Project Development

Needs Assessment:

Assessing the needs of service users is a fundamental role of mental health clinicians. The NiRA was developed to provide clinicians with a comprehensive and systematic tool for identifying unmet needs, and for developing a plan with service users to set goals in order to meet these needs.
The NiRA has been informed by current academic literature5, and a series of focus groups and workshops conducted with people who are recovering from a first episode of mental illness and mental health clinicians from diverse professional backgrounds.

5. Davies EL, Gordon AL, Pelentsov LJ, Hooper KJ, Esterman AJ. Needs of individuals recovering from a first episode of mental illness: A scoping review. Int J Ment Health Nurs Jul 5 2018

Individual Needs:

In developing this assessment tool, it was recognised that every person will experience recovery in a different way, under different circumstances and in different environments6. There may be many similarities with other people’s experiences, but it is important to recognise the unique experiences of each individual. Similarly, the type of needs which people experience in recovery will vary. Whilst many needs are considered to be universal7, the type and severity of need will be impacted by a person’s context, character, relationships, history, support systems and networks.

6. Cocchi A, Cerati G, Lora A, et al. Patients with first-episode psychosis are not a homogenous population: Implications for treatment. Clinical Practice and Epidemiology in Mental Health Vol 10 2014, ArtID 1-8 2014;10:1-8.

7. Phelan M, Slade M, Thornicroft G, et al. The Camberwell Assessment of Need: the validity and reliability of an instrument to assess the needs of people with severe mental illness. British Journal of Psychiatry 1995;167(5):589-595.

The inclusion of both service users and mental health clinicians at different stages in the process has been vital to the development of the NiRA as a relevant and practical assessment tool. Input from these stakeholders has been invaluable. It has shaped many of the features and items which have been included in the final version of the tool.

Further developmental considerations which have shaped this assessment tool include:

Population.

A first episode of mental illness can occur at different stages of life8-11. The NiRA has been designed for services users of varying ages, types of life experience, level of education, employment status, socio-economic backgrounds and relationships with family and friends.

8. Woodside H, Krupa T. Work and financial stability in late-onset first-episode psychosis. 2010;4(4):314-318.

9. Boeing L, Murray V, Pelosi A, McCabe R, Blackwood D, Wrate R. Adolescent-onset psychosis: prevalence, needs and service provision. British Journal of Psychiatry 2007;190:18-26.

10. Doucet S, Letourneau N, Blackmore ER. Support Needs of Mothers Who Experience Postpartum Psychosis and Their Partners. Journal of Obstetric, Gynecologic & Neonatal Nursing 2012;41(2):236-245.

11. Skärsäter I. Parents with first time major depression: perceptions of social support for themselves and their children. Scandinavian Journal of Caring Sciences 2006;20(3):308-314.

Array of needs

The NiRA facilitates a whole of person approach, incorporating a broad array of needs which may be experienced, comprehensive of practical and daily activity needs, as well as emotional, social, psychological and relationship needs.

Models of care

The NiRA is intended to co-exist with models of care which are person-centred, recovery-oriented and trauma-informed. It is not a model of care itself but has been designed to complement and enhance modern practice in mental health care.

Usability

The NiRA has been designed to be used across multi-disciplinary teams within the mental health system, including psychiatrists, psychologists, mental health nurses, social workers and occupational therapists. It could also be used to provide a comprehensive handover of service users’ needs to non-government organisations who are contracted to provide services to services users.

Collaboration

The NiRA has been designed to facilitate collaboration between service users and mental health clinicians in developing strategies for meeting unmet needs.

Empowering

A desired outcome of undertaking the NiRA for service users is that they feel empowered in their recovery as a result of discussing current needs and supported solutions to meeting these needs.

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Purpose & Objectives

Items of assessment

Development Team