Mental health assessments

A mental health assessment is a conversation between you and mental health professionals to help decide what kind of support you need.

You'll need to have a mental health assessment when you go to any mental health service for help.

A mental health assessment is not a test or an exam. It's about helping you. You only have to talk about what you want to talk about. The more open and honest you are, the easier it will be to get you the right help.

What happens during a mental health assessment

A GP or nurse may refer you for a mental health assessment. Social care services or educational services also sometimes refer people.

You'll have a detailed mental health assessment, which will usually be carried out by a specialist mental health doctor (psychiatrist).

Bringing someone to support you

You may be able to bring a friend or relative to support you.

Some people prefer to bring an advocate who can represent their views and interests. They can be volunteers, like mental health charity workers, or professionals, like lawyers.

If you want to know what advocacy services are available in your area, check with your local council.

What you'll talk about in your assessment

During the assessment, you and the mental health specialist will talk about your needs.

The conversation might cover:

mental health symptoms and experiences
feelings, thoughts and actions
physical health and wellbeing
housing and financial circumstances
employment and training needs
social and family relationships
culture and ethnic background
gender and sexuality
use of drugs or alcohol
past experiences, especially of similar problems
your safety and other people's
whether anyone depends on you, such as a child or elderly relative
strengths and skills, and what helps you best
hopes and aspirations for the future

You only have to talk about what you want to talk about but the more you're able to share, the easier it will be to find out what will work best for you.

At the end of the assessment

When the professionals you're talking to have all the information they need, they'll make their assessment and explain it to you in clear language.

You should get the chance to ask questions about your condition, the diagnosis, possible causes, the treatments on offer, and how those might affect your life.

You should be involved in making decisions about what treatments are best for you.

You can also expect to be given information to take home, so you can think about it in your own time, as well as advice on where you can find out more.

What you can do before and during the assessment

Do

think about who you could take with you for support and arrange for them to come along
make some notes before your appointment about what you want to discuss
tick each point off during the appointment, when they've been covered
ask as many questions as you need to about anything that's not clear
ask the mental health specialist to explain things to you as many times as it takes for you to understand it

Find out more about what to ask your doctor or other healthcare professional

Reviewing how it's going

Your needs can change over time so it's important your treatment is reviewed regularly.

You'll have a named person as your care co-ordinator or key worker. They should make sure you have regular reviews and you should go to them first if you’re worried about your treatment. They can also offer you support, including support for your family and friends if they need it.

Your review will be a face-to-face meeting in a familiar place. That's often the clinic, community mental health centre or GP surgery where you usually meet your care co-ordinator or key worker.

If you prefer, it may be possible for the meeting to take place at your house. Or it could be at another place where you feel comfortable, like a community centre.

You might want to bring someone with you, such as a friend, family member or advocate. You can find out about advocacy services from your care co-ordinator or local council.

Rethink, a mental health charity, also has more information about advocacy for mental health

If a treatment or service is not working for you

If a treatment or mental health service is not working for you, you should say something. It's important for the mental health professional you're seeing to know about this.

It might be that another approach or a new assessment is needed to find a service that's better for you.

If you do not feel that your concerns are being taken seriously, ask the manager of your mental health service if you can see a different member of the mental health team.

Your GP might also be able to help you, if you talk to them.

Getting a second opinion

If you're not sure about a diagnosis or treatment suggested to you, you can ask for another medical professional to give a second opinion.

NHS trusts deliver NHS services locally. They usually have a system for getting second opinions and will help you see another medical professional.

You can also ask your mental health professional, GP, care co-ordinator or key worker if they can arrange to get a second opinion for you.

You do not have a legal right to a second opinion but in most cases, you should be able to get one.

If your doctor refuses to pass on your request, or the mental health service refuses to offer a second opinion or a change of health professional, contact your local patient advice and liaison service (PALS). They'll give you advice on what to do next.

Or you could ask an advocate to help you. Your local council will be able to help you find a local advocacy service.

Find out more about getting a second opinion on the Rethink website

What if I want a specialist second opinion?

You might feel that your local mental health service is not specialised enough to give a proper diagnosis or treatment for your condition. If so, you might want an expert in your condition to help you instead.

You can ask for a specialist second opinion on the NHS. Some mental health trusts offer specialist services. If yours does not, they’ll have to find a specialist somewhere else.

Specialist services usually focus on one condition or problem, especially if that condition is complex or severe.

Conditions that may require a specialist service are:

obsessive compulsive disorder (OCD)
eating disorders
severe conditions before, during and after pregnancy, including postpartum psychosis
gender identity conditions
conditions needing specialist neuropsychiatry services

If you want an independent opinion from a specialist, your psychiatrist might agree that it's a good idea and help you find the right specialist. Or your GP can arrange this for you.

To do this, your GP might need to contact your local integrated care board (ICB). ICBs are in charge of the funding for your local NHS and decide where the money should be spent. They'll decide whether to pay for an independent opinion.

Some specialist services have their own funding to cover the cost of treating people who are referred to them. They usually have information on their websites about this.

Although getting a second opinion could be a difficult step that takes time, this should not stop you asking for one if you really need one.

If your GP disagrees or refuses to pass on your request, ask again. Explain why you feel you need a second opinion.

Include examples such as:

I feel that standard treatments are not working for me. My mental health is not improving and I have been in and out of hospital, or have been in hospital for a long time.
I am having side effects from the medication, which is seriously affecting my health. My doctor cannot find any answers or alternatives.

It's important to explain how your diagnosis or treatment is causing problems in your life and why you think a second opinion might help.

If the integrated care board (ICB) will not fund a second opinion

If your request for specialist support is refused because the ICB is not funding it, your GP or a specialist clinician can ask NHS England to reconsider it.

This is known as an individual funding request (IFR).

You cannot make an IFR yourself, but you can work with your GP or specialist on the request if they believe you’re eligible for specialist support.

Find out more about individual requests for funding on the NHS England website

The process is also explained on some ICB websites, along with the application forms needed to make a claim for funding.

If you're not happy with any aspect of your care, including how your request for a second opinion has been handled, you can file an official complaint using the NHS complaints procedure.

Your rights under the Mental Health Act

There are a few situations where decisions might be made about a person's care without their agreement, through the Mental Health Act. This is sometimes known as being sectioned.

This is done to protect people who may not be able to make decisions about their care because of the effects of a mental illness.

Find out more about the Mental Health Act