Assessments - An Introduction

The NICE Guideline makes clear the expectation that all service users should receive a Comprehensive Assessment of their needs. This section provides some additional information on what a comprehensive assessment means for the individual service user and their carer(s). Further information is available in the policy guidance Effective Care Coordination in Mental Health Services refer to resource section of Website for more information.

An assessment should normally result in the production of a Care Plan - which sets out clearly the expected benefits and outcomes for the service user and their carer(s). The care plan is an agreed package of care that is the basis for ongoing expectations between all individuals involved in the person's care.

Service users and the carers, where appropriate, should always be central participants in the process. The service user must be given full information about the CPA process and a copy of the agreed care plan which must:

• Identify the interventions and anticipated outcomes;
• Record all the actions necessary to achieve the agreed goals;
• In the event of a disagreement, include the reasons;
• Give an estimated timescale by which the goals will be achieved
• Detail the contributions of all the agencies involved; and
• Include appropriate crisis and contingency plans (such as advance directives).

Furthermore, that care plans should:

• Focus on individuals strengths and seek to promote their recovery;
• Very clearly acknowledge, reinforce and promote service user strengths at an individual, family and social level.
• Reflect the individual's cultural and ethnic background, their faith and religious needs, as well as their gender and sexuality; and
• Include action and outcomes in all aspects of an individual's life where support is required (i.e. across psychological, physical and social functioning).

Contained in this section are examples of assessments used by mental health workers to identify the needs of service users. Assessments are not 'Tests' to see if you know the right answers. Assessments are usually informal and may feel a bit like an everyday conversation. Sometimes assessments can be a bit like a 'question and answer session' - this should not feel the case and the mental health worker should always try to provide a clear rationale for why questions are being asked.

Assessments normally lead to a formulation being built constructed with the service user and the worker to develop a joint understanding of the reasons for the problems. A formulation should help to develop an understanding of what has caused an individual's problems and what is keeping them going considering psychological, social, cultural and biological factors based on a values and evidence based model. Normally, the formulation is jointly developed and shared.