Mental Health Assessment

Question 1

What are 7 indications for a mental health assessment?

Answer 1

1. Behaviour changes - depressed, illogical, withdrawn
2. Changes in mood
3. Anxiety
4. Self-harm or suicide ideation
5. Hallucinations
6. Delusions (particularly paranoid delusions)
7. Alterations in cognition (orientation, memory, problem-solving)

Question 2

What are the four methods of assessment for MH?

Answer 2

1. Emergency: acute/urgent
2. Observation (appearance, behaviour, cognition, and thinking)
3. Interview (health history)
4. Physical assessment (ADLs, IADLs, cultural)

Question 3

What are the four questions to ask during an acute MH assessment?

Answer 3

1. Have you ever tried to harm or kill yourself?
2. Do you have a plan for how you might kill yourself?
3. Do you have the things you need to carry out this plan?
4. Have you made preparations for your death?

Question 4

List the SAD PERSONAS screening tool

Answer 4

S - sex
A - age
D - depression
P - previous attempt
E - ethanol abuse
R - rational thinking loss
S - social supports lacking
O - organized plan
N - no spouse
A - access to lethal means
S - sickness

Question 5

Describe the 10-point scale for the SAD PERSONAS tool

Answer 5

0 to 2 - send home with a follow-up
3 to 4 - close follow-up; consider hospitalization
5 to 6 - strongly consider hospitalization, depending on confidence in the follow-up arrangement
7 to 10 - hospitalize or commit

Question 6

What 5 components are involved in appearance?

Answer 6

1. Posture
2. Facial expression
3. Body movements
4. Dress
5. Grooming and hygiene

Question 7

What 5 components are involved in behaviour?

Answer 7

1. LOC
2. Facial expression
3. Mood
4. Affect
5. Speech

Question 8

What 4 components are involved in cognition?

Answer 8

1. Orientation
2. Immediate/recent/remote memory
3. Attention and concentration
4. Comprehension and abstract reasoning

Question 9

What 5 components are involved in thinking?

Answer 9

1. Perception
2. Content
3. Process
4. Insight
5. Judgement

Question 10

Describe an MMSE

Answer 10

Mini-mental state examination

Used by clinicians to help assess dementia - its progression and severity

It is a series of questions and tests, each of which scores points if answered correctly for a total of 30 points max.

MMSE tests a number of different mental abilities, including memory, attention, and language

Question 11

What complaints is an MMSE most commonly used to test for?

Answer 11

Tests for complaints of cognitive and memory problems

Question 12

Describe a MoCA

Answer 12

Montreal Cognitive Assessment

A brief 30-question test that takes around 10-12 minutes to complete and helps assess people for dementia

Assesses orientation, memory, language ability, and clock-drawing test

Question 13

What is a MoCA good for testing/detecting?

Answer 13

Good for detecting dementia and delirium and differentiating these from psychiatric mental illness

Question 14

Define an obtunded state

Answer 14

Transitional state between lethargy and stupor

Sleeps most of the time, difficult to arouse, confused when aroused, speech is mumbled or incoherent

Question 15

Define stupor

Answer 15

Spontaneously unconscious, responds only to persistent and vigorous shaking or pain, has appropriate motor response, only groans or mumbles

Question 16

What are the differences between delirium and dementia?

Answer 16

Delirium is a sudden onset that is temporary/acute and typically is in the presence of an underlying medical disorder (UTI, hypoxia)

Dementia is a progressive onset that is chronic and typically associated with a decline in age and cognitive function

Question 17

What are the four general components of a full mental status examination?

Answer 17

1. Appearance
2. Behaviour
3. Cognition
4. Thinking