The following is the mental health evaluation TCCH BHS uses for their intake process. It could be considered a form of a social history.
This evaluation serves a couple of purposes. One to complete an assessment, determine a plan… etc. It is also used as a mechanism to demonstrate compliance with WAC and other legal concerns.
- Dimension I. Client Personal Information
- Dimension II. Referral & Admitting Problem
- Referral and presenting problem
- Dimension III: Client Treatment History, Mental Health/Psychiatric/Substance Abuse
- History of treatment, and outcomes
- Substance abuse information
- Dimension IV: Family/Significant Other Mental Health/Psychiatric History
- Family history (homicide, suicide, mental health)