Continuing Medical Education

Adapting the psychiatric assessment for primary care

J Parker


  • The traditional form of psychiatric assessment needs to be shortened to facilitate its use at the primary care level.
  • This can be done if there is a good understanding of the aims and purposes of a mental health assessment and its nature as a work in progress.
  • Because many people with mental illness struggle to identify the preceding, it is important to know when to suspect it and what questions to ask.
  • Developing and maintaining rapport is vital for a successful assessment, but doing so simply requires attention to skills that should be basic for any practitioner.
  • Collateral information is vital in many instances.
  • It is seldom possible or desirable to reach a definitive diagnosis and treatment plan at the first assessment, so this should be seen as the beginning of a collaborative process of investigation that, in and of itself, has therapeutic value. 
  • It is vital to identify what steps must be taken urgently at the first assessment, so a careful risk assessment is crucial. This requires a clear understanding of the hierarchy of risks that may be present.
  • A diagnostic framework of broad syndromal categories will then provide a basis to direct further enquiry.

Author's affiliations

J Parker, OPD, Outreach and Medium Term Services, Lentegeur Hospital, Division of Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa

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Primary care; assessment

Cite this article

South African Medical Journal 2014;104(1):75. DOI:10.7196/SAMJ.7731

Article History

Date submitted: 2013-11-13
Date published: 2013-11-19

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