COMPONENTS OF PSYCHOSOCIAL

HEALTHCARE

They include
i. Mental health – thought pattern
ii. Emotional health – feelings
iii. Social health – External interactions
iv. Spiritual health – connection to something greater than oneself
What are the indicators of psychosocial health?

• Psychosocial health focuses on four aspects of ones life: mental, emotional,

social and spiritual ,when in balance a person will be :
✓ Optimistic
✓ Feel they have a purpose in life
✓ Forge and maintain positive connections with others and serve the
community
• When out of balance a person might:
✓ Have emotional outbursts
✓ Feel a loss of faith
✓ Isolate and or damage relationships and possibly develop psychosocial
disorder
NB
• Psychosocial aims to define the intersection of one’s individual
thoughts/ needs and external forces. It encompasses how a person
copes and accepts their own thoughts and behaviours in connection
to the external world.
• The psychosocial meaning focuses on the internal cognitive aspects
of a person’s life and how that internal world causes them to interact
with family, friends and their community.
 1.Mental health

• Encompasses the thinking portion of the psychosocial health.

• A person’s belief, value, opinions and connection with others all
reflect the mental health definition.
• E.g. If a person loses their job but maintains an optimistic attitude
and begins looking for work immediately, it most likely means they
are fostering positive mental practices.
• However, if a person loses their job and becomes depressed, choosing
not to look for new work, it may reflect poor mental health practices.
 2.Emotional health
• It entails the feelings portion of psychosocial health
• The way a person feels and reacts to various experiences reflects the
emotional health definition.
• It is natural to feel a range of emotions -from joy to grief- but the way
those emotions arise and manifest can illuminate a person’s
emotional health.
e.g. If a person loses their job but reflects on the fact that they showed
up late on most days and failed to meet deadlines, they may be upset
but are aware of their own shortcomings.
They may feel sad and disappointed but they are rational enough
to understand that their actions had consequences.
• However,
If a person loses their job and screams at their boss or throws papers
on their way out, it would reflect a state of poor emotional health
showcasing their inability to take responsibility for their actions,
• Within the realm of emotional health, it is important to understand
the importance of emotional intelligence.
Emotional intelligence- Is the ability to assess ones emotional state,
understand the feelings present and manage the emotional response.
Emotional intelligence can be broken down into five key
aspects:
1. Self awareness- recognizing and labelling the feelings that arise
even in difficult moments.
2. Self regulation- managing, expressing and coping with difficult
emotions in the moment and/ finding ways to reduce the severity.
3. Motivate yourself- the more you can do this independently in order
to achieve more in your life, the higher your emotional intelligence.
4. Recognise the emotions of others- the more you can empathise
with others the better.
5. Handle your relationships- the better you are at navigating conflict
in life and building a good second network, the higher your
emotional intelligence.
 3.Social health
• The ability to create and maintain healthy relationship with others.
• Social health goes beyond having appropriate emotional health and
intelligence.
• A person with good social health
1) Recognises the importance of social engagements, for pack animals after
all were not meant to live alone.
2) Is able to support their friends in a time of need and ask for their help if
they need it themselves.
3) They aren’t biased, prejudices, racist or sexist.
4) Listens to others well, expresses their feelings just as well and act in a
responsible manner around others.
 NB:
A person with good social health is a person who has friends that they
enjoy listening to and feels close enough to share important feelings
with.
 4.Spiritual health
• Describes an individuals sense of peace, purpose, connection to others and
belief about the meaning of life.
• Refers to the sense of belonging to something greater than the purely
physical or personal dimensions of existence.
• Behaviours often associate with wellness are key components of a healthy
spiritual life. Examples include:
✓Volunteering
✓Social responsibility
✓Optimism
✓Contributing to society
✓Connecting with others
✓Feeling of belonging
✓A reason to care for oneself
PATIENT ASSESSMENT OF PSYCHOLOGICAL
NEEDS
• Psychosocial assessment informs a holistic understanding of the
person in their social and cultural context to help guide the
development of the individual care plans.
• Psychosocial needs may be assessed by health professionals as part of
their role and if issues arise i.e.. Anxiety, distress etc a referral may be
made for a specialist support.
• Def. a psychosocial assessment is an evaluation of an individuals
mental health and social well being
• It assesses self perception and the individuals ability to function in
the community
• The psychosocial assessment goal is to understand the patient to
provide the best care possible and help the individual obtain optimal
health
• Psychosocial assessment helps a HCP determine if the patient is in
mental health or a mental illness state
• MENTAL HEALTH: is a state of well being one can deal with the typical
stresses of life, work, productivity and contribute to their community
• MENTAL ILLNESS: is a pattern of behaviours troubling the person or
the community where the individual resides
• Mental illness may modify reality influence daily living or harm
judgment
• Mentally ill individuals often have a reduced ability to cope with
society, maladaptive behaviours and a reduced ability to function
MAJOR COMPONENTS OF A PSYCHOSOCIAL
ASSESSMENT
• Identifying the patient
• Chief complaint
• Hx of presenting illness
• Psychiatric history
• Medical |surgical history
• Medication list
• Alcohol and drug use
• Cultural assessment
• Coping skills
1. First step in any assessment is to identify the patient
• A patients identity includes name, gender, birth, mental status, race
ethnicity and language
2. The chief complaint is the main reason the patient is presenting in
their own words
• The hx of the present illness in the chronological account of what led
up to the chief complaint
• This section may include the problems location, duration, severity,
timing, context, modifying factors and associated signs|symptoms
3. Psychiatric psychological history is the history of all psychiatric or
psychological concerns in the past
4.Medical | surgical history includes listing all medical illnesses,
surgeries and dates
5. All current and past medications should be listed including the dose
and frequencies
• A listing of who prescribed and why they are prescribed should be
documented
• A listing of why they were stated and stopped should be documented
for past prescribed medications
6.History of alcohol and drug use is important in the psychosocial
assessment
• The substances currently used should be documented including the
method of use the amount, frequency and the time
7. Social history provides clues as to how the person interacts with
others
• It is important to understand social relationships as those with a large
social network are more likely to have less severe mental illness and
recover better from mental and medical illness
8. Family history is important because many mental illness are
hereditary
• Common genetic illnesses include depression, bipolar disease,
schizophrenia and attention deficit disorder
9. Employment history is important- record the patients current
employment status and occupation
• If the patient is currently employed determine if this is a long term
employment contract
• Determine how they function at their job
10.Determining educational history will help HCP understand the best
way to interact with the patient
• What's the highest grade that the patient completed, where the
patient attended school, were they disciplined
• NB: this provides helpful clues to the patients mental health status
11.Developmental history will provide insight into the origins of
behaviour and help diagnose and manage some conditions
• Any psychological trauma experienced as such may lead to problems
in adulthood
12. A cultural assessment should list critical issues regarding the
patients ethnic and cultural background
• A good cultural assessment will help the HCP understand the patients
beliefs values and practices- these factors can be respected and
considered when providing care
13. Financial assessment should describe the patients financial
situation and helps understand financial situation is important
because- patients in lower socioeconomic class are at a higher risk for
many mental health conditions
• Also patients with limited financial resources may need help with
money and may benefit from a social workers consultation
14. Determining coping skills is an important part of the psychosocial
assessment
• If a HCP understands the current patients coping techniques they will
provide better care by fostering adaptive coping skills
MENTAL STATUS EXAMINATION
• Factors to observe during the mental status examination
1. Orientation
2. Appearance
3. Behaviour
4. Speech
5. Mood
6. Attitude
7. Presence of hallucinations delusions or strange thoughts
APPERANCE
• One should describe the prominent physical features of an individual
and should be detailed enough
• Key areas to note may be – general grooming, hair colour, texture or
styling, skin texture, scar formation, tattoos, clothing ( type,
appropriateness) or jewellery
BEHAVIOUR
• Observation of movement or behaviour , firmness and strength of
handshake
• Any involuntary or abnormal movements , tremors and mannerisms
SPEECH
• This is a behaviour mechanical evaluation of speech
• Items that might be commented on include- the rate of speech, the
spontaneity of verbalizations the range of voice intonation patterns
the volume of speech and any defects with verbalizations (
stammering or stuttering)
ATTITUDES
• One should comment on how the patient related to the examiner
• This usually includes a discussion of the patients degree of
cooperativeness with the examiner
EMOTIONS
• Divided into two
• 1.Mood- is a sustained feeling tone that prevails over time for a
patient. At times the patient will be able to describe their mood
• Evaluator must inquire about a patients mood or infer it from the rest
of the interview
• Qualities of mood that may be commented on include the depth of
the mood, the length of time that it prevails and the degree of the
fluctuation
• Common words used to describe mood include:-
• Panicky, terrified, sad, depressed, angry, enraged, euphoric, and guilty
• One should be as specific as possible in describing a mood and vague
words such as upset should be avoided
• 2. Affect- is a behavioural observable manifestation of mood
• Some aspects of mood that we might comment on include the
following:-
1. Appropriateness of the affect to the described mood( does the
person look the way they say they feel?)
2.The intensity( is there too much –heightened or dramatic)
3. Mobility –is it too little, constricted or fixed
THOUGHT
• Its divided into two categories i.e.. The thought process and content
of their thoughts
• 1.Thought process- manner of organization and formulation of
thought
• Coherent thought is clear, easy to follow and logical
• A disorder of thinking tends to impair coherence and any disorder of
thinking tends to impair coherence
• Any disorder of thinking that affects language , communication or the
content of thought is termed a formal thought disorder