Mental health: strengthening our response

Mental state examination Watch the video and provide answer of the following questions Link of the video- https://www.youtube.com/watch?v=ZB28gfSmz1Y 1. Define the mental state assessment, describe when it is to be used and describe why it is a useful tool for nursing or midwifery practice (max 100 words) 2. Describe Andy’s appearance and behaviour during the initial assessment (100 words) 3. Differentiate between mood and affect, and then describe affect as it relates to Andy (max 50 words) 4. Discuss Andy’s speech (max 50 words). 

Running head: CASE-STUDY
Case-Study
Name of the student
Name of the university
Author’s name

1CASE-STUDY
1. Define the mental state assessment, describe when it is to be used and describe why it is
a useful tool for nursing or midwifery practice (max 100 words) 5 marks
Mental state examination (MSE) or mental state assessment is organized in a way to present,
actions, attitude, power, expression, thought process, quality of awareness, vision, intellect and
intuition to track and describe the individual's state of mind. The MSE is used when
psychologists have to assess a patient’s mental status. The aim of the MSE is to provide a
detailed cross-sectional overview of the state of mind of the individual, that, once integrated with
the psychological history biographical and background details, helps the practitioner to make a
definitive assessment and formulation necessary for coherent care (Trzepacz, Hochstetler, Wang,
Walker and Saykin 2015).
2. Describe Andy’s appearance and behavior during the initial assessment (100 words) 3
marks
From the Andy’ appearance in the video, it could be seen that Andy did not comb his hair,
and more importantly it looked like he did not take a bath. Along with that he did not shave and
his face was full of beard which made him look dirty. Whole over, he did not look clean. During
the assessment Andy was distracted and he prevented himself from doing an eye contact during
the entire video. His language was jumbled and very often difficult to understand. He represented
decreased motor function and reduced arousal rates. Andy demonstrated that he has
been suffering since the last two months from stressful events. He also said that he can hear his
roommate’s voices throughout the time, even if they were not present. Andy also mentioned that
his roommates have putted some kind of memory card inside his brain and are playing with his

2CASE-STUDY
brain by putting dreams all the time. He seems to be preoccupied with his own set of thoughts
and is confused.
3. Differentiate between mood and affect, and then describe affect as it relates to Andy
(max 50 words) 3 marks
Mood is the state of voice that underlies it. Concepts such as limited, normal range, suitable
for background, flat, and depth define the affect. Mood corresponds to the intensity of feeling,
and is defined as nervous, depressed, dysphoric, euphoric, angry and irritable. Andy portrayed an
anxious and gloomy effect that lasted for nearly the whole moment in the video. From inside he
looked uncomfortable and deprived. Most of his responses, nevertheless, answered the questions
raised (Correa, Abadi, Sebe and Patras 2018).
4. Discuss Andy’s speech (max 50 words) 3 marks
Andy was murmuring, and was vague sometimes. His answers have in several instances been
difficult to comprehend. He talked minutely and replied to only the questions raised. His speech
intensity was too slow, with significant duration. His pace was soft yet disquieting. He has often
portrayed a slurred fluency. He constantly tried to explain his point though.
5. What signs or symptoms associated with an episode of psychosis can you identify in the
interview with Andy? (Max 50 words) 5 marks
It can be interpreted that Andy is going through different psychotic disorders. Judging
everybody, difficulty in focusing, not liking the family, misapprehension and suicidal behaviors
were the sign and symptoms which are observed in Andy. The individual becomes seriously

3CASE-STUDY
depressed and used in the past to have suicidal thoughts. Individual suspected of attempting
suicide by drug poisoning.
6. What tests might Dr. Taylor request at the end of the consult with Andy, and why are
these important in the context of symptoms consistent with psychosis? (max 100 words)
3 marks
Adequate medical evaluation shows a need for prompt treatment and rehabilitation action.
Laboratory and other studies are conducted, often including brain imaging methods like a
computerized tomography (CT) scan or brain magnetic resonance imaging (MRI). Physical
observations may refer to the symptoms of schizophrenia or the drugs that the individual may
take (Arciniegas 2015). By conducting a CT and MRI scan, it will help in providing a more
detailed knowledge regarding the brain structure and tissues and enabling to view different parts
of the brain, thus giving a more clear idea about the symptoms of the disorders (psychosis) which
the brain is suffering (Vilela and Rowley 2017).
7. Dr. Taylor assesses Andy’s thought. Describe how you think she might describe and
document her findings in the progress notes? (max 50 words) 5 marks
Dr. Taylor describes Andy's roommates ' dialogue and behind - the-scenes observations as
third-person visions. Sometimes, she finds illusions in his thinking because he feels he has a
device implanted into his head. Suicidal thoughts and experience on medications, and being
indicative of a psychiatric disorder, probably schizophrenia.
8. How would you assess Andy’s insight into his current emotional and cognitive state?
What are the likely positive or negative outcomes associated with this level of insight?
Please comment on his overall judgment as well. (max 50 words) 3 marks

4CASE-STUDY
The victim has psychiatric disorder. The clinical symptoms experienced by Andy include
suspiciousness, unable to focus, social isolation, paranoia, suicidal behavior and feelings
(Isvoranu, Borkulo, Boyette, Wigman, Vinkers and Borsboom 2016). The individual is at greater
risk of hurting others, the two roommates in particular. The individual held a baseball bat and
knife in the room with the intention of hurting the two housemates because they annoyed him so
lately. The patient is in severe distress and has in the past experienced suicidal thoughts. The
nurse was speaking about committing suicide by drug poisoning.
9. Looking at Andy’s presentation overall, what risks does he currently present with? Are
there risks that you have excluded? Provide evidence for all your responses. Please give
consideration to his physical health as well as all other possible risks. (max 150 words) 5
marks
Andy articulated his suicidal thoughts as a diversion from the discussions in the background
and the flood of emotions which he cannot manage. He found over consuming drugs as an
alternative for ending his life. He has also stopped himself from feeding because he feels it is
tainted. It reveals the threats to his health and life that he faces. Psychotic sicknesses are
followed by health effects such as respiratory disorders, sexual dysfunction, and decreased
physical performance and enhanced diabetes mellitus chances. In fact, he had in his space a
pistol and a baseball bat for personal defense. Although he does not wish to harm others, and if
possible, he will not refrain. He becomes wary of his co-workers and a lecturer, too. It renders
him a threat to everyone around him. Other risk variables involve alienation from society and a
behavioral decline.

5CASE-STUDY
10. Andy is diagnosed with a psychotic disorder. What interventions/treatment and care
pathways/options would be appropriate for his care? Give consideration to the setting
in which this care might be provided. Provide rationales for your plans. You will need
to read the relevant chapter in your textbook, as well as look for other academic sources
(max 300 words) 10 marks
The two primary objectives of earlier time intervention in psychotic disorders are to decrease
the time span among the beginning of psychosis and the beginnings of effective therapy, as well
as provide coherent and thorough treatment throughout critical early years of disease. In order to
ensure optimal symptomatic and functional stabilization and rehabilitation, appropriate
intervention during crucial, early years requires diligent participation and the initiation of
medications and psychosocial interventions (McGorry 2015).
Even though these drugs are not a remedy, they are also helpful in the treatment of the
most problematic symptoms of psychotic disorders including the visions, confusion and thought
difficulties. The most common type of medications that doctors recommend is "antipsychotic"
drugs. For instance the doctor can prescribe Lurasidone, Paliperidone, Ziprasidone, and many
more. There are various kinds of psychotherapy – such as individual treatment, group counseling
and family therapy – that really can assist people with a PSD. Many individuals with psychiatric
disorders are classified as outpatient clients which means they might not stay in hospitals.
However, individuals often have to be hospitalized as if they have serious symptoms and are at
risk of injuring themselves and also the others near them due of their condition (Albert, Melau,
Jensen, Hastrup, Hjorthøj and Nordentoft 2017).

6CASE-STUDY
Those undergoing psychotic treatment can react differently to rehabilitation. Some will
be rapidly improving. For others, symptoms can be relieved for weeks or months. Those patients
that need further therapy for a long time. Some may require medication continuously, like those
with multiple serious episodes. The drug is usually taken at the lowest possible dosage in these
situations, in order to reduce adverse effects (Haddock and Slade 2019).
Psychotic disorders cannot be treated. The medicines can only help to prevent the related
symptoms. Seeking help as soon as possible can help the person's life, family, and relationships.
Avoiding medications such as marijuana and alcohol can help avoid or prolong such symptoms
for those with high risks for a psychotic disorders, including those who have family history of
mental illness (Haddock and Slade 2019).

7CASE-STUDY
References
Albert, N., Melau, M., Jensen, H., Hastrup, L.H., Hjorthøj, C. and Nordentoft, M., 2017. The
effect of duration of untreated psychosis and treatment delay on the outcomes of prolonged early
intervention in psychotic disorders. NPJ schizophrenia, 3(1), pp.1-8.
Amminger, G.P., Schäfer, M.R., Schlögelhofer, M., Klier, C.M. and McGorry, P.D., 2015.
Longer-term outcome in the prevention of psychotic disorders by the Vienna omega-3
study. Nature communications, 6(1), pp.1-7.
Arciniegas, D.B., 2015. Psychosis. Continuum: Lifelong Learning in Neurology, 21(3 Behavioral
Neurology and Neuropsychiatry), p.715.
Arevalo‐Rodriguez, I., Smailagic, N., i Figuls, M.R., Ciapponi, A., Sanchez‐Perez, E.,
Giannakou, A., Pedraza, O.L., Cosp, X.B. and Cullum, S., 2015. Mini‐Mental State Examination
(MMSE) for the detection of Alzheimer's disease and other dementias in people with mild
cognitive impairment (MCI). Cochrane Database of Systematic Reviews, (3).
Correa, J.A.M., Abadi, M.K., Sebe, N. and Patras, I., 2018. Amigos: A dataset for affect,
personality and mood research on individuals and groups. IEEE Transactions on Affective
Computing.
Haddock, G. and Slade, P.D., 2019. Cognitive-behavioural interventions with psychotic
disorders. Routledge.

8CASE-STUDY
Isvoranu, A.M., van Borkulo, C.D., Boyette, L.L., Wigman, J.T., Vinkers, C.H., Borsboom, D.
and Group Investigators, 2016. A network approach to psychosis: pathways between childhood
trauma and psychotic symptoms. Schizophrenia bulletin, 43(1), pp.187-196.
McGorry, P.D., 2015. Early intervention in psychosis: obvious, effective, overdue. The Journal
of nervous and mental disease, 203(5), p.310.
Trzepacz, P.T., Hochstetler, H., Wang, S., Walker, B., Saykin, A.J. and Alzheimer’s Disease
Neuroimaging Initiative, 2015. Relationship between the Montreal Cognitive Assessment and
Mini-mental State Examination for assessment of mild cognitive impairment in older
adults. BMC geriatrics, 15(1), p.107.
Vancampfort, D., Stubbs, B., Mitchell, A.J., De Hert, M., Wampers, M., Ward, P.B.,
Rosenbaum, S. and Correll, C.U., 2015. Risk of metabolic syndrome and its components in
people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive
disorder: a systematic review and meta‐analysis. World Psychiatry, 14(3), pp.339-347.
Vilela, P. and Rowley, H.A., 2017. Brain ischemia: CT and MRI techniques in acute ischemic
stroke. European journal of radiology, 96, pp.162-172.