Details of mental health assessments can be entered on the “Assessment” subtab of the “MH”
tab.
When you select the MH tab, you will be at the “Basic” subtab by default. Click on the “Assessment”
subtab to begin entering mental health screening and assessment records to a client’s mental health
file.
Figure 1. “Assessment” subtab
Your access to this subtab can be limited to read only, full edit access or none at all. If you do
not have access to this subtab in the MH tab, you will not see this tab at all. If you do not have
access to any of the MH subtabs, you will not see the MH tab in a case. This depends on the role
assigned to you in NCAtrak.
To learn how to manage privileges for the Mental Health Tab and its subtabs, see the help file
for “Roles.”
Layout of the Mental Health Assessments Tab
Add a New Assessment
STEP 1: Select “Add New Assessment”
On the Assessment subtab, click on the “Add New Assessment” button to begin to enter details about
your mental health assessment for the client.
Figure 2. “Add New Assessment” button
STEP 2: Enter Assessment Details
An Edit dialog box will come up with different fields for you to fill out regarding your
assessment.
Click on the “Assessment Instrument” dropdown list to select which one was used with the client.
Figure 3. “Assessment Instrument” list
NOTE: A list of common, evidenced-based Assessment Instruments has been pre-populated in this
field. See “Add New Assessment Instruments,” below, for instructions on how to add additional
Assessment Instruments to this list.
Enter the date of the session in the “Session Date” field and the date the Assessment was done in
the “Assessment Date” field. These fields show today’s date by default if none has been set yet.
Figure 4. “Session Date,” and “Assessment Date” fields
Select the appropriate “Provider Agency” and “Provider Personnel” who conducted the assessment from
the drop down menus.
Figure 5. “Provider Agency,” and “Provider Personnel” fields
STEP 3: Enter Assessment Measure Scores
Once an Assessment Instrument is selected from the “Assessment Instrument” dropdown list, the
Assessment’s scoring measures will auto populate in the “Scores of this Assessment’s Measures”
section.
Enter the scores from the client’s assessment in the available fields to record your scores for
this assessment. You can add any notes related to the assessment to the “Comments” text box.
Figure 6. “Scores of this Assessment’s Measures” fields
STEP 4: Save Assessment Details
Once you have completed entering all details for the assessment, click on the “Update” button to
save the record and return to the list of Assessments, or “Cancel” to forego adding a new
Assessment.
Figure 7. “Update,” and “Cancel” buttons
Repeat the process to add other assessments if necessary. These assessments may be administered
with different Assessment Instruments or records of the same Assessment Instrument may be entered
to show a client’s progress during treatment.
Review, Edit and Delete Existing Assessments
Every time a new assessment has been added, it will appear at the top of the list in the table for
Assessments Given.
You can sort the different columns in the table, i.e. sort the names of the Assessment Instruments
alphabetically or sort the dates from latest to oldest or vice versa. To do this, you just have to
click on the column name once and it will sort. If you click on the same column name, it will sort
in the reverse order.
For example, you want to sort by date. When you click on the Date column once, it will sort the
entries from oldest to latest and an upward arrow will appear beside the column name. If you click
on the Date column again, it will sort the entries in reverse order and a downward arrow will
appear beside the column name.
Figure 8. Sorting assessments by “Date”
Figure 9. Sorting assessments by “Date” in reverse order
To make changes in one of the entries in the “Assessments Given” table, choose the entry you
want to modify and click on the “Edit” button next to it to review and change the details.
Figure 10. “Edit” button
Once you click on Edit, the details of the selected assessment will come up in the Edit dialog box.
Make changes to any field and click on the “Update” button, or select “Cancel” to forego any edits.
The dialog box will close and you will be back at the “Assessments Given” table.
For detailed instructions on making selections in each field of the Assessment menu, see “Add a New
Assessment” above.
To delete an assessment, click on the Delete button beside the assessment you want to delete. A
dialog box will come up asking you to confirm the deletion.
Figure 11. Delete confirmation dialog box
If you click OK, the dialog box will close and the selected entry in the “Assessments Given” table
will be deleted. If you click Cancel, the dialog box closes and the selected assessment will not be
removed.
Add a New Assessment Instrument
STEP 1: Select “Add New” Assessment Instrument in the Assessment Subtab.
Common Assessment Instruments have been included in the list of Assessment Instruments options.
Additional Assessment Instruments can be added to this list to be made available for your CAC
whenever entering a new Assessment record.
On the Assessment subtab, click on the “Add New Assessment” button. An Edit dialog box will appear
with a menu of options to include in the details about the Assessment.
Click on the “Add” link next to the Assessment Instruments field.
Figure 12. “Add” an Assessment Instrument
The “Edit Assessment Instrument” box will appear. It will include the current list of Assessment
Instruments.
STEP 2: Select “Add New Instrument”
Click on the “Add New Instrument” button at the top of the Edit Assessment Instrument box. Open
fields will appear to allow you to enter a new Assessment Instrument and its associated assessment
measures.
Figure 13. “Add New Instrument” button
Type in the name of the new Assessment Instrument that you want to add in the field under the
Assessment Instrument column.
Figure 14. Assessment Instrument name text box
Click on the arrowhead pointing to the right just beside the “Update” and “Cancel” buttons. This
will expand the menu so you can enter the measures associated with the new Assessment Instrument
that you want to add.
Figure 15. Arrow button to expand menu
Click on “Add New Measure” button to enter the measures for the new Assessment Instrument. In the
“Measure” field, type the name of the Measure and provide a description of the Measure in the
“Description” field.
Select “Update” to save the measure.
Figure 16. “Measure,” and “Description text boxes
Repeat this process to add more Assessment Measures to the Assessment Instrument. Once all of the
Measures are entered select the “Update” button next to the Assessment Instrument at the top.
NOTE: Every Assessment needs to have at least one measure. If you do not enter a Measure, the
system will not allow you to save the Assessment Instrument to the list.
STEP 3: Review and Edit Assessment Instruments and Measures
To review and make changes to any Assessment Instrument and associated Measures, click on the
“Edit” button to the left of the Assessment Instrument in the list.
Figure 17. “Edit” button
Once changes are made, click on the “Update” button to save your changes and return to the list of
Assessment Instruments, or click “Cancel” to forego any edits.
Add a New Diagnosis
STEP 1: Select “Add New” Diagnosis in the Assessment Subtab.
On the Assessment subtab, click on the “Add Diagnosis” button to enter a new one in the
“Diagnosis Log” section of the Assessment subtab.
Figure 18. “Add Diagnosis” button
A dialog box will appear with a menu of options to include in the details about the Diagnosis.
STEP 2: Enter Diagnosis Details
Select the appropriate “Provider Agency” and “Provider Personnel.”
Enter the “Diagnosis Date,” and select the appropriate “ICD 10 Group” and “ICD 10 Diagnosis”
codes.
Select “Update” to save the record and return to the list or “Cancel” to forego adding a New
Diagnosis.
Figure 19. “Provider Agency,” “Provider Personnel,” “Diagnosis Date,” ICD 10 Group,” and “ICD 10
Diagnosis” fields
Repeat this process to add more Diagnoses to the Diagnosis Log as necessary.
STEP 3: Review and Edit Diagnoses
To review and make changes to any Diagnosis record, click on the “Edit” button to the left of
the Diagnosis in the list.
Once changes are made, click on the “Update” button to return save your edits and return to the
list.
To delete a Diagnosis record, click on the “Delete” button. A pop up box will ask, “Are you sure
you want to delete this record?”. Click on “OK” to delete or “Cancel” to forego deleting the
record.
Figure 20. “Edit,” and “Delete” buttons
Document Upload
To upload documents related to assessments given to clients and their diagnoses, scroll down to the
“Document Upload” section. This is available in every MH subtab. Files uploaded in one subtab are
NOT visible in other subtabs.
Use the “Select Files” button to upload files.
Figure 21. “Select Files” button in the document upload section
Refer to the “Document Upload” help file for details on uploading and managing documents.
NOTE: NCA does not recommend the storage of evidentiary documents as part of this case record. Any
copies of evidentiary materials should be retained by the appropriate law
enforcement and prosecution partners.