Mental Health Treatment Plan Patient Assessment (Page 2 of 2) in pdf

Mental Health Treatment Plan Patient Assessment Page 2

GP MENTAL HEALTH TREATMENT PLAN

PATIENT PLAN

PATIENT NEEDS / MAIN ISSUES

GOALS

REFERRALS

REATMENTS

Record the mental health goals agreed to by

Note: Referrals to be provided by GP, as

Treatments, actions and support services to

the patient and GP and any actions the

required, in up to two groups of six sessions.

achieve patient goals

patient will need to take

The need for the second group of sessions

to be reviewed after the initial six sessions.

CRISIS / RELAPSE

If required, note the arrangements for crisis

intervention and/or relapse prevention

YES 



APPROPRIATE PSYCHO-EDUCATION PROVIDED

PLAN ADDED TO

COPY (OR PARTS) OF THE PLAN

YES



THE PATIENT’S

OFFERED TO OTHER PROVIDERS

NOT REQ’D 

RECORDS

COMPLETING THE PLAN

On completion of the plan, the GP is to record that s/he has discussed with the

patient:

the assessment;

all aspects of the plan and the agreed date for review; and

offered a copy of the plan to the patient and/or their carer (if agreed by patient)

DATE PLAN COMPLETED

REVIEW DATE

(initial review 4 weeks to 6 months after completion of plan)

REVIEW COMMENTS

OUTCOME TOOL

(Progress on actions and tasks) Note: If required, a separate form may be used for the Review.

RESULTS ON REVIEW

Mental Health Treatment Plan Patient Assessment Page 2