Psychosocial Assessment Domains — MRCPsych Paper B MCQ
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Correct answer: D — Collaboratively explore the function of this episode, the person's values and preferences, and historic, current, future and protective factors to identify strengths, vulnerabilities and needs.
Explanation lettering: C = shown as B · D = shown as C · B = shown as D
B is correct. NICE describes psychosocial assessment as a collaborative, comprehensive process rather than a narrow prediction exercise. It should develop a shared understanding of why this episode occurred and explore its function, the person's values and treatment preferences, and historic, current or changeable, future, and protective or mitigating factors. These domains inform a formulation of strengths, vulnerabilities, needs and safety. Option A is incorrect because NICE advises against risk scales and global low/medium/high stratification for predicting self-harm or deciding discharge. Options C and D include relevant information but exclude essential psychological and social domains. Collateral information in E can be valuable, with appropriate attention to consent and confidentiality, but static factors and family accounts cannot replace direct, person-centred assessment.
Reference: NICE. Self-harm: assessment, management and preventing recurrence (NG225), recommendations 1.5.1 and 1.5.9–1.5.10 and section 1.6, 2022 (updated August 2024). https://www.nice.org.uk/guidance/ng225/chapter/recommendations