Priority 1: Get Initial Assessments Right

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“Initial assessments are undertaken in a timely manner, with a holistic approach and involving the young person throughout and parents, carers or friends where agreed.”

Mental health assessments need to show interest and awareness of the whole person, not narrowing on a presenting problem. We asked young people for their feedback on assessments. Here are some of their recommendations:

  • Let the person know what to expect from the assessment. We should be informed about what processes we are getting into.
  • Allow each individual to express what their issues are rather than bombarding them with questions.
  • Continuity is important; we shouldn’t  be passed from person to person. A new worker, for example in adult services, needs to familiarise themselves with case histories. Repetition is disheartening.
  • Parents at assessment is not always the answer. There should be a choice about if you want your parent there. Having a youth worker or peer mentor do the assessment with you can be valuable, to advocate for you through the process.
  • There should be constant feedback so that points can be checked continually for accuracy and that there is the right information in going forward.

The best way to make sure that your assessment processes work for young people is to involve young people in the design and review of these systems.

How not to do it

“When I was bulimic it hurt more than my anorexia. The doctor wouldn’t take me seriously because there was nothing I could show him. My ECG was horrible, but they said “oh well” basically and shoved me out. The next day, I fainted and had extremely bad palpitations and it was terrifying.

“When I spoke to a doctor about it the week after this is what I was told:

  1. Anorexia is more important than bulimia.
  2. A depressive episode is ignorable despite a history of suicide attempts, but a manic episode would be worrying.
  3. Anxiety is ok, but phobias are worth treating.

“Basically, people prioritise the mental illnesses they treat. I think that’s what it comes down to. I wasn’t told that I wasn’t sick enough – I was told I wasn’t the right kind of sick.”

Talking about Talking Therapies, YoungMinds, March 2011

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