Domain 6 - Social and Environmental Stressors (Contextual Domain)
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Overview
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This initial assessment domain should consider how the person’s environment might contribute to the onset
or maintenance of a mental health condition. Significant situational or social complexities can lead to
increased condition severity and/or compromise ability to participate in the recommended treatment.
Unresolved situational or social complexities can limit the likely benefit of treatment. Furthermore, understanding the complexities experienced by the individual (with carer/support person perspectives if
available), may alter the type of service offered, or indicate that additional service referrals may be required
(e.g., a referral to an emergency housing provider).

Assessment of an individual on this domain should consider life circumstances that may be associated with distress such as:

   * significant transitions (e.g., job loss, relationship breakdown, sudden or unexpected death of loved one),
   * trauma (e.g., physical, psychological, or sexual abuse, witnessing or being a victim of an extremely violent incident, natural disaster),
   * experiencing harm from others (including violence, vulnerability, exploitation),
   * interpersonal or social difficulties (e.g., conflict with friend or colleague, loneliness, social isolation,bullying, relationship difficulties),
   * performance related pressure (e.g., work, school, exam stress),
   * ability to or difficulty having basic physical, emotional, environmental, or material needs met (such as homelessness, unsafe living environment, poverty), and
   * legal issues.


Scoring
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**0 = No problem in this domain – no descriptors apply**


**1 = Mildly stressful environment**

   a. Person experiences their environment as mildly stressful.
	

**2 = Moderately stressful environment**

   a. Person experiences their environment as moderately stressful.


**3 = Highly stressful environment**

   a. Person experiences their environment as highly stressful.


**4 = Extremely stressful environment**

   a. Person experiences their environment as extremely stressful.