Psychiatric Mental Status Assessment

Question 1

What is a mental status?

Answer 1

• Evaluation of a person’s emotional and cognitive functioning
• Optimal mental status occurs when there is a balance and satisfaction in work, relationships and health

Question 2

What is involved in a psych mental status assessment?

Answer 2

• Identifying characteristics (ex. age, name, address)
• Mental status exam (appearance, behavior, psychomotor activity, speech)
• Psycho-social assessment (ex. stressors, support, coping, roles and relationships, daily routines, sleep habits, substance use, self concept)
• Developmental assessment
• Physiological assessment (ex. may be underlying physical causes for conditions, such as pain, hypoglycemia, thyroid issues, infection, delirium, chronic disease causing depression, etc.)
• May include other diagnostic tools

Question 3

How do we assess the “presenting problem” when a patient is first being assessed?

Answer 3

• Asking what brought the patient to the hospital (good starting story; also gives insight into recall, memory, judgement, attitude, etc.)
• Recent psychosocial stressors (ex. family death, lost job)
• Recent changes in presentation
• Personal and family history of mental illness (ex. depression, anxiety)
• How was the pt referred? Voluntary or involuntary?
• Level of insight (ex. do they understand why they’re on a psych unit, or why they take certain medications? or do they think they came in voluntarily when it was involuntary?)

Question 4

What are the symptoms we look for when assessing mental status?

Answer 4

• Physical (ex. posture, gait, eye contact, level of tension)
• Psychological/behavioral (ex. asking about mood, distressing thoughts, voices)
• Social (ex. are they isolated or spending time with others? recent changes in family dynamics?)
• Work

Question 5

What aspects of a mental status exam do we “assess”?

Answer 5

• Appearance, behavior, cognition and thoughts are four main categories
• Appearance
• Behavior/activity
• Attitude
• Speech
• Mood (subjective) and affect (objective)
• Thoughts
• Perceptions
• Sensorium/cognition
• Judgment
• Insight
• Reliability

Question 6

Describe mental status assessments and the nursing process:

Answer 6

Mental status assessment > Nursing diagnoses > Interventions > Evaluation