Assessment and Care Planning for Mental Health Service Users in the UK: A Comprehensive Guide for Nurses

Outline The Assessment and Care Planning Required For The Physical And

Mental Health of a Mental Health Service User

Select a client

This needs to be from your current placement.

They can have any diagnosis, but experience some of the symptoms. we have covered in the module.

Ask your Practice Assessor’s advice.

Gain consent from the client.

Maintain confidentiality: pseudonym, don’t use any identifiable information.Criteria 1

Present a formulation of the service user, using a recognised model, which demonstrates how data derived from assessment explains the causative factors of the services user’s mental health problems.

Use the information from the client assessment to summarise the factors which have led to the client’s current episode of involvement with the service.

You can use the biopsychosocial model, stress vulnerability model or 5Ps

Discussthefactorswhichhavecaused theclient’scurrentepisode of mental health problems. Demonstrate how these interrelate

Criteria 2

Demonstrate the ability to apply and explain the use of biological, psychological and social interventions with this service user, incorporating risk management, multi-professional collaboration, person-centred care planning and carer involvement

Focus on current interventions in relation to needs identified in the formulation.

Address biological interventions for physical health and mental health medication and symptom management

Address social interventions: related to the client’s current social circumstances and occupational and vocational needs.

Address psychological interventions e.g. CBT, Psychosocial interventions.

Criteria 4

Demonstrate the ability to apply and explain the use of biological, psychological and social interventions with this service user, incorporating risk management, multi-professional collaboration, person-centred care planning and carer involvement

•Include risk management

•Ensure that you make reference to service user and carer involvement

•Highlight how you worked in conjunction with the MDT.

Give an analytical account of how the effectiveness of care for this service user was assured and evaluated. Refer to multi-professional and multi-agency involvement and recognised evaluation frameworks.

•Revisit the identified goals and present the evidence which demonstrates whether or not these have been met.

•Include the evidence presented by the client, their carers and the members of the team.

•Make reference to frameworks such as CPA, or relevant care pathways

Criteria 4

Analyse any legal and ethical issues and unmet needs and how these were addressed by the service and organisational processes.

•Discuss any legal and ethical issues involved in working with the client.

•This can be the Mental Health Act (1983 revised 2007) or the Mental Capacity Act (2005), Safeguarding, Deprivation of Liberty, guardianship

•Ethical issues can include: consent, collaboration, choice best interests.

•Summarise any areas of unmet need and plans to address this

UK mental health nursing assessment and care planning

Multidisciplinary mental health care planning NHS UK

UK service user risk assessment and intervention planning

Featured in 6 UK Universities, 3 Australian universities and 2 Universities in New Zealand