Mental State Assessment (MSA)

Question 1

What is a MSE? (Mental state examination)

Answer 1

Process of assessing an individual’s mental state and behaviour at the time of an interview

To identify signs and symptoms of mental illness to ensure appropriate assistance can be given to the client and that any safety issues/risks are addressed.

The MSE is not a series of questions, but an evaluation process based on the clinician’s observations and interactions, (objective and subjective data) with the individual.

Question 2

Whats the format for basic MSE? (8)

Answer 2

They are:
1. Appearance
2. Behaviour
3. Speech and language
4. Mood and affect (feelings)
5. Thought content (thinking)
6. Perception
7. Cognition
8. Insight and judgement

Question 3

What to write in the APPEARANCE part of an MSE?

Answer 3

Note overall appearance

• Age, gender, race/ethnicity, build, hair style & colour, grooming, posture, level of hygiene, mode of dress, level of health, signs of AOD use (Drunk & alcohol)

Question 4

What to write in the BEHAVIOUR part of an MSE?

Answer 4

Observations of persons behaviour

• How do they behave? Facial expressions, eye contact, body movements and gestures
• How is the pt reacting to being in the session? Co-operative, angry, hostile, withdrawn, inappropriate, afraid, suspicious

Question 5

What to write in the SPEECH AND LANGUAGE part of an MSE?

Answer 5

How is the pt speaking?
- Rate, volume, tone, quantity of information, quality (stutter, slurring, etc…)

How does the pt express themselves?
- Incoherent/ illogical, derailment, loosening of association, thought blocking

Question 6

What to write in the MOOD AND AFFECT part of an MSE?

Answer 6

How does the pt describe their emotion mood?

How does the pts emotional state appear?

Question 7

What to write in the THOUGHT CONTENT part of an MSE?

Answer 7

What is the person thinking about?

• The amount of thought and its rate of production- Does speech flow easily? Does conversation stay on track? Any limitation to think?
• Continuity of ideas- Do the thoughts being expressed flow logically and stay on track? Are certain words or ideas repeated? Are there gaps in thinking?

-Disturbances of language- Communication coherent and well organised? Correct words being used?

• Delusional thoughts- False beliefs?
• Preoccupations- permanent in clients minds but not as firmly held as delusions. Include- paranoid, depressive, anxious.
• Thoughts or harm (To self or others)

Question 8

What to write in the PERCEPTION part of an MSE?

Answer 8

Perceptual disturbances

• Hallucinations
• Dissociative symptoms

Question 9

What to write in the COGNITION part of an MSE?

Answer 9

Consider the clients
- LOC
- Attention
- Memory
- Orientation
- Concentration
- Abstract thinking

Question 10

What to write in the INSIGHT AND JUDGEMENT part of an MSE?

Answer 10

Clients capacity to recognize their own problems and symptoms