Mental Health Assessment and Medication

This assignment delves into the complexities of mental health assessment. It focuses on the Mental Status Examination (MSE) and how it influences medication decisions for patients. The discussion highlights the influence of MSE on different domains like appearance, mood, speech, and behavior. Additionally, various tools used in the assessment process, such as suicidal risk assessment tools, are mentioned.

Exploring
Mental Health Assessment Tool

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
PART A...........................................................................................................................................1
1. Purpose of Mental State Examination (MSE).........................................................................1
2. Explanations of the following domains...................................................................................1
3. Affected domains of the mental health diagnoses...................................................................4
4. Explaining the actions.............................................................................................................5
PART B............................................................................................................................................5
1. Mental health assessment tool ................................................................................................5
2. Ethical and Legal Considerations............................................................................................9
CONCLUSION..............................................................................................................................10
REFERENCES..............................................................................................................................11

INTRODUCTION
Mental state examination acts as a structured way of observing and discussing the
psychological functioning of the patient. The process is done by considering all the domains
which includes the appearance, mood, speech, behaviour etc. Each domain is being affected by
different disorders (Creek and Lougher, 2011). While under going the mental health assessment,
some considerations are to be taken as well and it may be ethical as well as legal. The report
consists of two parts which considers an assessment tool for gauging the symptoms for mental
illness.
PART A
1. Purpose of Mental State Examination (MSE)
As an essential part of the clinical assessment process, MSE is considered as a practice
in psychiatric processes. This examination helps in providing the information for the
identification and then assessment of the disorder and the response, it is giving to the treatment.
Some other provider if analyses the patient, it is easy for them to determine that the status of the
patient has changed or not and it can be done even without any previous analysis of the patient.
The examination can also be used for functioning of the baseline and appropriate tracking of the
symptom. It also can be helpful in narrowing down the medications that might be positive as
well as negative for the mental status of the patient (Mark, 2010). Under the Emergency medical
treatment and Active Labour Act (EMTALA), the nurses can use the examination in order to
treat the patients. EMTALA mainly focuses on preventing the hospitals from doing the treatment
of the patients or rejecting them. It also covers the fact that transferring the patients to the charity
or government based hospitals just because the patients are not able to pay for the medications
required.
2. Explanations of the following domains
Appearance
The following domain which is being considered in the assessment initially is
Appearance. In that glance only, the nurse or the clinician can estimate the age, body language
and range of the patient. It involves the proper analysis of the posture, dress , grooming of a
person. While the examination of MSE, a level of alertness can also be helpful. The facial
expression of a person also tells various things about the situation. A dull face means going
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through the complicated and complex situations. The particular attitude and behaviour towards
the person, whosoever is examining matters equally important. Whether the behaviour of the
person is cooperative or not, these factors helps in the overall process of MSE.
Behaviour
It refers to the eye contact. The behaviour of the person is evaluated appropriately. It can
be analysed by the eye contact also, whether the contact patient is making with the examiner is
normal, bad or seems piercing (Stuart, 2014). Movement of hands or legs also helps in the
assessment of MSE. Psychomotor processes as agitation and retardation which involves wringing
of hands or legs also considered as important factors. Unsteady gait, which means walking
inappropriately or not able to walk properly, abnormal movements or any sort of vibrations in
any part of the body, which usually is in hands or legs are also assessed properly in the
examination of MSE.
Speech
It can also act as an essential feature that can reveal about a person to a huge extent.
Inappropriate or inefficient speech sometimes may be because of some stressed event, anxiety or
because of mood swings. In the examination of MSE, speech is also accessed properly. The
speech rate can be evaluated, whether it is rapid, reduced or pressured. The volume can be
analysed as well on the basis of its loudness or softness or it may be normal as well. The way of
talking, which is also referred as the tone of the person also helps a lot. It may be tremulous or
monotonous as well (Rudd, Goulding and Bryan, 2011).
Content of Speech
Where speech helps in analysing various features while the examination of MSE, it is
also equally important to focus on the content of the speech. While the MSE, content also are
assessed. It is very important to focus on the way, the person is speaking and the matter they are
speaking about.
Mood and Affect
The emotional state of a person can help in analysing much about the mood of that
person. It is not necessary that while the whole process of examining, the person tells the
examiner the correctness of the situation. Although it is very important to tell the practitioners
and examiners about the appropriate and exact condition, but still some lack in doing so because
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of various reasons. The person may be shy or guilty of something. However, these two factors
are also assessed properly in the MSE of a person. The affect means the emotional state observed
of the person. It involves the type of mood, whether it is normal, good, elevated or depressed.
These ranges affect the whole procedure of MSE (Goodell and et.al, 2011). Mental stability
also affects the procedure.
Thought
It includes the rate of thoughts and its flow along with the ways, they are connected. In
the MSE, it checks whether the thoughts are normal, logical, tight or illogical. When the
involved associations are not clear, they are termed as abnormal and unorganized. An example
of this can be any circumstantial situation. It initially involves the unnecessary and inappropriate
details but eventually, gets to the point. It can also be tangential which means moving from one
thought to the other that seems quite related to each other but are not efficient enough for
reaching the point. There may be some sort of illogical shifting in the topics that are not related
to each other.
Perception
Concealing about the perceptual disturbance acts critically for identifying the serious
mental health problems. An example of this can be psychosis which is relatively more in
youngsters although the peak onset lies between 19 to 22 years. It may also involve various cases
of mood disorders and fatigue (Creek and Lougher, 2011). It also acts important in the case of
substance abuse or in any form of trauma. Perceptual disturbances are disturbing and also can be
frightening for the person. However, it helps in the overall procedure of MSE. Dissociative
symptoms can be the feeling of observing that something around is not real and seems fake.
Also, the feeling of being detached from the people.
Cognition
It considers the current capacity of a person for processing the information. It is referred
as an important process as it acts very sensitive for the mental and health issues. Some internal
factors are also considered as the level of consciousness that the person is whether alert,
intoxicated and drowsy. Orientation to the real world is equally important which is often taken in
regard with the place, time or person. The way their memory is functioning that the person has a
sharp or has short term memory, it also helps in better assessment while the MSE.
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3. Affected domains of the mental health diagnoses
In the diagnoses of mental health, various domains can also get affected at the same time.
In case of anxiety and depression, behaviour and mood of the person may get affected. The
person experiencing depression must be under going some situations that does not seems friendly
and effective for them and so are creating issues. When the situation does not goes according to
one, it is an obvious fact that causes some sort of stress. That stress when lasts for a long time
turns into depression where the person thinks that there are no ways left for preventing it and
staying protected from it (Stuart, 2014). While the person is tired enough and does not feel
capable of doing things, it generally affects the behaviour of the person as well. That change in
behaviour is not intentional but it gets affected a lot as the tiring body always sends wrong
signals to the parts of the body that the person feels uncomfortable.
Psychotic disorders are considered as mental disorders that enables the abnormality in the
perceptions and thinking of the person. It is a group of serious illness factors that directly or
indirectly affects the mind. These makes a person unable to think efficiently and making
decisions. Also, it minimizes the emotional power of a person. When the symptoms of this
disorder increases, it makes very tough for them to staying with the reality. They are sometimes
even make unable for the person to manage their daily life. It worsens from day to day. In case of
these disorders, perception is the only domain that can get affected. It involves the serious mental
as well as health problems (Goodell and et.al, 2011). Also in case of any trauma or substantial
abuse, it can be considered. As Psychotic problems concerns with the disorders that are mental,
so it can have the involvement of the domain Perception.
Psychosis is a well known example of the specific issue which is very disturbing and
frightening at the same time. These disorders can occur because of some other medical
conditions as hallucinations, delusions etc. It can be due to some other illness factor which
affects the overall functioning of the brain (Rudd,Goulding and Bryan, 2011). It can be either a
brain tumour or a head injury as well. The following disorder can also be prevented which will
also help the domains from staying unaffected. These people should avoid substantial use such as
leaving the use of these substances, alcohol etc. Avoidance to these substances may help them in
staying fit and protected from these diseases. In response to the recovery of the person, every
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people is affected differently by the treatment. Some take weeks, whether some take months
from staying protected from the disease.
4. Explaining the actions
Person centred care
While the MSE assessments are being examined in the person centred care, it is essential
to support these approaches in order to improve the physical and mental health consisting social
services, housing and allied supports (Friederlike,2014). There has huge benefits in producing a
personalised services which further includes the reflective listening leading to improved and
better understanding of people.
Cultural appropriateness
It is also considered as the competencies in which the way of dealing with patients varies
from other cultural backgrounds. It reflects on the assumptions and beliefs while negotiating a
plan of care or related to it.
The Multidisciplinary team
For achieving the success, teamwork acts as the most important. The multi disciplinary
team can act as an internal team for providing proper care and support to the patient. Along with
the input amount of the members, it requires the coordinated effort of the internal disciplinary
team (Lamers and et.al, 2011).
Psychotropic medications
The term refers to the drug abuse which directly or indirectly affects the mental state of a
person. While the MSE, various Psychotropic drugs are provided as a medication such as Xanax,
Celexa etc.
PART B
1. Mental health assessment tool
The report includes the use of Suicide Risk Assessment Tool. It is also considered as
Screening tool for assessing risk of suicide (STARS). The tool is to be used for collecting the
data about a person who is describing their own experience of a suicidal state. The whole process
is to be done for supporting the decision making about planning the safety. Any suicidal state or
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estimated risk can be determined by a nurse or a clinician which is perceived as a snap shot of
the overall presentation of the person at the time of assessment.
The purpose of this scale is that it is usually recommended that the nurse or clinician
determine their confidence level as a rating in the 'risk level'. Also, provides a short notation as
whether it is highly, low or moderate confident (Goodell and et.al, 2011). This data helps the
other professionals the weighting and strength of the specific cumulative data from every section,
thus informing the actual and final summary of the risk.
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The process also will be containing some clinical notes which are represented as under :
Description of warning signs (immediate risk indicators)
Description of circumstances of life
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Risk factors
Protective factors( Also includes the presence or absence of these factors)
Planning and response of safety
Any response to the safety measures must be correspondent to the experience that has
been identified with the actual state of the person which is suicidal. The planning should be done
for estimated as well as immediate short term risks of suicidal behaviour. It is being done on the
combination based on risk, warning symptoms and signs and the protective factors.
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2. Ethical and Legal Considerations
While considering the ethical examination at the time of undertaking the mental health
assessment can be various issues that the examiner have to deal with. Nurses or the staff, on a
daily basis, faces various issues for the autonomy versus paternalistic behaviour. They have to
deal with various considerations as in some situations, the patient does not wants to take the
medication, refuses for the treatment procedure etc. Various related considerations, nurses and
the staff need to follow while examining the mental health of an individual and it needs patience
to treat them properly.
While referring the legal considerations, it is essential for the nurses and the whole
organisation to be aware of the legislations that have been provided by the government for
mental health acre system related issues (Goodell and et.al, 2011). According to the Mental
Health Act 1990, NSW is responsible for giving the care for these issues. The Act covers both
the voluntary as well as non voluntary treatment for the patients. The issues people face while
considering these situations are that they are quite confused about when the patient should be
discharged. Also, many people are not even aware of the services the Act provides for the
patients.
3. Actions that must be taken
Person Centred care
Along with the family, friend etc. are also involved in proving the support to the people suffering
from any sort of mental health issues. The suicide risk assessment tool can help in collecting
information about the experience of the person who have experienced some suicidal attempts or
states (Friederlike,2014).
Cultural Appropriateness
It ensures the interventions being more efficient when they are served to the population as
cultural appropriate. The tool can help in assessing the sensitivity if it with respect to the other
cultures.
Multidisciplinary team
While the assessment of the suicide risk assessment toll, more members of different
disciplines can also be involved which can provide efficient and appropriate services to the
patients (Chalmers and et.al, 2012).
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Psychotropic medications
The term considers the substantial abuse which affects badly on the health of the brain.
While assessing the suicidal tool, these medications can help the persons addicted to these
problems as drug abuse may be one of the reasons of losing the mental stability.
CONCLUSION
It has been concluded from the report that MSE is a part of the process of the clinical
assessment which deals with the psychiatric issues. It however narrows down the medications
that is being provided to the patient. While the whole process of MSE, various domains also
gets affected and it can be either the appearance, mood, speech, behaviour etc. Different
domains gets affect on different disorders. There are various tools also that can be used in the
assessment process such as the suicidal risk assessment tool etc.
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REFERENCES
Books and Journals
Chalmers, A. and et.al., 2012. Establishing sensory-based approaches in mental health inpatient
care: a multidisciplinary approach. Australasian Psychiatry. 20(1). pp.35-39.
Creek, J. and Lougher, L., 2011. Occupational therapy and mental health. Elsevier Health
Sciences.
Goodell, S. and et.al., 2011. Mental disorders and medical comorbidity. The Synthesis Project.
HERT, M. and et.al., 2011. Physical illness in patients with severe mental disorders. I.
Prevalence, impact of medications and disparities in health care. World psychiatry. 10(1).
pp.52-77.
Lamers, S. and et.al., 2011. Evaluating the psychometric properties of the mental health
continuum‐short form (MHC‐SF). Journal of clinical psychology. 67(1). pp.99-110.
Leamy, M. and et.al., 2011. Conceptual framework for personal recovery in mental health:
systematic review and narrative synthesis. The British Journal of Psychiatry. 199(6).
pp.445-452.
Mark, T. L., 2010. For what diagnoses are psychotropic medications being prescribed?. CNS
drugs. 24(4). pp.319-326.
Rudd, M. D., Goulding, J. and Bryan, C.J., 2011. Student veterans: A national survey exploring
psychological symptoms and suicide risk. Professional Psychology: Research and
Practice. 42(5). p.354.
Stein, B. D. And et.al., 2013. Use of a computerized medication shared decision making tool in
community mental health settings: impact on psychotropic medication adherence.
Community mental health journal. 49(2). pp.185-192.
Stuart, G. W., 2014. Principles and Practice of Psychiatric Nursing-E-Book. Elsevier Health
Sciences.
Online
Friederlike., G. 2014. Practice Guide to Person Centred Clinical Risk Assessment. [PDF].
Availablethrough:<https://www.adhc.nsw.gov.au/__data/assets/file/0009/338814/
Practice_Guide_to_Person_Centred_Clinical_Risk_Assessment.pdf>. [Accessed on 31st
August 2017].
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