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Psychosocial Assessment - Coggle Diagram
Psychosocial Assessment
Chief Complaint
main reason they are here
History of Present Illness
has there been a history of this issue?
Past Psychiatric/Psychological History
is there any history of psychiatric problems?
Past Medical History
Any major ongoing medical issues?
Past Surgical History
any major surgeries?
Allergies
any drug allergies?
any allergies at all?
Current Medications
what are any current medications?
how much and how often are these being taken
Past Medications
what medications were taken in the past?
Drug/Alcohol Assessment
do they drink?
do they use drugs?
Suicidal/Homicidal Ideation
are they a suicide risk?
do they want to hurt people?
do they self injure?
Abuse Assessment
are they in an abusive relationship?
have they been abused in the past?
Family/Social History
who raised them?
any brothers or sisters?
are they married?
any kids?
Family History of Mental Illness
does anyone in the family have problems with mental illness
Employment
are they currently working?
is this a long term job?
Education
what is the highest grade completed?
any problems in school?
Current Legal Status
are they on parole/ probation?
are there any charges pending?
Developmental History
was the childhood traumatic/painful/uneventful?
what is their sexual orientation
Spiritual Assessment
what is their religious background
do they attend religious services
Cultural Assessment
important events that affected their cultural background?
Financial Assessment
what is the current financial situation?
Coping Skills
what does the patient do to cope?
Interests & Abilities
what are their hobbies?
what brings them pleasure?
Mental Status Exam