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Aims and Method  The aim of the study was to examine the association between the assessment of need by staff and by severely mentally ill patients using the Camberwell Assessment of Need in a semi-rural setting (Maidstone,  n =50) and an inner-city area (Camberwell,  n =127). Staff and patients were interviewed separately. We specifically examined differences in the total number of needs between Camberwell and Maidstone, differences in the number of unmet needs and differences in the level of agreement between staff and service users.    Results  Patients in Maidstone had fewer needs than those in Camberwell according to both staff (4.9  v . 5.8) and patients (4.2  v . 6.3), fewer unmet needs rated (staff, 1.1  v . 1.5; patients, 1.0  v . 1.9) and a greater level of concordance between staff and patients.    Clinical Implications  The needs of severely mentally ill patients were greater in the inner-city area compared with the semi-rural one. The fact that agreement between staff and service users was less in the inner-city area also suggests that more stable staff–patient relationships existed in the rural area.

The Camberwell Assessment of Need: comparison of assessments by staff and patients in an inner-city and a semi-rural community area