Information on our assessment process

What follows is an overview of the usual assessment process when you come to Dundee. The following is just a guide but we will explain any changes to you on the day. We would usually hope that patients are accompanied by friends/ relatives/ partners/ etc. and we will seek your consent to get additional information from them.

Over the last few years, referrals have become increasingly complex, with multiple overlapping conditions, and it is quite common for further assessment(s) to be needed. This might include: inviting you back to Dundee; online assessment with you or a family member; or visits to your home.

Casenote Review

Before you come to Dundee we will have reviewed all available case notes so that we have as much information as possible on previous treatments. It also helps us to identify areas where there is uncertainty (e.g. diagnosis), and also issues that we should focus on (such as previous experience of treatment).

Psychiatric Review

Part of the day (usually the morning) will involve a psychiatric assessment with one of the psychiatrists (Dr David Christmas or Dr Lori-An Etherington). They will conduct a detailed psychiatric interview, focusing on your current symptoms and the impact of the illness upon your life. We will also spend time understanding more about you, your family, and your work. We routinely use semi-structured interviews and rating scales to improve the reliability of diagnosis and to rate the severity of your illness.

Nursing review (psychological assessment)

You will also meet one of our experienced psychological therapists (all nurses) who will take a slightly different approach to understanding your difficulties. This session will include a review of the previous psychological therapies that you have received and looks at your experiences of these, so that we can offer advice on the likelihood that further psychological therapies (e.g. CBT) will be of benefit.

If you have OCD, we will also use this time to get more information about how your OCD works and get some additional info on how it has affected your family life. Other psychiatric assessments (e.g. exploring autism spectrum disorder) may also be completed.

Discussion with family members

It is helpful for us to be able to speak to people that know you well and who can describe not only how your symptoms affect you currently, but also what you were like before you were more unwell. Either the psychiatrist or the nurse (sometimes both) will speak to your family (with your permission) to get additional information about how your illness affects you, and other aspects of your life. We will sometimes complete some additional assessments with them to get the best understanding of your difficulties.

Discussion

As some point during the process, we will usually aim to meet with you and relevant members of your family to outline our thoughts about further treatment. We would also try to come to a common understanding of your difficulties and to ensure that you go away with a sense of what could happen next in terms of treatment. In some cases we will suggest having further discussions online once all the information is available.

Please note: There may be reasons why such a session is not possible. These reasons might include:

1. We still need additional information, for example medical notes from other services, NHS Boards, or departments;
2. We need to arrange further assessments and we cannot provide clear treatment recommendations on the day;
3. We might want to have further discussions with the referring psychiatrist/ team before making treatment recommendations;
4. The main reason for assessment is to resolve issues about diagnosis rather than plan for treatment. In some cases, these detailed discussions about diagnosis will be provided to the referring psychiatrist.

Reports

Once we have all the information we need, we will write a detailed report to your psychiatrist and your general practitioner. This will cover our assessment, diagnosis, and treatment recommendations. We will normally aim to send the report within 2-3 weeks of assessment (unless other information is needed before we can complete our assessment).

We will usually write to you with a summary of the treatment recommendations so that these can be discussed with your mental health team at your next visit.

Online assessments

We believe that the best assessment is done face-to-face, so we will usually aim for this. But in some situations (such as someone being too unwell to travel) we might suggest conducting the assessment online. The process is similar to that described above, except that we might spread the different parts of the assessment over different days.