The development and properties of the support needs questionnaire

Abstract

The Support Needs Questionnaire (SNQ) measures the support people with severe mental illness need to attain valued social roles as a route to social inclusion. Its design derives from Wolfensberger's Social Role Valorisation theory. It is a clinical tool comprising a comprehensive lifestyle inventory of "universal basic" and "disability" needs; and "revalorisation needs" arising from social devaluation and deep exclusion. The SNQ comprises eight discreet sub-scales based on O'Brien's Five Service Accomplishments, the domains of which include Community Presence, Community Participation, Choice and Control, Social Roles and Respect, Skills and Competencies, and Finance. There are also two descriptive sub-scales: Physical and Mental Health. The item set was developed collaboratively with service users. This paper introduces the SNQ, its design rationale and development, and investigates aspects of its reliability, validity and utility. Care co-ordinators in a Community Mental Health Team rated eighty-two service users' support needs at a two week interval using the SNQ, the Global Assessment Scale and the MARC-2. The SNQ is shown to have high test-retest reliability, good construct and concurrent validity, and good discriminatory power. It exhibited no floor or ceiling effects with the reference population. It could be used with a more diverse population. The descriptive sub-scales were weakest. The population profile showed moderate support was required for physical integration but high levels for social integration which is consistent with previous research. The SNQ has some good psychometric properties. Future research should address internal consistency and potential item redundancy, determine inter-rater reliability and change sensitivity.