The development of needs in a group of severely mentally ill - A 10-year follow-up study after the 1995 Swedish mental health care reform

Background The objective of this study was to follow the development of met and unmet needs in a sample of severely mentally ill after the 1995 Swedish mental health care reform and to analyse whether the efforts made by social services and mental health care have been more adequate since the reform. Method Inventories were made in 1995/1996, 2000/2001 and 2006 in an area of Sweden. A total of 171 persons who were considered to be severely mentally ill both in 1995/1996 and 2006, using the same criteria of definition, were interviewed using the same form of interview and their needs were assessed according to Camberwell Assessment of Need on all three occasions. Results The number of met needs had increased between 2006 and 1995/1996 and unmet needs in important need-domains had decreased. The changes in needs mostly referred to needs in the factor 'functional disability'. The degree of effort by psychiatric care and social services had increased. The number of wage-earners in the group had decreased to almost zero and the degree of social isolation had increased in 2006. Conclusions The target group had made some progress referring to their functional disability and the efforts from services had increased. However, the integration in society had decreased in fundamental aspects.