Box

SHARES is a clinically useful mnemonic for ensuring that the various needs of chronically disabled mentally ill patients are being addressed. (!3) Symptoms: How is the patient's illness responding to the specific treatment provided?

Housing: Are the patient's housing needs adequately met? Does he or she have adequate supervision in the home? Is he or she in danger of eviction?

Activities of Daily Living: Are the person's needs for assistance in everyday living being met? Can he or she obtain an adequate diet, take care of laundry, shopping and personal safety?

Recreation: Does the person have opportunities for relaxation and amusement?

Employment: Is the person participating in pre-vocational or vocational training, or is he or she engaged in sheltered employment, or working in the open labour market?

Significant others: Does the person need help in fostering a network of social supports, including family and friends?

If the problem-oriented record approach and the individualized treatment plan are not used wisely, they may simply lead to a series of lists with little coherent logic, in which all needs or problems are given equal weight in the development of a treatment plan. To avoid this, the diagnostic evaluation of the patient should include a formulation, which comprises a summing-up of the salient facts of the case and of the aetiologically important factors ( Chapter.1.:.i10.1). The treatment plan then emerges from the formulation and reflects its logic in prioritizing the needs of the patient.

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