Consumer and Case Manager Agreement on Needs Assessments in Programs for Homeless Adults With Serious Mental Illness

Abstract

Effective treatment planning is optimal when consumers’ perceived needs align with their providers’ assessments of those needs, which can facilitate collaborative partnerships and recovery-oriented services. This study compares consumers’ and case managers’ perceptions of consumer needs for adults in programmes serving homeless adults with serious mental illness that use either a Housing First (HF - prioritising access to independent housing) or non-Housing First (TF - a treatment first approach that requires abstinence as a condition for independent housing) approach. The study was guided by the following three research questions: (a) Is there agreement between consumers and case managers on perceived service needs? (b) Are there categories of need that produce more agreement (i.e., concrete services vs. treatment)? (c) Are there differences in agreement rates between consumers and case managers associated with HF and TF programs? Descriptive statistics were calculated based on a 20-item needs assessment checklist. Results of analyses with 72 consumer–case manager dyads show that although there was high agreement on the need for housing, case managers assessed greater needs in the clinical and social domains whereas consumers reported greater needs in the vocational and independent living domains. The areas of disagreement may impede engagement and the delivery of recovery-oriented services, particularly when working with individuals experiencing multiple and sometimes competing needs such as homeless adults with serious mental illness.