OBJECTIVE: Clients' and providers' perceptions of clients' needs were
compared in 18 community treatment programs participating in the Access to
Community Care and Effective Services and Supports program of the Center
for Mental Health Services, a national demonstration project on treatment
of homeless persons with mental illness. The study sought to determine
whether perceptions differed and whether assessed needs for services were
related to service use. METHODS: A total of 1,482 clients contacted through
community outreach who entered the case management phase of the program
after an average of 32 days were given an evaluation interview at entry
into the program. The clients and outreach workers identified clients'
needs in seven core domains-mental health, general health, substance abuse,
public financial support, housing assistance and support, dental care, and
employment. Use of related services in the 60 days before the case
management evaluation was determined. RESULTS: The greatest differences
between clients' and providers' perceptions of service needs were in dental
and medical services, which were more frequently identified as needs by
clients, and in substance abuse and mental health services, which were more
frequently identified by providers. Clients' and providers' assessments of
need were significantly, but not strongly, correlated with each other, and
both were correlated with use of mental health and substance abuse
services. CONCLUSIONS: Mental health service providers are less likely than
clients to identify needs for services other than mental health services.
Service use, at least in the short run, is related to both clients' and
providers' assessments of need.