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.