Mental State Examination Workbook for Nursing and Midwifery

This workbook provides an opportunity to develop and demonstrate knowledge of processes associated with assessing a person’s mental state in different health care contexts, and supporting the person to navigate to a place of recovery. The workbook contains 10 questions about mental health assessment, and strategies to work with people with mental illness. The workbook responses will be assessed based on the use of evidence to interpret and analyze the mental state assessment, including an assessment of risk, interpretation and use of evidence to plan care to support the mental health needs of the person in diverse health settings, critical appraisal of principles of equity, rights and access, information literacy skills, and written presentation including structure, grammar, application of referencing protocol Harvard.

HLT301, Semester 1, 2020
GROUP 1
Assessment Task 1: Mental State Examination Workbook for Nursing, Midwifery and
other disciplines
50 Marks (1000 words)
Description
This task provides you with an opportunity to develop and demonstrate knowledge of
processes associated with assessing a person’s mental state in different health care contexts,
and supporting the person to navigate to a place of recovery.
Assessment Criteria
The workbook responses will be assessed according to the following criteria:
 Use of evidence to interpret and analyse the mental state assessment, including an
assessment of risk
 Interpret and use evidence to plan care to support the mental health needs of the
person in diverse health settings
 Critical appraisal of principles of equity, rights and access
 Information literacy skills: use of sources and citations
 Written presentation including structure, grammar, application of referencing protocol
Harvard
Workbook Format
The workbook contains 10 questions about mental health assessment, and strategies to work
with people with mental illness. You must adhere to the word limit provided for each
response.
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Workbook Instructions
Nursing and Midwifery students: Watch the video ( copy the http link to google and watch
the video link is https://youtu.be/ZB28gfSmz1Ytitled and answer according to the question
 Answer each question in the workbook template. Please ensure that you include both
the question and its accompanying answer.
 You are required to respond to the questions in your own words. You may use direct
quotes from the video (i.e. the person’s statement may be quoted as long as it is
relevant, fits into your word count and helps to explain your application of theoretical
understanding to the practice video).
 Each question includes a guide for the maximum number of words expected for the
response. Keep within this word limit, although there is a +/- 10% leeway provided.
Supporting literature to answer the questions:
You need to demonstrate you have used the most appropriate source for your responses e.g.
policy documents, journal article, textbook etc. Not all the answers require a citation,
however you are expected to use a variety of sources eg textbook, journal articles, credible
websites etc.
Academic sources should be published within the last 5 years.
Reference List:
At the end of the paper you need to provide the full reference details of each citation
(reference) you have used in your responses. You are asked to use the Harvard Referencing
guide I attached it in the files please look please give at least 2 references in 100 words also
in 9th and 10th question.
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Use this book for some question as references compulsory
The book is :
Year - 2018
Title -Mental health care 3rd Edition wiley
Publisher
Hungerford, C., Hodgson, D., Bostwick, R., Clancy, R., Murphy, G, de Jong, G. & Ngune, I.
2018
HLT301 Assessment Task 1: Workbook
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
Answer:
In the fields of appearance, attitudes, behavior patterns, mood, affect, speech, thought
process, content of thought, perception, cognition and insight; the mental state assessment is a
structured way of monitoring and describing a patient's current thinking (Ciesielska et al.
2016, p.1039).
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The objective of the Mental State Assessment is to acquire a full cross-sectional
portrayal of the patient's mental health, and this enables the clinician to make the exact
diagnosis and formulation of action plan. The biographical and past psychiatric history of the
patient also helps in formulation of such treatment plans (Trzepacz et al. 2015, p.107)
2. Describe Andy’s appearance and behaviour during the initial assessment (100 words) 3
marks
Answer:
Andy’s appearance was a bit clumsy with trimmed beard and properly cutted hairs.
He came over wearing a casual outfit and had a shaky attitude while answering certain
questions. Andy’s appeal towards the questions by Dr. Taylor was proper and clear, however
his answers to the questions which was regarding his addictions were a bit shaky as if he was
not willing to share the facts. Even throughout the assessment it was noted that he was not
being able to have a proper eye contact which was often seen in the patients with severe
schizophrenia (Seymour et al., 2016, p.15).
Moreover, the appearance shown clearly that he was having a trust issue with his
consultant Dr. Taylor as well. Even during the assessments he asked her that either she have
trust on him or not that his feelings and thinking s are all real (youtube.com, 2020).
3. Differentiate between mood and affect, and then describe affect as it relates to Andy (max
50 words) 3 marks
Answer:
The affect is usually used more as a noun, with two variations of very similar
meanings. Affect may mean shifting the state of mind of an individual or either modifying the
emotions of an individual . Mood is usually a temporary, phase of feeling
(emotional), resulting from a particular stimulus (Tang, and Pinsky., 2015, p.54).
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In case of Andy the affect shown that he is getting more conscious at times feeling
that he needs to carry safety equipments such as knife or baseball bat for his protection.
4. Discuss Andy’s speech (max 50 words) 3 marks
Answer:
Andy’s speech varied with the questions asked by Doctor Taylor. At the start
of the assessment when Andy was asked about the history and background of his problems,
and he replied unhesitatingly. However, at times when he was asked about the drugs he used
to take, Andy hesitated answering the questions. That was due to excessive uptake of
cannabis which he was unwilling to reveal (Bedi et al., 2015, p.15030).
5. What signs or symptoms associated with an episode of psychosis can you identify in the
interview with Andy? (max 50 words) 5 marks
Answer:
The signs that came into notice upon interviewing Andy were (Lutgens, Gariepy, &
Malla, 2017, p.326):
 He was too insecure in concern to his surroundings.
 He also got tendencies of having hallucinations of hearing sounds.
 He got tendencies of carrying equipments for his sagfety; such as knife and
baseball bats.
The symptoms shows that (youtube.com, 2020):
 He was unknowiningly being schizophrenic and can get violent on anyone around
him on whom he feels having threat of.
 He can even have threat of having suicidal tendencies as well.
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
Answer:
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The assessments that Dr. Taylor went through were: Assessment of the background of
the case, Assessment of the risks, Assessment of the Drug History and assessment of the
insights(youtube.com, 2020).
Based on the finding of the risk assessments Dr. Taylor can ask for the test of Becks
depression Inventory which can state his chances of getting depressed and having panic
attacks. In addition, based on the assessment of the Drug history and his answers to the
questions one more assessment that can be brought into account is the test for the neural
system, and the Thematic Apperception Test which might be due to the excessive uptake of
the cannabis (Stein et al., 2015)
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
Answer:
Dr. Taylor will list down her findings based on her assessments. The four assessments
brought into the practice helped her in understanding that:
 Andy was having fear of his surroundings.
 He usually keeps knife and baseball bat as protection.
 He often have voices in mind, thus counts the symptoms of halucinations.
 His confession of having trust issues regarding his parents confirmed that the
symptom is growing.
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 judgement as well. (max 50 words) 3 marks
Answer:
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The overall judgement says (Joseph, Narayanaswamy, & Venkatasubramanian, 2015,
p.5):
 That Andy has a positive thinking, as he is aware of his situation and he reads
book which speaks of similar conditions as him.
 The negative term stays in his uptake of excessive drug.
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
Answer:
The overall situation states that Andy is too much insecure regarding the things in his
surroundings. The interview clearly states that he have issues trusting almost all individuals
around him. He also confessed that at times he felt that he need to protect himself from his
parents as well.
Thus the risks that prevails in the cetrtain case are (Lal et al., 2015, p.18):
 Severe rates of hallucinations
 Severe risks of having panic attacks due to the thoughts that some entity is having a
look over him.
 The risks of having suicidal tendencies are very common in such cases.
 The risks of violence towards others due to lack of trust also prevails.
However, having such conditions always tends to have risk to the physical and psychological
health as well, which includes self harm and social exclusion (Killaspy et al., 2014, p.148).
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
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the relevant chapter in your textbook, as well as look for other academic sources (max 300
words) 10 marks
Answer:
The most widespread medication for individuals with a psychotic disease is
intervention with a class of drugs regarded as antipsychotics.
Antipsychotics are successful in reducing symptoms of psychosis in psychiatric disorders
such as schizophrenia, however, the underlying psychotic diseases do not get treated or cured
by themselves.
Medical professionals most frequently use the so-called second-generation
antipsychotics to treat psychosis. While their use within the United States is widespread,
however that is controversial. They are not recommended by the World Health Organization
(WHO), except for clozapine (the U.S. branded Clozaril and FazaClo), which can be used
only under special supervision, that too if there has been no intervention from other
antipsychotic drugs.
The present state of Andy suggests that he is very much insecure of his life and
happenings around him. The care plan thus suggest that his treatment need to be done using
holistic approach by engaging his friends, parents, relatives and collegues to gain his trust. In
addition he also requires assistance of health care professionals who can make him
understand by the use of Cognitive Behavior Therapy (CBT), that his insecurity regarding his
life is illegitimate.
Personalized care is an approach to the provision of health care that focuses primarily
on the person they help. This focus shall take account, alongside of Andy’s physical and
mental health needs and preferences, of a very unique experiences or stories, aspirations and
goals of him. Dr. Taylor offering focused care will support him in gaining his full potential–
behaviorally, biologically, culturally, educationally, emotionally, environmentally,
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financially, functionally, mentally, professionally, corporately, recreationally, sexually,
spiritually and socially –throughout his lifetimes (Hungerford et al., 2018, p.54).
When taking a person‐centred approach, the health professional will work to empower
consumers to make their own decisions about the health care they receive. This means the
consumer will be an active participant in the assessment process (Hungerford et al., 2018).
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References
Bedi, G., Carrillo, F., Cecchi, G.A., Slezak, D.F., Sigman, M., Mota, N.B., Ribeiro, S., Javitt,
D.C., Copelli, M. and Corcoran, C.M., 2015. Automated analysis of free speech predicts
psychosis onset in high-risk youths. npj Schizophrenia, 1, p.15030
https://doi.org/10.1038/npjschz.2015.30
Ciesielska, N., Sokolowski, R., Mazur, E., Podhorecka, M., Polak-Szabela, A. and Kedziora-
Kornatowska, K., 2016. Is the Montreal Cognitive Assessment (MoCA) test better suited than
the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection
among people aged over 60? Meta-analysis. Psychiatr Pol, 50(5), pp.1039-1052 doi:
10.12740/PP/45368.
Hungerford, C., Hodgson, D., de Jong, G., Murphy, G., Ngune, I., Bostwick, R. & Clancy, R.
2018. Mental health care. 3rd ed. Milton: John Wiley & Sons Australia, Ltd, p.54.
Lal, S., Dell'Elce, J., Tucci, N., Fuhrer, R., Tamblyn, R. and Malla, A., 2015. Preferences of
young adults with first-episode psychosis for receiving specialized mental health services
using technology: a survey study. JMIR mental health, 2(2), p.e18 doi: 10.2196/mental.4400
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Lutgens, D., Gariepy, G. and Malla, A., 2017. Psychological and psychosocial interventions
for negative symptoms in psychosis: systematic review and meta-analysis. The British
Journal of Psychiatry, 210(5), pp.324-332 doi: 10.1192/bjp.bp.116.197103
Seymour, K., Rhodes, G., Stein, T. and Langdon, R. (2016). Intact unconscious processing of
eye contact in schizophrenia. Schizophrenia Research: Cognition, 3, pp.15-19
doi: 10.1016/j.scog.2015.11.001
Stein, M.B., Slavin-Mulford, J., Siefert, C.J., Sinclair, S.J., Smith, M., Chung, W.J., Liebman,
R. and Blais, M.A., 2015. External validity of SCORS-G ratings of Thematic Apperception
Test narratives in a sample of outpatients and inpatients. Rorschachiana
https://doi.org/10.1027/1192-5604/a000057
Tang, M.H. and Pinsky, E.G., 2015. Mood and affect disorders. Pediatrics in review, 36(2),
pp.52-60 doi: 10.1542/pir.36-2-52
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 doi: 10.1186/s12877-015-0103-3
youtube.com 2020. Psychiatric Interviews for Teaching: Psychosis. [online] youtube.com.
Available at: https://www.youtube.com/watch?v=ZB28gfSmz1Y [Accessed 27 Feb. 2020].
Killaspy, H., White, S., Lalvani, N., Berg, R., Thachil, A., Kallumpuram, S., Nasiruddin, O.,
Wright, C. and Mezey, G., 2014. The impact of psychosis on social inclusion and associated
factors. International Journal of Social Psychiatry, 60(2), pp.148-154
doi: 10.1177/0020764012471918
Joseph, B., Narayanaswamy, J.C. and Venkatasubramanian, G., 2015. Insight in
schizophrenia: relationship to positive, negative and neurocognitive dimensions. Indian
journal of psychological medicine, 37(1), p.5 doi: 10.4103/0253-7176.150797
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Task 3 Mark Allocation
Question 1 5 marks
Question 2 3 marks
Question 3 3 marks
Question 4 3 marks
Question 5 5 marks
Question 6 3 marks
Question 7 5 marks
Question 8 3 marks
Question 9 5 marks
Question 10 10 marks
Written presentation including structure and grammar,
and application of the Harvard referencing protocol.
5 marks
/50 marks
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