My background is in Mental Health, having worked in most areas, acute, children’s & adolescent, elderly as well as over twenty years in Forensic Mental Health, I feel I have the clinical nous to talk about mental health assessment.
So what has prompted me to write a ‘Blog’ about mental health assessment? Simply this, I have just adapted a mental health assessment for use in a Domiciliary Care company, the one they were using was not fit for purpose.
The reasons for it not being fit for purpose were, it was scored 0 – 4, the criteria from none present to severe, one being ‘severe deviance’!! For a person with little or no background in mental health it had the potential to create a nightmare, mind you, for a person with a background in mental health it was a little baffling.
The ‘suicidal ideation’ scale went from ‘No history’ to ‘Severe current risk’. Not helpful, as it gave no structure for arriving at a conclusion.
The other issue that nudged it towards being unfit for purpose was the lack of purpose in the assessment, apart that is, from filling it in.
It is well accepted that mental health assessment cannot be based solely on psychometrics alone, and that numerical formulations offer scant help clinically. Chris Webster, developer of the KGV and START assessments believed that good assessment was based on well observed behaviours and an accurate understanding of a persons past and present circumstances, which in turn are documented accurately. The forms themselves acting as tools to gather the information in a logical and a sequential format that would allow for future assessments to be measured in the same way. Though even using the same tools, information can be recorded and interpreted differently based on the experience, knowledge, understanding and mindset of the person undertaking the assessment. Does the person undertaking the assessment ‘like’ the person being assessed? Is the person undertaking the assessment risk averse or risk taking? So many extraneous variables!
So my first task in adapting a user friendly questionnaire and one that is fit for purpose, was to move away from a numerically based assessment and onto a guided information gathering tool. The GMHT/PC questionnaire offered a good basis to do this, taking out the numerical scoring and focussing on the use of questions to gain the information. It was important to move away from anything that numerically interpreted the information and failed to provide a context to it. It was also necessary to concentrate on a few key areas, such as anxiety, concentration and away from the more specialist areas that would be hard to complete by a person without any knowledge, understanding or experience in mental health.
The questionnaire is being used by non mental health professionals as part of a broader assessment package to provide the basis of the service users support / care plan so that a more holistic programme can be developed.
Should undertaking the mental health questionnaire raise concerns about a service user, then it provides the framework to share the narrative and underlying issues that trigger those concerns in a clear manner. It does not ask the person completing the assessment to measure level of depression, anxiety, etc, only to be able to share the concerns with other professionals so they can act accordingly.
Any member of the team carrying out the mental health questionnaire will undertake a two hour training session in order to know what is expected of them and how to do the questionnaire in practice.
If you would like any support in Mental Health assessment please get in touch.