Mental health assessment process

MENTAL health assessment falls under the medical model of care in the healthcare system. Needs presented to formal service providers should follow guidance from the informal care support unit, usually the family or community where the individual would have come from.

Ideally, a community psychologist would have played a role in the support of this individual at an informal level through provision of community and family support services. This is critical for triaging and referring to other service providers through the social worker who supports the individual throughout their care and treatment journey.

The social worker also assesses the circumstances and carers’ needs through therapeutic counselling to help shed light on the individual’s culture, religion, other practices and how these may contribute to the presentation.

The social worker is also a key player and often the care coordinator, as they have firsthand knowledge about the individual and appropriate services for them to access.

Similarly, they understand which organisations provide the charitable support needed, basing on means testing. This initial support usually leads to formal care services, through primary healthcare, when medical investigations and physical examinations are conducted.

The physician — through the guidance of brief assessment tools like the Beck depression inventory, the patient health questionnaire and the peritraumatic distress inventory — seeks to eliminate any physical issues that could explain the behaviours presented or provide treatment for them.

Psychology complements this by helping to understand the individual’s life journey, intellectual and learning needs, dynamics, unresolved emotional needs or traumas that may explain any emotional blocks and any issues theories can help explain according to established concepts in the profession.

However, it covers a wide range of spectrums of human behaviour — educational, industrial and clinical, among others.

It is noteworthy to add that the clinical aspect of psychology plays a very small part of the psychology field. We are yet to explore military psychology.

Another important role is that of the occupational therapist to explore meaningful activities for the individual, focusing on their strengths for a purposeful life.

Where an admission is required, the Mental Health Act guides the process and provides for the rights of the patient, as their liberty is often limited.

The social worker, physician and psychiatrist ensure relevant documentation is in place to prevent illegal detention, under the purview of magistrates. Psychiatric nurses play an important role of monitoring daily activities, administering medication and reporting the effects of the treatments prescribed.

There may be need for the interventions where crimes have been committed as a result of the presentation. But this is where the partnership of law-enforcement agents may be necessary. So, a holistic care approach takes into account all the input from various disciplines. Whatever intervention is implemented is as good as the assessment conducted. Assessment is, therefore, a crucial part of this entire process. If the assessment is wrong or incomplete, so will the intervention be, which would be a waste of resources and efforts.

Therefore, we must ensure we provide for thorough and holistic assessments that inform inclusive care planning, implementation and reviews. Reviews should be a critical requirement and the responsibility of the care coordinator to ensure they are done.

This is usually where most service providers and their patients falter as there is no effective legislation to provide for this.

The care plan should clearly outline the diagnosis and treatment pathway to be followed, and the people responsible. This will ensure the family and others concerned also know their role in the journey of the individual. Any reports compiled should be held in confidence and only shared with those with direct interest in the care of the individual, unless there are risk concerns to self and/or others, including occupational considerations.

◆ Mertha Mo Nyamande is a psychotherapist. He can be contacted on: Insightwellbeing.mo@gmail.com or @ www.i-wellbeing.weebly.com