COVID-19 has had a sudden and unexpected impact on health centers, transport, freedom of movement, commerce, leisure and cultural activities, and the distribution of economic aid, the psychological cost has been analyzed in the general population, in health professionals and to a lesser extent in people who were already affected by a mental illness or problem. The pandemic caused by COVID-19 has shown some shortcomings and associated risks in community mental health care for the most serious patients.The objective of this study is to analyze the care needs in a sample of people with severe mental disorders during the peak of the COVID-19 pandemic, specifically in Spain, in the Community of Madrid, the Valencian Community, Extremadura and the Basque Country. The "Needs of Assessment (NCA)" instrument and the "Life Restriction Scale (ERVI)" were used. The sample was 669 people and 144 cohabiting family caregivers. The most frequently found clinical problems were anxiety, followed by slowness, low activity and depression. In the area of ​​skills and abilities, the most frequent problems were sleep structuring, community integration, time occupation and cognitive capacity, in the area of ​​support media, the main problem was the lack of a social support network .The study offers us data of interest to know the needs of people during the COVID-19 pandemic. The deterioration in skills associated with the increase in clinical symptoms of anxiety, depression and somatic symptoms is reflected in the high rates of presence, as well as in its scarce coverage. The main problems found are those related to anxiety, sleep, abilities and personal skills, specifically those that have to do with the occupation of leisure time. Also problems related to health problems and attentional cognitive impairment of people.