6. A holistic approach as the key to assessment
Mental health work relies heavily upon personal relationships and involvement with people from different backgrounds.
In Letting Through Light (Department of Health/Race Equality Unit 1998), Ratna Dutt and Peter Ferns outline a holistic model for working with service users and their families. The model has 12 components, which relate to ESCs 5, 6 and 7:
- Holistic assessment – individual needs are assessed within a wider socio-economic context, as well as health and basic physical care needs.
- Challenging stereotypes – assessment of needs is not based on ‘assumptions’ or ‘stereotypes’ of people but on a careful assessment of individual circumstances.
- Reinforcing cultural heritage – discovering a person’s chosen lifestyle and strengthening their cultural identity to increase opportunities for personal growth and development.
- Culturally appropriate services – identifying cultural and religious needs in an accurate way which can then facilitate the development of culturally appropriate services.
- Overcoming language barriers – attending to the person’s communication needs to enable fuller participation in the assessment process.
- Outreach and preventive work – needs are assessed with a view to involving community-based resources in providing support for the person and preventing crises from occurring.
- Focus on discriminatory barriers – needs analysis is not based on a discriminatory view of the person as a ‘cause’ of the problems but focuses on problematic social processes which exclude the person from ordinary community living.
- Appropriate intervention – interventions are culturally appropriate and strengthen cultural identity to increase opportunity for personal growth and development.
- Family/carer support – individual needs of the person are assessed within a context of their significant personal relationships with family and friends.
- Range of treatment options – needs should not be restricted to artificially narrow aspects of the person’s life defined by professionals and service organisations, but should encompass the whole of a person’s life.
- Empowerment and advocacy – ensuring that the person and his/her family participate fully in the assessment process with independent advocacy or self-advocacy support if required.
- Safeguarding rights – establishing checks on the quality of the assessment process and ensuring that the person has proper access to a complaints procedure if required.
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