Domain 6 - Social and Environmental Stressors (Contextual Domain)
Overview
This initial assessment domain should consider how the person’s environment might contribute to the onset or maintenance of a mental health condition. Significant situational or social complexities can lead to increased condition severity and/or compromise ability to participate in the recommended treatment. Unresolved situational or social complexities can limit the likely benefit of treatment. Furthermore, understanding the complexities experienced by the individual (with carer/support person perspectives if available), may alter the type of service offered, or indicate that additional service referrals may be required (e.g., a referral to an emergency housing provider).
Assessment of an individual on this domain should consider life circumstances that may be associated with distress such as:
significant transitions (e.g., job loss, relationship breakdown, sudden or unexpected death of loved one),
trauma (e.g., physical, psychological, or sexual abuse, witnessing or being a victim of an extremely violent incident, natural disaster),
experiencing harm from others (including violence, vulnerability, exploitation),
interpersonal or social difficulties (e.g., conflict with friend or colleague, loneliness, social isolation,bullying, relationship difficulties),
performance related pressure (e.g., work, school, exam stress),
ability to or difficulty having basic physical, emotional, environmental, or material needs met (such as homelessness, unsafe living environment, poverty), and
legal issues.
Scoring
0 = No problem in this domain – no descriptors apply
1 = Mildly stressful environment
Person experiences their environment as mildly stressful.
2 = Moderately stressful environment
Person experiences their environment as moderately stressful.
3 = Highly stressful environment
Person experiences their environment as highly stressful.
4 = Extremely stressful environment
Person experiences their environment as extremely stressful.