Evaluations & Clinical Measures
An essential component of a mental health assessment is carrying out a detailed exploration of the presenting problem. This assessment will cover why you are seeking help, a history of the problem and a history of your mental health. Your clinician will ask you questions such as how long you’ve had your symptoms, what your personal and family mental health history looks like, and if you’ve had any previous psychiatric treatment.
It is important to consider how the symptoms affect your day-to-day life, what makes them better or worse, and whether you’ve tried to manage them on your own. You may be asked questions about your ability to carry out daily responsibilities: these include looking after yourself, and whether you are able to go to work or your place of education. The assessment will also engage with your relationships with your friends and family.
It can be useful to reflect on your own understanding of the problem and what explanations you have already considered. Existing attribution systems often significantly impact treatment and recovery outcomes.
Not only will you be asked questions about your lifestyle and personal history but also about relationship status and previous relationships, work, and interests. Furthermore, questions about upbringing, especially childhood and adolescence, are not uncommon. Many mental health problems can have predisposing developmental factors. The assessment will enquire about particular sources of stress in your life and whether you have experienced any significant trauma, loss, or other adverse events. This is not always an easy conversation to have. Our practitioners are sensitive to these difficulties and are able to pace and manage the conversation in a semi-structured way. They will try to avoid explicit details when this could be distressing and unhelpful to you at this early stage.
You will be asked questions about your attitudes, values, beliefs, thoughts, feelings, and behaviours. In addition, your clinician will observe and provide an appraisal. This will answer questions like are you cooperative, appeasing, irritable, shy, or hostile? Do you make eye contact? Are you talkative and open, or cagey? How do you compare with others your age, similar problems, circumstances, etc.?
As part of the assessment process, you may be asked to complete some clinical forms. This can take place either before, during or after the consultation. The practitioner might use a range of clinical measures to aide their understanding of the nature and severity of your difficulties. Clinical measures only serve as an aide and should be used only in the context of a face-to-face meeting with a qualified professional. Screening tools for various conditions are available online. However, these should be used with caution. They can only provide preliminary and sometimes inaccurate evidence of a potential issue that should be evaluated further by a qualified clinician.
Depending on the presenting problem and the patient’s history, during the assessment, your clinician may want to formally gauge your ability to think clearly, recall information (memory), and your capacity for mental reasoning. Formal cognitive assessments using a standardised battery of tests tend not to be routine. They are, however, generally used where the clinician feels that mental health might not be the full explanation for the presenting problem. The clinician explores whether some underlying neurodevelopmental (ASD, ADHD) or neurological conditions (dementia, brain injury, other medical conditions) might contribute to current difficulties.
A cognitive evaluation needs to be carried out by a trained, qualified and specialist clinician. Usually, there is a formal and more lengthy assessment process that may take more than one consultation and involve meeting more than one specialist. In addition, information may be collected from others who know you well in a variety of contexts. When assessing children or adolescents this information may be collected from someone at their school, their GP, or their parents. You will be informed about additional costs of an extensive in-depth assessment in advance of the formal assessment process.
You may be asked to take tests for basic cognitive tasks, such as focusing your attention, remembering short lists, recognising common shapes or objects, or solving simple problems.
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