Adapting the psychiatric assessment for primary care

Abstract

• 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.