Emergency Department, Mental Health Liaison, Royal Prince Alfred Hospital, University of Sydney andSydney Local Health District, Camperdown, New South Wales, Australia.
School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
Int J Ment Health Nurs. 2020 Apr;29(2):171-176. doi: 10.1111/inm.12656. Epub 2019 Sep 9.
Conducting and documenting a mental health assessment is considered a central activity from a clinical and organizational perspective. In recent years, thinking and practice in mental health service delivery has changed considerably to embrace principles of recovery, trauma-informed care, and strengths-based approaches. The aim of the present study was to determine the degree to which these concepts are reflected in the content of assessment formats across mental health services in Australia and New Zealand. Copies of mental health assessments used in each state and territory in Australia, and three District Health Boards in New Zealand were obtained. Assessment formats were compared for similarities and differences, and to determine whether concepts of recovery, trauma-informed care, and strengths-based approaches were incorporated. The assessment formats analysed (n = 11) contained many traditional features targeted at identifying harms, problems, risks, and pathology. Some attempts to redress this discrepancy were evident. Overall, assessment formats did not adequately voice the individual's perspective or promote a truly comprehensive assessment through an exploration of individual strengths, skills and abilities, past successes, and future hopes. Assessment formats across Australia and New Zealand are not currently aligned with contemporary thinking and practice in mental health care. Given the heavy influence that mental health assessment has on clinical decision making in particular, a reappraisal of the focus and content of formats used is urgently required.
从临床和组织的角度来看，进行和记录心理健康评估被认为是一项核心活动。近年来，心理健康服务提供的思维和实践发生了很大变化，开始采用康复、创伤知情护理和基于优势的方法等原则。本研究旨在确定这些概念在澳大利亚和新西兰的心理健康服务中评估格式的内容中体现的程度。获得了澳大利亚每个州和地区以及新西兰三个地区卫生局使用的心理健康评估的副本。对评估格式进行了比较，以确定是否纳入了康复、创伤知情护理和基于优势的方法等概念。分析的评估格式（n=11）包含了许多旨在识别伤害、问题、风险和病理学的传统特征。已经有一些尝试来纠正这种差异。总体而言，评估格式并没有充分表达个人的观点，也没有通过探索个人的优势、技能和能力、过去的成功和未来的希望来促进真正全面的评估。澳大利亚和新西兰的评估格式目前与心理健康护理的当代思维和实践不一致。鉴于心理健康评估对临床决策的影响特别大，迫切需要重新评估所使用格式的重点和内容。
