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Depa amen o
de Pe sonalidad,
E aluación y
T a amien o
Psicológicos
Anua io de Psicología Clínica y de la Salud
Annua y o Clinical and Heal h Psychology Yea 2011 • Volume 07 • Pages 15 o 23
In oduc ion and Desc ip ion o his S udy
I is e iden ha he ca e o people wi h se e e and p o-
longed men al diso de s has expe ienced p o ound ans-
o ma ions o e he pas ew decades. The communi y men-
al heal hca e model aims o help hese people wi h hei
psychia ic and psychosocial p oblems wi hin hei own
social and communi y en i onmen in o de o s eng hen
hei main enance and in eg a ion in he amily and social
con ex in he mos no mal way possible (Des ia , 2010;
Gisbe , 2002; Guinea, 2007). Wi hin his model, ami-
lies ep esen one o he main pilla s o suppo and ca e
(Cañama es e al., 2001; De la Hoz e al., 1997; Tou iño,
Inglo , Baena and Fe nández, 2010). Awa eness o he
needs o people wi h men al illness and hose o hei amily
membe s is c i ical when planning and p o iding adequa e
communi y ca e (Bebbing on and Rees, 2001; Jones, 2009;
Sob ino and Rod íguez, 2007).
In he ield o men al heal h, he ques ion o need usually
a ises when he e is a heal h de iciency and, mo e p ecise-
ly, when he e is a de ici ha can be add essed because a
emedy o i exis s (To es, Rosales, Mo eno and Jiménez,
2000). Some au ho s de ine need as he p esence o a p ob-
lem ha in e e es in a pe son’s e olu ion, ehabili a ion o
social in eg a ion, hus necessi a ing a speci ic ype o e-
sponse, ca e o solu ion (B ewin, Wing, Mangen, B ugha
and MacCa hy, 1987). In ela ion o communi y heal h-
ca e, needs ha e been de ined as he condi ions ha allow
indi iduals o uphold, main ain o eco e an accep able
le el o social independence o quali y o li e (Depa men
o Heal h Social Se ices Inspec o a e, 1991).
The needs ha e been b oadly e alua ed h ough he use
o di e en ins umen s such as he Needs o Ca e Assess-
men (NCA) (B ewin e al., 1987) and he Cambe well As-
sessmen o Need (CAN) (Phelan e al., 1995), he la e o
which has been widely used o e he las ew yea s. A e iew
o he s udies ha ha e u ilized he CAN indica es ha he
mos equen needs a e ela ed o e e yday ac i i ies, com-
pany, psychia ic symp oms and anguish (e.g., Kulha a e
al., 2010; Lasal ia, Rugge i, Mazzi and Dall’Agnola, 2000;
McC one e al., 2001; Ochoa e al., 2003; Ochoa e al.,
2005; Popescu and Micu lia, 2009; Rosales, To es, Luna,
Baca and Ma ínez, 2002; Slade, Phelan and Tho nic o ,
1998; Tho nic o e al., 2002). The o al numbe o needs
desc ibed in he di e en s udies is he e ogeneous, ang-
ing om 3.34 needs ob ained in he s udy by Lasal ia e al.
(2000), in which 247 use s o men al heal hca e communi y
se ices in Ve ona we e e alua ed, and 8.64 needs ob ained
in he s udy by Phelan e al. (1995), who analyzed a sample
o 60 people ecei ing men al heal hca e se ices in Lon-
don.
In e ms o needs o he in o mal ca egi e s, he e a e
some di e ences, gi en ha hese indi iduals do no ha e
an illness o disabili y o which he e is no ea men . Some
au ho s use he e m “need” o desc ibe he lack o wellbe-
ing among in o mal ca egi e s (B ewin, 1992). Mo e e-
cen de ini ions allude o ci cums ances in which he am-
ily membe s would like o ecei e assis ance om se ice
Va iables ela ed o psychosocial needs among people wi h
se e e men al illness using communi y se ices and hei in o mal
ca egi e s
Guillén And és, Ana Isabe
l
Ph.d. in Psychology.
Muñoz López, Manuel
Ph.d. in Psychology
Con ac in o mac ion:
Ana Isabel Guillén And és
Depa amen o de Pe sonalidad, E aluación y T a amien o
Psicológico I.
Facul ad de Psicología. Uni e sidad Complu ense de Mad id
Campus de Somosaguas s/n
28223 Mad id
Telephone: 91 394 30 40
E-mail: [email protected]
Abs ac
Objec i es: To assess he needs o people wi h se e e men al illness who li e in he communi y and he needs o hei in o mal
ca egi e s, and o iden i y he a iables associa ed wi h needs.
Me hod: Two ela es samples we e e alua ed: ou pa ien s wi h men al illness (N=95) an hei in o mal ca egi e s (N=53).
Resul s: The mos equen ly needs pe cei ed by wi h people wi h men al illness in ol ed symp oms, in o ma ion, companion-
ship and day ime ac i i ies; he quan i y o needs we e ela ed o age, educa ional le el, p o essional ac i i y, no li ing wi h
amily, li ing in communi y esidences, global unc ioning, disabili y, and heal h. The mos equen ly needs pe cei ed by in-
o mal ca egi e s in ol ed indi idual counseling and suppo o amily, economical assis ance, amily associa ions, and espi e
ca e; he quan i y o needs we e ela ed o coping and u iliza ion o se ices, as well as he quan i y o needs and disabili ies o
he ela i e wi h men al illness.
Conclusions: People wi h men al illness and hei in o mal ca egi e s ha e a ious ypes o needs, despi e he suppo p o-
ided by hei o mal and in o mal ne wo ks.
Key wo ds: Needs assessmen - Men al illness - Ca egi e s
Recei ed: 3/31/2011 Accep ed: 7/11/2011
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Anua io de Psicología Clínica y de la Salud
Annua y o Clinical and Heal h Psychology Yea 2011 Volume 7
p o essionals (Osse, Ve nooij-Dassen, de V ee, Schadé and
G ol, 2000). In he sociocul u al con ex o Spain, he con-
sensus documen coo dina ed by Guinea (2007) poin s ou
he p incipal needs pe cei ed by he amily membe s o
hose wi h men al illness: in o ma ion, ma e ial and eco-
nomic assis ance, pe iods o es o espi e, emo ional sup-
po , echnical suppo , and being conside ed when deci-
sions a e made ha could ha e epe cussions on he amily.
The numbe o s udies which assess he needs o he in-
o mal ca egi e s is much lowe han he quan i y o hose
ocused on people wi h men al illness. None heless, he e
a e many s udies ha ha e used s anda dized and alida ed
ools o assessmen , such as he Ca dinal Needs Schedule
(RCNS) (Ba owclough, Ma shall, Lockwood, Quinn and
Sellwood, 1998), he In ol emen E alua ion Ques ion-
nai e (Schene and an Wijngaa den, 1992) and he Ca egi -
e s’ Need o Suppo Scale (S enga d, 2002). Along wi h
he adi ional objec i e o iden i ying he educa ional and
in o ma ional needs o amily membe s (Ma shall and Solo-
mon, 2000; Muese , Bellack, Wade, Saye s and Rosen hal,
1992; S enga d and Salokangas, 1997), he e has been
g owing in e es in e alua ing addi ional a eas o need
as well as he deg ee o impo ance o each o hese a eas
o amily membe s and he deg ee o which hese needs
a e me . In his ega d, se e al s udies ha e been done o
e alua e how use ul amily membe s pe cei e he esou ces
designed o hem, he a ailabili y o hese esou ces and
hei use (G aap e al., 2008; Pea ce, McGo e n and Ba -
owclough, 2006; Samele and Manning, 2000; Yeh, Liu and
Hwu, 2010).
Based on he da a ound in li e a u e on he needs o peo-
ple wi h men al illness and hei amily membe s, his s udy
was designed o p o ide upda ed da a ha a e ep esen a-
i e o Spain’s social and cul u al con ex .
Objec i es
This s udy has he ollowing objec i es: 1) To desc ibe he
needs o people wi h se e e and p olonged men al illness,
along wi h he needs o hei in o mal ca egi e s; 2) To ana-
lyze how he o al numbe o needs expe ienced by people
wi h men al illness is ela ed o po en ially associa ed a i-
ables: sociodemog aphic cha ac e is ics, global unc ion-
ing, disabili y and he ype o acili y (cen e s o psycho-
social ehabili a ion, job ehabili a ion cen e s, day cen e s
o small esidences); 3) To analyze how he o al numbe
o needs expe ienced by hei in o mal ca egi e s is ela ed
o po en ial associa ed a iables o bo h he ca egi e (soci-
odemog aphic cha ac e is ics, heal h, amily bu den o he
ca egi ing asks and coping) as well as hose o he pe son
wi h he men al illness (sociodemog aphic cha ac e is ics,
global unc ioning, disabili y and he ype o acili y poin
o o igin).
Me hod
Pa icipan s
The sample o people wi h men al illness was comp ised o
95 people selec ed a andom om he 12 cen e s o he Ne -
wo k o Social Se ices o people wi h se e e and p olonged
men al illness in he Communi y o Mad id: cen e s o
psychosocial ehabili a ion (n=37), job ehabili a ion cen -
e s (n=32), day cen e s (n=8) and small esidences (n=18).
All he pa icipan s we e ecei ing ca e a men al heal hca e
cen e s. The a e age age was 39 (DT= 10.02); 57% we e age
18-40 and 43% we e be ween he ages o 41 and 65. Mos o
he pa icipan s we e men (73.7%), single (83.2%) and had
comple ed high school (75.8%); hey did no ha e any p o-
essional ac i i y (56.8%) and li ed wi h amily membe s
(66.2%). A o al o 55.2% o he pa icipan s had been diag-
nosed wi h schizoph enia, 11.5% wi h dep ession, 8.3% wi h
bipola diso de and 7.3% wi h pe sonali y diso de s, while
3.1% had ecei ed o he diagnoses. A o al o 14.6% did no
know hei diagnosis o did no espond o he ques ion.
The sample o in o mal ca egi e s was comp ised o 53 peo-
ple. The a e age age o ca egi e s was 60 (DT=12.65) and
19.2% we e o e he age o 70. The majo i y o he ca egi -
e s we e women (77%), ma ied (69.8%) and did no wo k
ou side he home (75.5%). In e ms o hei ela ionship wi h
hose hey we e ca ing o , in 61.5% o he cases, hey we e
he mo he s o he pe son wi h men al illness; 13.5% we e
he a he s and ano he 13.5% we e he sis e s. O he amily
ela ions appea ed, hough o a less ex en : b o he s (5.8%),
wi es (3.8%) and daugh e s (1.9%). App oxima ely 70% o
hose in e iewed s a ed ha hey had been ca ing o hei
amily membe o mo e han en yea s.
All he people pa icipa ed in he s udy olun a ily a e be-
ing in o med o he s udy’s objec i es and gi ing hei w i en
consen .
Design
Fo his s udy, a c oss-sec ional su ey design was used wi h
wo samples o ela ed pee s ( he sample o people wi h men-
al illness and he sample o hei in o mal ca egi e s). Two
independen e alua o s we e esponsible o ga he ing he
da a in each sample. The e alua ion o each pa icipan was
done du ing a single mee ing by applying a se ies o s anda d-
ized ins umen s du ing an in e iew wi h he pa icipan .
Ins um en s
People wi h men al illness
Sociodemog aphic ques ionnai e (designed by he au ho s)
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Monog aphic A icle
Va iables ela ed o psychosocial needs among people wi h se e e men al
illness using communi y se ices and hei in o mal ca egi e s
Guillén and Muñoz
Cambe well Assessmen o Need ques ionnai e (CAN)
(Phelan e al., 1995), Spanish language e sion by Jiménez,
Mo eno, Rod íguez and To es (1995). The CAN assessed
whe he need was p esen in 22 a eas. Fo each iden i ied
need, he deg ee o assis ance ha he pe son ecei es om
iends and amily membe s was assessed, along wi h he
deg ee o assis ance ecei ed om public se ices and he
deg ee o assis ance he pe son needs (in e a e eliabil-
i y=0.99; es - e es eliabili y=0.78; Kappa = 0.18).
The Sho Disabili y Assessmen Schedule o he Wo ld
Heal h O ganisa ion (WHO-DAS-II) (Üs ün, 1999), Span-
ish language e sion by Vázquez-Ba que o e al. (2000).
This ins umen has 12 i ems which allows he esea che
o gauge he se e i y and du a ion o he disabili y which is
assessed based on an indi idual’s s a e o heal h (in aclass
co ela ion coe icien s=0.40-0.74).
Global Assessmen o Func ioning (GAF) (Ame ican As-
socia ion o Psychia y, 2007). The GAF is an ins umen
employed in Axis 5 o he Diagnos ic and S a is ical Manual
o Men al Diso de s (DSM-IV-TR) o he e alua ion o
gene al ac i i y. I consis s o a 100 poin scale in which he
p o essional mus e alua e bo h he se e i y o he symp-
oms he pe son is expe iencing as well as he deg ee o de-
e io a ion in one’s school, job o social ac i i ies (in aclass
co ela ion coe icien =0.57).
In o mal ca egi e s
Sociodemog aphic ques ionnai e (designed by he au-
ho s)
Ques ionnai e o he needs o he in o mal ca egi e (de-
signed by he au ho s). Based on he Ca egi e s’ Need o
Suppo Scale de eloped by S enga d (2002), amily mem-
be s a e ead a lis o he di e en se ices o he in o mal
ca egi e s o people wi h men al illness. Fo each o he se -
ices, he amily membe mus indica e: a) o wha deg ee
he/she conside s each o hese se ices necessa y o he
amily on a scale o 0 (no necessa y) o 10 (highly neces-
sa y); and b) i du ing he las yea , he/she has ecei ed any
o hese se ices. The C onbach’s alpha has been calcula ed
o his scale a 0.80. The ques ionnai e also includes an
i em aken om he Eu opean S udy on he Needs o Fam-
ily Membe s o People wi h Men al Illness (Spanish Fede a-
ion o People wi h Men al Illness and hei Families, 1994),
which asks he amily membe whe he he/she needs mo e
guidance o in o ma ion on di e en subjec s o in e es .
Ca egi e Bu den In e iew (CBI) (Za i , Ree e and
Bach-Pe e son, 1980), Spanish adap a ion by Ma ín e al.
(1996). This assesses he main ca egi e ’s subjec i e expe i-
ence o bu den. I includes 22 i ems on a scale o 1 (ne e )
o 5 (almos always). The C onbach’s alpha ob ained in his
s udy was 0.91.
Ques ionnai e on coping s yles (COPE) (Ca e , Scheie
and Wein aub, 1989), Spanish language adap a ion by C e-
spo and C uzado (1997). The sho e sion was employed o
his s udy and includes 28 i ems ha desc ibe di e en ways
o coping. The scale goes om 1 (I ha e no been doing his
a all) o 4 (I’ e been doing his a lo ). The C onbach’s alpha
ob ained in his s udy was 0.85.
P ocedu e
A mul icen e -mul ise ice sampling was done a he acili-
ies o he ne wo k o social se ices o people wi h men al
illness in he Communi y o Mad id. A each o he pa ici-
pa ing cen e s, use s we e andomly selec ed and da a was
hen ga he ed among he sample o people wi h men al ill-
ness. A e iden i ying he main in o mal ca egi e s and
eques ing au ho iza ion o con ac hem, he nex s ep
in ol ed ga he ing da a among he sample o ca egi e s.
Ele en o he ca egi e s e used o pa icipa e in he s udy.
O he ci cums ances ha led he ca egi e no o pa ici-
pa e included he ollowing: he pe son wi h he illness in-
dica ed ha he/she had no amily (7 people); he pe son did
no g an au ho iza ion o he esea che s o con ac hei
amily membe (15 people), o he ca egi e could no be
loca ed (9 people). The only di e ence be ween he people
wi h men al illness whose in o mal ca egi e pa icipa ed
in he s udy and hose who did no was ha he la e g oup
included a g ea e pe cen age o people wi hou any p o es-
sional ac i i y (χ2(2,95)= 9.532, p<0.01).
The s a is ical analyses consis ed in desc ip i e analyses
o each o he samples and in an analysis o co ela ions o
de e mine he ela ion and deg ee o associa ion in e ms o
he quan i y o needs and possible a iables (Pea son co e-
la ion coe icien s o he quan i a i e a iables wi h Gauss-
ian dis ibu ion; Spea man co ela ion coe icien s o he
quan i a i e a iables wi h non-Gaussian dis ibu ion and
he Pea son chi-squa ed es o ca ego ical a iables). All
he s a is ical analyses we e done using he S a is ical Pack-
age o he Social Sciences Ve sion 12.0 (SPSS 12.0S o
Windows, 2003).
Resul s
People wi h men al illness
The a e age numbe o needs was 7.65 needs pe pe -
son (DT=2.72). Speci ically, he mean o me needs was
6.21 (DT=2.42) and he mean o unme needs was 1.44
(DT=1.51). Table I shows ha he mos equen needs ( ha
is, he sum o he me and unme needs) co esponded o he
a eas o psychia ic symp oms (p esen in 94.5% o he sam-
ple), in o ma ion on illness and ea men (87.1%), company
(68.4%) and daily ac i i ies (66.3%).
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Anua io de Psicología Clínica y de la Salud
Annua y o Clinical and Heal h Psychology Yea 2011 Volume 7
As can be seen on Table I, mos o he needs we e me . How-
e e , in some cases, he need was unme and he p oblem pe -
sis ed, especially in he a eas o ela ionships wi h a pa ne
(33.0%), company (26.3%), in o ma ion (23.7%) and sexual-
i y (16.9%).
Table 2 shows he pe cen age o people wi h me needs who
we e ecei ing assis ance, be i in o mal ( ha is, help om
amily membe s, iends, e c.) o o mal ( om p o essionals,
public se ices, ins i u ions, e c.) On a e age, 55% o he peo-
ple wi h me needs we e ecei ing in o mal assis ance while
60% ecei ed o mal assis ance.
The esul s o he analysis o co ela ions be ween he num-
be o needs in he o al sample o people wi h men al illness
(N=95) and he di e en a iables o in e es shows ha a
g ea e quan i y o needs is associa ed wi h:
Inc eased age ( = .234, p<0.05).
Highe disabili y ( = .326, p<0.01).
Lowe le el o global unc ioning ( = -.440, p<0.01).
A wo se assessmen o hei gene al s a e o heal h ( = .265,
p<0.01) and highe in e e ence o hese heal h issues ( =.214,
p<0.05).
Only inishing elemen a y school (χ2(3.95)=9.263, p<0.05).
No ha ing any p o essional o p ep o essional ac i i y
(χ2(2.93)=6.107, p<0.05).
No li ing wi h amily membe s (χ2(3.95)= 10.368, p<0.05).
The ype o acili y poin o o igin, speci ically, li ing in a
small esidence was associa ed wi h mo e needs, while being
a a job ehabili a ion cen e was associa ed wi h ewe needs
(χ2(3.95)= 21.022, p<0.001).
No signi ican co ela ions we e ound be ween he numbe
o needs and o he a iables o he pe son wi h men al illness
excep hose e e ed o abo e.
In o mal Ca egi e s
A o al o 58.5% o he ca egi e s expe ienced bu den as-
socia ed wi h he ca e o hei amily membe and in 41.5% o
he cases, his bu den was in ense. The majo i y o he ca e-
ake s conside ed he di e en se ices a ailable o amily
membe s o people wi h men al illness as highly necessa y
(see Table 3), especially he suppo and indi idualized ad-
iso y se ices o he amily (94.2%); economic assis ance
(87.5%); amily school p og ams (80.8%), and subs i u e ca -
egi e se ices (80.4%). Howe e , he use o se ices du ing
he pas yea had only been limi ed, wi h pe cen ages anging
om 40.5% in he case o amily schools o 14.6% o in o -
ma ion ho lines.
Wi h espec o he p inciple needs o in o ma ion, 94.3%
o he ca egi e s exp essed a need o mo e in o ma ion and
guidance on he u u e o hei amily membe ; 77.4% wan ed
mo e social, economic and job in o ma ion, and 75.5% de-
si ed mo e in o ma ion on a ailable se ices. O he subjec s
Table 1: Pe cen age o people wi h men al illness wi h me o unme needs in each a ea o he CAN (N= 95).
Me Need % (N) Unme Need % (N)
Accommoda ions 57.9 (55) 3.2 (3)
Food 54.7 (52) 0
Daily ac i i ies 60.0 (57) 6.3 (6)
Home ca e 30.5 (29) 1.1 (1)
Pe sonal ca e 14.9 (14) 0
Childca e 4.2 (4) 3.2 (3)
Basic educa ion 27.7 (26) 4.3 (4)
Money 51.6 (49) 2.1 (2)
Company 42.1 (40) 26.3 (25)
Rela ionship wi h a pa ne 4.3 (4) 33.0 (31)
Sexuali y 3.9 (3) 16.9 (13)
Psychia ic symp oms 93.4 (88) 1.1 (1)
Physical heal h 31.9 (30) 4.3 (4)
Anguish (Dis ess) 30.9 (29) 4.3 (4)
Risk o onesel 9.6 (9) 5.3 (5)
Risk o o he s 1.1 (1) 1.1 (1)
Alcohol 3.2 (3) 0
D ugs 0 0
In o ma ion on one’s s a e and ea men 63.4 (59) 23.7 (22)
T anspo a ion 35.5 (33) 3.2 (3)
Telephone 0 1.1 (1)
Social bene i s 5.3 (5) 8.4 (8)
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h p://ins i ucional.us.es/apcs
Monog aphic A icle
Va iables ela ed o psychosocial needs among people wi h se e e men al
illness using communi y se ices and hei in o mal ca egi e s
Guillén and Muñoz
o in e es o he ca egi e s included in o ma ion on u ela y
ounda ions (67.9%), legal in o ma ion (67.9%), in o ma ion
on hei igh s as amily membe s (64.2%), in o ma ion abou
he gene ic/he edi a y aspec o he illness (62.3%) and in-
o ma ion abou how o ca e o he pe son (60.4%).
A g ea e quan i y o needs among ca egi e s was associ-
a ed wi h he ollowing a iables o he ca egi e and he pe -
son wi h men al illness:
A g ea e use o ce ain coping s a egies by he ca egi e ,
speci ically, he use o alcohol and o he subs ances ( = .356,
p<0.01) and a educed use o humo as a coping s a egy ( =
- .324, p<0.05)
No ecei ing o u ilizing di e se se ices o am-
ily membe s du ing he pas yea : indi idualized sup-
po (χ2(1.52)=17.093, p<0.0001), economic assis -
ance (χ2(1.51)=10.218, p<0.001), subs i u e ca egi e
se ices (χ2(1.52)=9.329, p<0.01), elephone ho lines
(χ2(1.53)=6.675, p<0.01), amily membe associa ions
(χ2(1.50)=7.232, p<0.05), amily schools (χ2(1.53)=7.715,
p<0.05).
G ea e disabili y o he pe son wi h men al illness in e e y-
day ac i i ies ( = .95, p<0.01).
A lowe quan i y o needs o he pe son wi h he men al ill-
ness ( = -.399, p<0.01).
Table 2: People wi h men al illness wi h me needs who ecei e o mal and in o mal assis ance.
People wi h me need
(n)
People who ecei e in-
o mal assis ance % (n)
People who ecei e o -
mal assis ance % (n)
Accommoda ions 55 67.3 (37) 47.3 (26)
Food 52 61.5 (32) 65.4 (34)
Daily ac i i ies 57 52.6 (30) 100 (57)
Home ca e 29 37.9 (11) 48.3 (14)
Pe sonal ca e 14 42.9 (6) 50.0 (7)
Childca e 4100 (4) 25.0 (1)
Basic educa ion 26 65.4 (17) 53.8 (14)
Money 49 79.6 (39) 35.4 (17)
Company 40 87.5 (35) 85.0 (34)
Rela ionship wi h a pa ne 4 100 (4) 50.0 (2)
Sexuali y 333.3 (1) 33.3 (1)
Psychia ic symp oms 85 48.2 (41) 96.5 (83)
Physical heal h 30 40.0 (12) 93.3 (28)
Anguish (Dis ess) 29 69.0 (20) 100 (29)
Risk o onesel 9 55.6 (5) 66.7 (6)
Risk o o he s 1 0 0
Alcohol 366.7 (2) 66.7 (2)
D ugs 000
In o ma ion on one’s s a e and ea men 59 23.7 (14) 89.8 (53)
T anspo a ion 33 27.3 (9) 75.8 (25)
Telephone 0 0 0
Social bene i s 540.0 (2) 20.0 (1)
Table 3: Deg ee o need o di e en ypes o se ices on he pa o ca egi e s and he use o hese se ices o e he pas yea
(N=53).
No necessa y
% (n)
Mode a ely
necessa y % (n)
Highly neces-
sa y % (n) Use % (n)
Schools o amilies 7.7 (4) 11.5 (6) 80.8 (42) 40.5 (17)
Indi idualized suppo and assis ance 1.9 (1) 3.8 (2) 94.2 (49) 38.8 (19)
In o ma ion and help ho lines 7.7 (4) 13.5 (7) 78.8 (41) 14.6 (6)
Family associa ions 0 20.8 (10) 79.2 (38) 23.7 (9)
Economic assis ance 6.3 (3) 6.3 (3) 87.5 (42) 21.4 (9)
Ca egi e subs i u e se ices 11.8 (6) 7.8 (4) 80.4 (41) 19.5 (8)

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Annua y o Clinical and Heal h Psychology Yea 2011 Volume 7
No signi ican co ela ions we e ound be ween he quan-
i y o needs and he o he a iables ela ed o he ca egi e
o he pe son wi h he illness.
Discussion
The mean o needs o people wi h men al illness in his s udy
was 7.65, which is simila o he indings o p e ious s ud-
ies hough somewha highe han he a e age o 6.42 needs
calcula ed in he s udies ha ha e applied he CAN among
he Spanish popula ion (McC one e al., 2001; Ochoa e al.,
2005; Rosales e al., 2002). This mino di e ence does no
seem o be owed o a highe p esence o needs ha a e unme
(whose mean was 1.44 in ou s udy, which was lowe han he
mean o 2.11 needs calcula ed o he a o emen ioned s ud-
ies), bu o a highe numbe o me needs ( he mean in his
s udy is 6.21, which is qui e highe han he mean o 4.28
needs calcula ed based on hose s udies). The esul s sugges
ha pa icipan s expe ience needs in di e se a eas o unc-
ioning, bu ha hese needs a e me hanks o assis ance p o-
ided by he amily and/o se ices. In his ega d, i is impo -
an o conside he ype o pa icipan s, ha is, whe he hey
a e people who use he public ne wo k o se ices o people
wi h men al illness and a e hus ecei ing suppo om he
se ices, albei o a ying deg ees.
The main a eas o need de ec ed a e hose o psychia ic
symp oms, in o ma ion abou he illness and he ea men ,
daily ac i i ies, company, ela ionship wi h a pa ne and
sexuali y. These esul s a e simila o he da a ob ained om
o he s udies, especially in e ms o he equen p esence o
needs in he a eas o company, psychia ic assis ance and dai-
ly ac i i ies (e.g., Foldemo, Ek and Bog en, 2004; Hansson e
al., 2001; Ko ess e al., 2000; Mo eno, Jiménez, Godoy and
To es, 2003; Rosales e al., 2002)
Ce ain au ho s such as McC one e al. (2001) ecommend
being p ecau ious abou in e p e ing needs, as he p o ision
o se ices can “c ea e” needs ha a e me . In o he wo ds,
he pe son can assume ha i he/she is ecei ing a speci ic
se ice, i has a co esponding need. In con as , i he spe-
ci ic se ices a e no p o ided, hen i can lead he pe son o
assume ha no need exis s in his a ea, hus leading ac ual
unme needs o be concealed.
The esul s indica e ha he inc ease in he quan i y o
needs o people wi h men al illness is associa ed wi h ce ain
heal hca e and unc ioning a iables (lowe global unc ion-
ing, highe disabili y and poo e s a e o pe cei ed heal h)
and sociodemog aphic (olde , no ha e any p o essional o
p ep o essional ac i i y, lowe le el o educa ion, no li ing
wi h amily membe s and esiden ial acili ies as he poin o
o igin). In his espec , he decisi e in luence o psychosocial
unc ioning on he quan i y o needs concu s wi h he esul s
o p e ious s udies. In he wo k by Middelboe e al. (2001),
he le el o unc ioning was a signi ican p edic o o he o al
quan i y o needs, and in he s udy by McC one e al. (2001),
i was he bes p edic i e a iable o he quan i y o unme
needs. The in luence o he le el o disabili y also e lec s
s udies ha ha e included measu emen s o his a iable (Is-
sakidis and Teesson, 1999). Gi en ha ou s udy ocused on
a iables associa ed wi h he o al quan i y o needs, i would
be in e es ing o speci ically analyze he di e en ypes o
needs and hei ela ion o di e se a iables in u u e s udies.
In e ms o he s udy o he in o mal ca egi e s, i is impo -
an o no e ha ca egi ing asks a e gene ally handled by
women, who ep esen 77% o he sample. The p edominan
p o ile is ha o a woman a ound he age o 60, ma ied, gen-
e ally he mo he o he pe son wi h he men al illness and
someone who does no wo k ou side he home.
When in e p e ing he esul s o he needs o ca egi e s, i
is impo an o bea in mind ha ou s udy is limi ed o he
e alua ion o he needs o esou ces and se ices o ca e ak-
e s, bu no o he ypes o pe sonal needs ela ed o coping
wi h he illness. Ca egi e s conside ha he di e se se ices
which a ge he amily membe s o people wi h men al ill-
ness a e essen ial, bu he pe cen age o use du ing he pas
yea was only mode a e. This s udy o e s a gene al pano ama
o he needs pe cei ed by amily membe s, bu i s objec i es
and he design o he esea ch do no allow us o de e mine
which ac o s explain he limi ed use o he se ices. Au ho s
such as Inglo , Tou iño, Baena and Fe nández (2004) ha e
sugges ed ha e en hough he amily membe s o people
wi h men al illness equen ly exp ess a need o suppo ,
hey do no always ha e he a ailabili y o oppo uni y—and
a e no always willing— o u ilize he se ices. Acco ding o
González-Blanch and Ca a (2001), his phenomenon could
be ela ed o he physical, psychological and economic cos s
o he in e en ion o amilies, bu was also associa ed wi h
a iables ela ed o he se ices hemsel es.
The esul s show ha a g ea quan i y o he needs o he
in o mal ca egi e s a e associa ed wi h some o hei psycho-
logical and social cha ac e is ics, and mo e speci ically, wi h
he use o ce ain coping s a egies and a lowe use o sup-
po esou ces. This concu s, a leas pa ially, wi h a s udy by
S enga d (2002), which classi ied he in o mal ca egi e s in
i e conglome a es based on he s yle o coping and he di -
e en dimensions o ca e. The conglome a e e e ed o as
“coping” g ouped ca egi e s who handled he si ua ion e ec-
i ely, wi h low le els o psychological discom o , a low le el
o bu den and minimal needs o suppo and in o ma ion.
Unlike S enga d, howe e , we ound no ela ion be ween bu -
den and he needs o he ca egi e .
The esul s also e ealed ha a g ea e quan i y o ca egi e
needs is associa ed wi h ce ain a iables ela ed o he pe -
son wi h he men al illness: a highe le el o disabili y and a
lowe quan i y o needs. This inal esul is in e es ing, bu in
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Monog aphic A icle
Va iables ela ed o psychosocial needs among people wi h se e e men al
illness using communi y se ices and hei in o mal ca egi e s
Guillén and Muñoz
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Jou nal o Pe sonali y and Social Psychology, 56 (2), 267-
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Es udio eu opeo sob e las necesidades de amilia es de en-
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he li e a u e on he needs o ca egi e s, we ha e no ound
any s udy which examines he ela ionship be ween hese
a iables in o de o help explain his inding. One possible
in e p e a ion is ha he suppo p o ided by he amily con-
ibu es o educing he needs o he pe son wi h he men al
illness bu a he same ime can lead o a g ea e numbe o
suppo needs among amily membe s who p o ide his co -
e age in a p olonged way o e ime. In his ega d, he li e a-
u e on he in o mal ca e o people wi h men al illness e eals
ha ca egi e s equen ly gi e hemsel es o e o he ask o
ca egi ing while hei needs ake second place (Azna and
Be langa, 2006; De la Hue a, Co ona and Méndez, 2006;
Losada, Mon o io, Izal and Má quez, 2006; Na aie-Walise
e al., 2002).
Conclusions
The needs o he people wi h men al illness and hei in o -
mal ca egi e s a e complex, mul idimensional phenomena.
The co ela ions wi h o he s udies by Spanish esea che s
show ha he psychosocial needs o hese people a e qui e
simila in di e en loca ions wi hin ou sociocul u al con-
ex , which sugges s ha he esul s o his wo k could be
gene alized and applied o o he au onomous communi ies
wi h compa able heal hca e and social se ices. Gi en ha
he e a e unme needs among people wi h men al illness and
hei amily membe s in spi e o he assis ance ecei ed om
suppo ne wo ks, i would be in e es ing o in es iga e he
main obs acles o ecei ing assis ance and mee ing needs on
he pa o he people wi h men al illness, hei amily mem-
be s, and he se ices hemsel es.
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** Acknowledgemen s
We would like o hank he Complu ense Uni e si y o
Mad id, since his s udy has mainly been inanced by a
g adua e esea ch g an .
In addi ion, we would like o hank he Depa men o Family
and Social A ai s o he Communi y o Mad id, he
cen e s ha comp ise he Ne wo k o Social Se ices, and
he people wi h se e e and p olonged men al illness who
pa icipa ed in his s udy.