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

  1. Person experiences their environment as mildly stressful.

2 = Moderately stressful environment

  1. Person experiences their environment as moderately stressful.

3 = Highly stressful environment

  1. Person experiences their environment as highly stressful.

4 = Extremely stressful environment

  1. Person experiences their environment as extremely stressful.