Social and structural context

Housing, financial and occupational instability

Housing, financial, occupational or educational conditions affecting daily life and access to care.

Structural contextClinically reviewed

Social

Fit, function and alternatives

Test this factor against the case

A contextual factor earns a place in the formulation when case evidence links it to the presentation, not because it is present.

Check alternatives

Do not infer the process from a label, search phrase or diagnosis alone. Assess actual circumstances and source-specific population limits.

Next steps

Elicit case evidence, examine alternatives, discuss the hypothesis with the person, and revise when relevant evidence changes.

Qualification

Specify the actual barrier. Population findings do not show that unemployment caused this presentation or that any work will improve it.

Caveats for this record

Educational formulation aid, not a diagnostic instrument, score or treatment order.
No generated history, trauma, protective factor, or patient preference may be asserted without case evidence.

Record status

Record type: Structural context
Population: Adult-general clinical formulation; apply narrower source population limits
Review: Clinically reviewed

Evidence

S08Comprehensive Care Standard

Australian Commission on Safety and Quality in Health Care · HTML text. Comprehensive assessment and care planning, Actions 5.10–5.14.

Organisation-level Australian standard, not a validated psychiatric formulation template.

Link withheld: this source remains held and is cited as metadata only.

S33Mental health effects of unemployment and re-employment: a systematic review and meta-analysis of longitudinal studies

Occupational and Environmental Medicine (BMJ) · 10.1136/oemed-2025-110194 · Bibliographic record and abstract. Abstract/methods/results; GRADE assessment.

Authors rated certainty low. Employment is not a universal remedy and job conditions matter. No individual causal certainty.

Link withheld: this source remains held and is cited as metadata only.

Evidence references only. Each source's own limitations still apply.

Social and structural context

Caregiving, parenting and role strain Justice/legal context Service fragmentation / access barriers Social isolation / loneliness

Guide modules

Rapid clinical formulation guide Foundations, terminology and evidence limits Practical assessment-to-formulation workflow Risk formulation and management linkage Documentation templates and worked examples

How to use this

Record the case evidence yourself. Nothing here is a patient finding, and no factor becomes a cause because it appears in the formulation.

Social and structural context

Housing, financial and occupational instability

Housing, financial, occupational or educational conditions affecting daily life and access to care.

Structural contextClinically reviewed

Social

Fit, function and alternatives

Test this factor against the case

A contextual factor earns a place in the formulation when case evidence links it to the presentation, not because it is present.

Check alternatives

Do not infer the process from a label, search phrase or diagnosis alone. Assess actual circumstances and source-specific population limits.

Next steps

Elicit case evidence, examine alternatives, discuss the hypothesis with the person, and revise when relevant evidence changes.

Qualification

Specify the actual barrier. Population findings do not show that unemployment caused this presentation or that any work will improve it.

Caveats for this record

Educational formulation aid, not a diagnostic instrument, score or treatment order.
No generated history, trauma, protective factor, or patient preference may be asserted without case evidence.

Record status

Record type: Structural context
Population: Adult-general clinical formulation; apply narrower source population limits
Review: Clinically reviewed