Domain 4 - Impact of Co-Existing Conditions (Primary Domain)

Overview

Increasingly, individuals are experiencing and managing multi-morbidity (coexistence of multiple conditions including chronic disease). An initial assessment should specifically examine the presence of other concurrent health conditions that contribute to (or have the potential to contribute to) increased severity of mental health problems and/or compromises the person’s ability to participate in the recommended treatment.

Assessment of an individual on this domain should consider:

  • substance use/misuse and the associated impact on the individual,
  • physical health condition and the associated impact on the individual’s concurrent mental health condition, and
  • intellectual disability or cognitive impairment.

Scoring

0 = No problem in this domain – no descriptors apply

1 = Minor impact

  1. Occasional episodes of substance misuse but any recent episodes are limited, are not currently causing any concerns and do not impact on the concurrent mental health condition of the person.
  2. Physical health condition(s) present but are stable and do not have an impact on the concurrent mental health condition of the person.

2 = Moderate impact

  1. Ongoing or episodic substance abuse impacting on, or with the potential to impact on, the concurrent mental health condition of the person or ability to participate in treatment.
  2. Physical health condition present and impacting significantly on the mental health condition of the person or their ability to participate in treatment.

3 = Severe impact

  1. Substance use occurs at a level that poses a threat to health or represents a barrier to mental health related recovery.
  2. Physical health condition present and requires intensive medical monitoring and is seriously affecting the mental health of the person (e.g., worsened symptoms, heightened distress).
  3. Intellectual disability or cognitive impairment that impacts significantly on the mental health condition and impedes the person’s ability to participate in treatment.

4 = Very severe impact

  1. Severe substance use disorder with inability to limit use without specialist AOD intervention, in the context of a concurrent mental health condition.
  2. Significant physical health conditions exist which are poorly managed or life threatening, and in the context of a concurrent mental health condition.
  3. Severe intellectual disability or severe cognitive impairment that impacts significantly on the mental health condition and impedes the person’s ability to participate in treatment.