Assessing the mental health needs of older people

Assessments of need


Assessments of need for welfare services have been enshrined in 'good practice' for many years and identified as an expectation in law by:

Summary: Assessments of need

The Single Assessment Process (SAP)

The Single Assessment Process (SAP) aims to ensure that older people receive appropriate, effective and timely responses to their health and social care needs, and that professional resources are used effectively, minimising duplication. It is a pivotal mechanism:

There are four types of SAP depending on the nature, severity and complexity of need:

SAP is viewed as part of the wider process of Care Management, which also includes the stages of:

It is also regarded as a mechanism which all statutory agencies and professionals in a single area 'sign up to', so that local care and assessment systems align with the SAP.

The Care Programme Approach (CPA)

People with severe and enduring mental health problems are subject to the Care Programme Approach (CPA). CPA was implemented at the same time as Care Management with the specific aim of providing a framework for the delivery of effective care of adults with mental health care problems. Its role has been reinforced by the National Service Framework for Mental Health. (50);

Although not primarily associated with older people, the CPA is relevant because one of the criteria for inclusion is a history of self-neglect, which is often a feature of older people with severe mental health problems. It is expected that the SAP will work in an integrated way with the requirements of the CPA and that the SAP plus critical aspects of CPA will be applied to older people with severe functional or organic mental health problems (see Further information for more on integrating the CPA and the SAP).

Carers' assessments

Carers who provide 'intensive and substantial' levels of care have a right to an assessment of their needs under the Carers (Recognition and Services) Act 1995 and the Carers and Disabled Children Act 2000. The former gave a carer the right to have their needs assessed at the same time as the person they care for. The latter Act gives carers a further right to an assessment even if the cared-for person refuses to be assessed. This Act also extended local authorities' powers to provide or arrange services that support carers in their caring role.

Further information

Further information about the Single Assessment Process can be found on the Department of Health website.

Department of Health guidance Care management for older people with severe mental health problems clarifies the relationship between the CPA and the SAP.

The report Integrating older people's mental health services: Community Mental Health Teams for older people (51) contains a review of recent evidence about the extent and efficacy of implementation of the SAP alongside the CPA.

For clear and accessible information on carers assessments, see the Carers UK website.

Next: Mental health legislation