The General-practice Users’ Perceived-need Inventory (‘GUPI’): a brief general practice tool to assist in bringing mental healthcare needs to professional attention

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ObjectiveThe General-practice Users’ Perceived-need Inventory (‘GUPI’) is a practical instrument to identify perceived need for mental health care in general practice. Empirical findings reported here explore the utility and acceptability of the GUPI.Design and settingCriterion validity and test–retest-reliability studies in metropolitan general practices in Melbourne, Australia.ParticipantsOne-hundred and twenty-two attendees at general practices examined cross-sectionally; 83 examined longitudinally.Main outcome measuresPerformance of the GUPI against the 12-item Somatic and Psychological Health Report (SPHERE) questionnaire and general, emotional and physical ill-health items from the Short Form Health Survey.ResultsPerceived need declared through the GUPI was positively associated with combined psychological and somatic SPHERE caseness, and higher scores on Health Survey items. Sensitivity of the measure for both these proxies of psychiatric caseness was good. A subset of three items has performance in psychometric terms largely equivalent to the five-item version. Within a reliability study, where a general practitioner consultation occurred within the time frame of the test and retest design, overall perceived need reduced in frequency over time. Stability through time was associated with perceived need for medication.ConclusionPerceived need as ascertained by the GUPI is associated with poorer general health, physical and emotional difficulties, and likely psychiatric caseness. The instrument may be useful in three- or five-item forms, the latter allowing for ultra-brief administration in combination with symptom and/or disability measures. Reassurance or treatment may account for a downward trend of perceived need through time. This instrument extends the range of brief mental healthcare needs assessment instruments available for general practice use.

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