Examination

Question 1

What are the key elements of a mental state examination?

Answer 1

Appearance and behaviour (clothing, weight, facial appearance, posture)
Speech (Rate, quantity, volume, flow, spontaneity)
Mood (subjective/objective)
Affect (observable behaviour associated with changing emotions)
Thoughts (overvalued ideas, phobia, obsessions, delusions)
Perception (sensory distortion, illusion (misinterpretation of a real stimulus, hallucinations)
Cognitive examination (orientation, concentration, memory, MMSE, MOCA)
Insight (aware of illness, acceptance of health or treatment, acceptance it’s a problem)

Question 2

What are common terms to describe affect?

Answer 2

Blunted or flattened affect - dulling of normal emotional response
Labile affect - sudden rapid and often marked shifts of affect
Inappropriate or incongruent affect - can be inappropriate to the thought content (e.g. laughter upon recounting the death of loved one) or inappropriate to the magnitude of events (e.g. emotional outburst after a small and insignificant event)

Question 3

What are the types of hallucinations that can occur in normal individuals?

Answer 3

hypnopompic hallucination (visual or auditory hallucination upon awaking)
hypnagogic hallucination (visual or auditory hallucination upon falling asleep)

Question 4

What are the 5 questions you ask to assess insight?

Answer 4

Is the patient aware that there is anything wrong?
If there is anything wrong, does the patient think it is due to an illness?
If an illness, is it physical or mental illness?
If it is a mental illness, can it be helped?
Is the patient willing to accept help or treatment?
This may include hospital admission - will the patient agree?

Question 5

What is the definition of risk?

Answer 5

Probability or threat of damage, injury, liability, loss, or any other negative consequence that is caused by internal or external vulnerabilities, that may be reduced through pre-emptive action

Question 6

What should be included in a risk assessment?

Answer 6

Deliberate self harm and suicide
Self-neglect
Exploited by others
Deterioration of mental or physical health 
Aggression and violence to other people 
Risk to children 
Risk to property and risk of driving

Question 7

What are approved mental health professionals (AMHPs)?

Answer 7

Usually be a social worker although they can be other allied health professionals etc. They have had further training in assessing if someone needs to be admitted to the hospital using the Mental Health Act

Question 8

What is an independent mental capacity advocate?

Answer 8

Someone with specialist training who helps someone lacking capacity make decisions around serious medical treatment or a change of accommodation. A legal right for people over 16 who lack mental capacity and do not have an appropriate family member or friend to represent their views

Question 9

What is an independent mental health advocate?

Answer 9

Someone specially trained to support people to understand their rights under the Mental Health Act and to help them participate in their care and treatment. A legal right for anyone detained under Sections 2 or 3 of the Mental Health Act, as well as some other parts of the Act