Assessing and screening patients is essential in identifying their health status. Assessment and comprehensive screening are crucial to identify a patient’s mental health status. A mental status examination (MSE) is commonly recommended and used to screen and assess the mental health status of patients. Various parts should be incorporated into the examination to ensure that the mental status examination is comprehensive, accurate, and reliable. The results of each part should be combined to note the patient’s mental status (Prakash, 2018). The MSE can be used to diagnose patients suffering from mental health issues or identify the effectiveness of mental health interventions and therapies. This paper aims to identify the various essential parts of a mental status examination.
The first part is the appearance. The patient’s appearance can be used to identify whether he or she is having any mental health issues. This part is assessed through observation. It is essential to observe if the client is dressed appropriately. For example, one should observe if the client is dressed appropriately according to the weather. A client wearing heavy clothes while it is hot and sunny is likely to have mental health issues (Prakash, 2018). Also, a client wearing light clothes during winter will likely be experiencing mental health issues. This is an essential assessment component as it provides the first insights into the possibility of a mental health issue.
The second part is behavior. A client’s behavior could indicate whether he is mentally fit or not. This part involves assessing whether the patient is cooperative and whether his behavior is consistent with the current circumstances. For instance, for a patient brought in by family or law enforcers for a forced evaluation, it would be fitting to record that the patient is not cooperative. If this patient is still laughing and agreeing with the exam despite being forced, it would mean he is inconsistent with the current situation. This finding would not be expected (Okobi, Jr., 2023). This part of the MSE is significant to APNs as it helps identify the patient’s incorrect behaviors, which may help in recording the mental status.
The third part is motor activity. This part aims to describe the client’s movements and how he or she is moving. This involves checking the posture of the client. Also, it would involve assessing any involuntary movements. For instance, if a patient has a combative posture, it would indicate a possibility of aggression or violence (Okobi, Jr., 2023). This part is crucial for the APNs as it helps identify clients facing violence and abuse, which is highly affecting their mental health.
The fourth part is speech. Observing the speech of the client is essential during the interview. This includes assessing the client’s amount of verbalization and the speed and tone of the speech. For example, a patient with slurred speech will likely suffer from substance abuse (Gagnon & Kertay, 2021). APNs benefit from this part as it helps identify substance abuse and mania cases in case the patient speaks rapidly.
The fifth part of the MSE is mood and affect. Observing a client’s mood and affect is crucial in a mental health exam. Mood involves how the patient reports her feelings, while affect is how the patient expresses her feelings through their voice and face. For example, if a patient reports losing a spouse but does not show pain or sadness, it would indicate a possible mental health disorder (Gagnon & Kertay, 2021). This part is significant to APNs as it helps them record how the patient’s mood and affect differ.
The sixth part of the MSE is the perception. This involves what the client hears, feels, or sees around them. For example, a client experiencing hallucinations is likely to be experiencing a mental health illness (Holzer, 2017). For the APNs, this part is crucial as it helps them dig deeper into what the client is seeing, hearing from the voices, or hallucinating about. This could be significant information in developing a plan of care.
The seventh part of the mental status examination is cognition. This part revolves around identifying whether the client is alert and oriented. This involves identifying whether the client knows what is happening around him (Holzer, 2017). For example, if a client does not know his name, date, or location, it would be evident that he is experiencing a mental disorder. APNs use this part in identifying cases of severe mental health issues.
The eighth part is insight and judgment. This part of the MSE aims to identify whether the client is aware of his current illness and whether he can make relevant and accurate decisions. For example, a patient experiencing hallucinations and can tell they are unreal can be identified as having a disordered perception but with fair insight (Black, 2021). On the other hand, if a patient has impaired judgment, he is likely experiencing alcohol abuse, Alzheimer’s, or bipolar disorder.
APNs have the role of conducting a comprehensive mental status examination, which should incorporate all the above parts. The APN combines data collected from all the parts to identify the client’s mental status and develop differential diagnoses. In conclusion, APNs should use the parts and information gathered to develop a proper care plan for the individual patient.
References
Black, D. W. (2021). The psychiatric interview and mental status examination. DeckerMed Psychiatry. https://doi.org/10.2310/psych.13001
Gagnon, F., & Kertay, L. (2021). Avoiding psychiatric disability Overdiagnosis (Part 2): Improving diagnosis and assessment of mental health disorders and psychiatric work disability. Guides Newsletter, 26(6), 15-18. https://doi.org/10.1001/amaguidesnewsletters.2021.novdec02
Holzer, J. C. (2017). The psychiatric and cognitive mental status examination in the medical-legal context. Oxford Medicine Online. https://doi.org/10.1093/med/9780199374656.003.0001
Okobi, Jr., D. E. (2023). Mental status examination. Encyclopedia of Mental Health, 493-502. https://doi.org/10.1016/b978-0-323-91497-0.00123-5
Prakash, P. (2018). Psychiatric history collection and mental status examination. Pocket Clinical Guide for Nursing Students, pp. 143–143. https://doi.org/10.5005/jp/books/14242_36
write