Clients with long-term mental disabilities in a Swedish county - conditions of life, needs of support and unmet needs of service provided by the public health and social service sectors

Objective. - The purpose of the study was to identify and describe conditions of life and needs of support and public service for clients with a mental disability in a Swedish county population. Methods. - Public health care and social service providers identified clients and completed a questionnaire concerning the clients' conditions of life and their special needs. A consecutively recruited sample of clients completed a similar questionnaire. Results. - Totally, 1261 clients were identified. The prevalence of clients with mental disabilities was in the urban and rural areas, 6.4/1000 inhabitants and 4.5/1000 inhabitants, respectively. The most prevalent unmet need (42.9%) was to participate in social and scheduled activities. Almost half of the group was reported to need support in activities of daily living. Clients living in urban settings more often needed support with activities of daily living (P < 0.001), whereas clients living in rural settings more often needed support with job training (P < 0.001) or finding work (P < 0.01). Clients and psychiatric care providers reported the needs of the clients in the same areas; however, clients reported a fewer number of needs than did the care providers. Conclusions. - By using both psychiatric care and social service providers, effective case findings of clients with a mental disability were possible to achieve. In general, there was high agreement between psychiatric care providers and clients regarding the clients' number of needs of support and their unmet needs of service. However, at the individual level, the agreement between client and psychiatric care providers was lower. (C) 2003 Editions scientifiques et medicales Elsevier SAS. All rights reserved.