Mental State Exams

Welcome! headspace Woodville have developed this online course to help you learn about using mental state examinations as part of your psychosocial assessments with people presenting with mental health concerns.

Introduction to Mental Disorders and the Mental State Examination

Introduction to Mental Disorders

The Diagnostic and Statistical Manual of Mental Disorders V (DSM V) admits that no single definition can give us exact boundaries for the concept of 'mental disorder.' That being said, it offers the following definition of a mental disorder:

In DSM-IV, each of the mental disorders is conceptualized as a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom

DSM V also offers some caveats to this definition of mental disorder:

  • The pattern must not be a 'normal' response to an event, for example the death of a loved one.
  • Deviant behaviours (e.g. problematic sexual behaviours) are not mental disorders, unless they are a symptom of a larger dysfunction in the person, as described above.
  • Conflicts between a person and society are not mental disorders, unless they form a symptom of a larger dysfunction in the person, as described above.

Reference: Stein, D.J., Phillips, K.A., Bolton, D., Fulford, K.W.M., Sadler, J.Z. and Kendler, K.S. (2010) ‘What is a mental disorder? From DSM-IV to DSM-V’, 40(11).

Introduction to Mental State Examinations

The mental state examination (MSE) is the psychological equivalent of a physical exam, which describes a person's mental state. It includes both the objective observations of the worker and subjective descriptions given by the client. The MSE can be defined as: 

The process of assessing an individual’s mental state and behaviour at the time of an interview. It uses a common format and language to record information, which can be readily understood across different services. The goal is to identify signs and symptoms of mental illness to ensure appropriate assistance can be given to the client and that any risks are addressed.

Most of us intuitively perform many parts of a MSE every time with observe or interact with others - think of all the times you've noticed things about others that helped inform your understanding of how they were functioning at a given point in time. MSEs focus on using what we can notice about another person to give us clues as to their mental state.

References:

Martin, D.C. (1990) The mental status examination. Available at: http://www.ncbi.nlm.nih.gov/books/NBK320/ (Accessed: 20 September 2016).

Understanding the Mental State Examination (MSE): A basic training guide. Available at: http://www.palmerston.org.au/_literature_92767/MSE_DVD_-_Booklet (Accessed: 20 September 2016).

Mental state examinations usually include observations across a number of domains, including: 

  • Appearance and behaviour 
  • Mood, affect and speech 
  • Thinking and perception 
  • Insight and judgement 

Reference: 

Clinical practice guidelines: Mental state examination. Available at: http://www.rch.org.au/clinicalguide/guideline_index/mental_state_examination (Accessed: 20 September 2016).

Why Do a Mental State Examination?

The MSE:

  • Helps to assess any problems with psychological functioning, including the type of problem and how severe it is.
  • Provides a 'snapshot' of a person's psychological functioning at a given point in time that you can check progress against.
  • Allows other workers to assess if the client's mental state has changed, even if they haven't seen the client before. 

Mental Disorders True or False

  • No single definition gives us exact boundaries for the concept of 'mental disorder'
  • A mental disorder can be a clinically significant behavioural OR psychological pattern
  • A mental disorder is not associated with a significantly increased risk of pain, disability, or death
  • A mental disorder must be associated with present distress OR disability
  • A mental disorder can be a 'normal' response to an event, such as the death of a loved one
  • Deviant behaviours are not mental disorders, unless they are a symptom of a larger dysfunction in the person
  • A person experiencing conflict between themselves and society, without it being a symptom of a larger dysfunction in the person, has a mental disorder
Please select whether these statements about mental disorders are true or false, according to DSM IV.

Mental State Examination Text Match

  • The MSE is a psychological version of
    A physical exam
  • The MSE includes the worker's observations and
    Descriptions given by the client
  • Mental state examinations assess
    The mental state of the client being seen
  • MSEs focus on what we notice about a client to
    Give us clues about their mental state
  • Most of us intuitively
    Perform parts of an MSE every time we meet with a person

Mental State Examination Multiple Choice

  • Appearance and behaviour
  • Home and environment
  • Education and employment
  • Mood, affect and speech
  • Thoughts and perceptions
  • Alcohol and other drugs use
  • Relationships and sexuality
  • Insight and judgement
Please select all the domains that are part of a mental state examination. 

Why Do a Mental State Examination Reflection Question

Please type a reason why you might consider adding a mental state examination to your assessment process.

Appearance & Behaviour

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