In the field of mental health and psychological assessments, the 5 Ps formulation is a widely used framework that helps professionals gain a comprehensive understanding of an individual’s mental health challenges.
At Northern Healthcare, we regularly encounter complex mental health diagnoses that require unique, individualised solutions every time. This is where the 5 Ps formulation proves invaluable, as it considers both internal and external factors, as well as emotional and physical health. By taking the more thorough, though often lengthier, route, we can reduce risks and potential relapses, ensuring that assessments and interventions are person-centred and tailored to each individual’s unique experiences.
“I have used the 5 Ps formulation throughout my nursing career and was pleased to see this framework incorporated into our assessment process when I joined Northern Healthcare. The assessment practitioners complete this formulation by gaining information from the person at assessment and through historical paperwork. This then feeds into our support plans and risk assessments when the person moves into the service to ensure we are effectively managing the person’s support needs and any risks.”
– Sophie Thomas, Mental Health Lead
Join us as we break down the 5 P formulation, why it matters, and how professionals including support workers, mental health leads and clinicians can utilise the framework to develop risk management plans and care and support plans that promote a person-centred approach to care and support as well as positive risk-taking.
Let’s start with the basics, shall we?
The 5 Ps formulation is a structured method used to explore and understand mental health difficulties, taking a biopsychosocial approach that considers biological, psychological, and social factors. This model allows clinicians, psychologists, and support workers to identify the key influences in an individual’s life that contribute to their current mental health state and risk profile. By examining not only the present situation but also potential triggers, support networks, and recurring issues in a person’s routine, professionals can develop more personalised and effective interventions. This helps to clarify not only the underlying causes of the issue but also the steps needed to resolve it, making the process of finding solutions much more systematic and accessible.
Instead of relying on a one-size-fits-all method, it enables a deeper, tailored understanding that can lead to more successful and sustainable outcomes – really getting to the root of what is going on!
Each “P” represents a different factor that contributes to an individual’s mental health and well-being:
This refers to the main issue or difficulty that the person is currently experiencing, which is the reason they seek or are referred for support.
Examples of presenting problems can include:
These issues can often be connected to a variety of factors, such as financial concerns, including money and debt, challenges within family and social relationships, or physical health problems. Other contributing factors may involve medication issues, personal losses, experiences of bullying, or the use of unhelpful coping strategies.
These are historical and genetic factors that make an individual more vulnerable to mental health difficulties. They may include:
These are the triggers or events that have led to the onset or worsening of the presenting problem, and examples can include:
Professionals need to ask at this stage, “What was happening when current difficulties started?” As these examples are not uncommon triggers, it’s connecting them to the lives of those in support that makes personalising risk management plans effective.
These factors maintain or prolong the individual’s mental health difficulties, including:
These are the factors that, more often than not, keep the individual ‘stuck’ in their situation without properly addressing underlying issues. Identifying these is crucial for people in support to take that big first step into a positive, resilient future.
These are strengths and resources that can help an individual cope with their difficulties, reduce risks, build strength and support their recovery, such as:
In supported living environments, the 5 Ps formulation can be a valuable tool for developing person-centred care plans. Support workers and clinicians can use this model to:
For example, if a person we support in one of our services is struggling with anxiety, applying the 5 Ps model might reveal that:
This is just one example of how the 5 Ps model can be applied, and it doesn’t take into account all the possible factors that may influence someone’s experience with anxiety.
The strength of the 5 Ps formulation lies in its all-encompassing approach. Instead of treating just the symptoms, it considers past, present, and future factors, ensuring interventions are tailored to each individual’s journey. This method supports:
While it’s true that more quantitative research is needed to establish statistical evidence of the 5 Ps model’s effectiveness, these insights highlight its potential to improve risk assessment and intervention processes.
Support workers, mental health nurses and clinicians can integrate the 5 Ps formulation into their daily practice by using it as a structured approach to understanding and addressing mental health challenges.
This can involve conducting informal discussions with individuals to gain insights into their experiences, using the model to guide case discussions and multidisciplinary team meetings, and identifying patterns in behaviour to inform intervention planning. Additionally, professionals can support individuals in recognising their own protective factors and developing resilience, ensuring that care plans are both personalised and effective in promoting long-term well-being.
“Using the 5 P formulation at NHC allows us to have a deeper understanding of a person’s whole life and supports identifying risks and the creation of personalised risk management plans to reduce or mitigate the risks. The 5 P approach looks at the person we are supporting with an all-inclusive view, and the identification of unique early warning signs allows staff to intervene early, to reduce harm and risk to self and others.”
Jo Willis, Quality and Governance Clinical Lead
Overall, the 5 Ps formulation is a powerful tool in mental health and supported living services, offering a structured yet flexible approach to understanding individuals and their needs. By considering all five factors and guidelines from the NHS’ CNTW (Cumbria, Northumberland, Tyne and Wear) division, our support teams can create meaningful, person-centred care plans that empower the people we support on their recovery journeys. At Northern Healthcare, we champion this comprehensive approach to ensure that every person we support receives care that is as unique as they are.
5ps and formulation CNTW – Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
An overview of case formulation
5-Ps-Plan-Formulation-poster-April-2023.pdf
The 5Ps Model: A Strategic Tool for High Achievers to Tackle Problems — Flourish Mindfully
