Purpose To investigate the pattern of associations between changes in unmet needs and treatment motivation in elderly patients with severe mental illness. Methods Observational longitudinal study in 70 patients treated by an assertive community treatment team for the elderly. Unmet needs and motivation for treatment were measured using the Camberwell assessment of needs for the elderly and the stages-of-change (SoC) scale, respectively, at baseline, after 9 and 18 months. SoC scores were dichotomized into two categories: motivated and unmotivated. Multinomial logistic regression analyses were conducted to determine whether changes in motivation were parallel to or preceded changes in unmet needs. Results The number of patients who were not motivated for treatment decreased over time (at baseline 71.4 % was not motivated, at the second measurement 51.4 %, and at 18 months 31.4 % of the patients were not motivated for treatment). A decrease in unmet needs, both from 0-9 to 0-18 months was associated with remaining motivated or a change from unmotivated to becoming motivated during the same observational period (parallel associations). A decrease in unmet needs from 0 to 9 months was also associated with remaining motivated or a change from unmotivated to motivated during the 9-18 months follow-up (sequential associations). Conclusions Our findings suggest that a decrease in unmet needs is associated with improvements in motivation for treatment.

Additional Metadata
Keywords Assertive outreach, CANE, Elderly, Needs, Severe mental illness, Treatment motivation
Persistent URL dx.doi.org/10.1007/s00127-014-0918-9, hdl.handle.net/1765/72343
Journal Social Psychiatry and Psychiatric Epidemiology: the international journal for research in social and genetic epidemiology and mental health services
Citation
Stobbe, J, Wierdsma, A.I, Kok, R.M, Kroon, H, Depla, M, & Mulder, C.L. (2014). Decrease in unmet needs contributes to improved motivation for treatment in elderly patients with severe mental illness. Social Psychiatry and Psychiatric Epidemiology: the international journal for research in social and genetic epidemiology and mental health services. doi:10.1007/s00127-014-0918-9