Physical welbeing (Keller BK, 2003)  and mental wellbeing (WHO, 2014), may be significantly impacted by prevailing social and financial circumstances

Physical and mental illness may affect the individual's ability and inclination to comply with medical advice (WHO, 2003) and the frequency of attendance in primary care (Vedsted P, 2004) and the emergency department (Byrne M, 2003).

The health care professionals concerned with a proactive and personalised plan of action will have to assess the individual's social situation and support structures in order to determine the interventions required.
Although an interview in the surgery, or a prepared questionnaire filled in by the patient prior to the consultation, may provide useful information, the ideal remains the assessment in the patient's home and in the presence of the next of kin or informal carers.

The Camberwell Assessment of Need (CAN) family of questionnaires is used for the assessment of health and social difficulties in different settings.

The completed assessment can be used for several purposes:

• to identify the appropriate level of care to offer (people with more severe and wide-ranging mental health problems should be seen by specialist mental health services);

• as a focus for care planning – negotiating the actual help and treatment to be offered;

• as a review mechanism, to record the service user’s needs at a particular point in time and to verify whether Unmet needs are becoming Met needs;

• (in aggregated form) to inform service developments, by identifying domains which are common needs amongst people using the service, but which the service does not currently address.

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There are several ways of completing the CAN.

Often the best approach – consistent with the principle that the focus should be on the conversation not the rating – is to use the 22 CAN domains as a mental checklist of areas to cover in the assessment, with the actual form filled in after the meeting. Many domains will be covered in the course of the assessment, and the remaining domains can then be assessed by starting with a statement such as: ‘To help me get a fuller picture, can I also ask you about…?’.

A second approach is to show the service user how to complete CANSAS-P, and give it to them for self-rating before or during the assessment meeting.

A third approach is for the staff to ask questions about each domain, and then fill in the service user assessment on the basis of their responses

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Not every portion of the CAN needs to be completed at one sitting.

Some domains may feel embarrassing or be counter-therapeutic to assess. However, although domains such as intimate relationships and sexual expression can be awkward to introduce, if discussed skillfully this does give an opportunity for people to talk about areas they might find too embarrassing to bring up themselves.