managing loneliness

Relationship needs

Needs relating to the quality of interactions with family, friends, colleagues, employers and peers, and the ability to navigate social contexts effectively and independently.

  • Discussing your diagnosis and recovery with:
    • spouse/partner
    • family members
    • friends
    • employer/school authorities
  • Finding a peer support group (e.g. mental health, online, addiction or physical
    illness support group)

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