Introduction
In this chapter we discuss contemporary, evidenced-based approaches to the assessment of mental health and mental illness from multiple perspectives. We discuss a range of themes, principles and concepts within the assessment and diagnostic systems in mental health, underpinned by personal experiences, contemporary, evidence-based research and a range of other literature. The personal accounts of consumers, their families and carers, and of health care professionals practising in a mental health context, are used to contextualise assessment and diagnosis as they relate to mental health and mental illness.
The meaning of mental health within health assessment
The early detection, effective assessment, accurate diagnosis and subsequent connection to treatment and care (together known as ‘early intervention’) can be an important factor in the prevention and the development of chronic conditions occurring in people with a mental health condition.
Most health service providers utilise structured documentation to record assessment data; however, assessment is not simply a matter of sitting down with the person and filling out forms in a question-and-answer format. It is a process of genuine therapeutic engagement between the person, as the expert in her or his own situation, and the practitioner, as a skilled facilitator of health care solutions. Through a process of engagement to hear the person's story, and with the aid of notes jointly created to facilitate shared understanding, the practitioner is later able to complete the structured organisational documentation.
Within the literature, mental health and mental illness are distinctly different concepts, despite the fact that they are frequently used as de facto descriptors for each other (Keyes, 2005; Westerhof & Keyes, 2010). Mental illness is referred to within this work. However, within diagnostic criteria, the term ‘mental disorder’ is used, and within the majority of Mental Health Acts within Australia the term ‘mental illness’ is used.
Mental health and mental illness are not considered to be two ends at polar opposites of the same continuum, but rather as two distinctly different trajectories (Manderscheid et al., 2010; Westerhof & Keyes, 2010; World Health Organization (WHO), 2005). In contrast to the term ‘mental illness’, the concept of mental health has rarely been researched. Interest in ‘mental health’ as a distinct concept emerged in the 2000s, with the main aim of improving the mental health of populations (Westerhof & Keyes, 2010).