Continuing Medical Education
Adapting the psychiatric assessment for primary care
- 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.
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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Date published: 2013-11-19
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