Mental State Examination Domains

This assignment focuses on the eight core domains of a Mental State Examination (MSE), which is a structured tool used by psychologists to evaluate an individual's mental state. The domains include appearance, behavior, speech content and form, mood and affect, perception, cognition, insight, and judgement. Understanding these domains provides a comprehensive framework for assessing various aspects of mental health.

Mental State Examination

Table of Contents
INTRODUCTION...........................................................................................................................1
PART A...........................................................................................................................................1
1. Purpose of mental health examination...............................................................................1
2. Explanation of domains of MSE........................................................................................2
3. Domains which affected most............................................................................................4
4. Actions which are taking at the time of such MSE............................................................5
PART B............................................................................................................................................6
1. Mental health assessment tool............................................................................................6
2. Ethical and legal consideration...........................................................................................7
3. Actions for the taking assessment tool...............................................................................7
CONCLUSION................................................................................................................................8
REFERENCES................................................................................................................................9

INTRODUCTION
Mental state of mind is a method through which an individual current state of mind
position get analyse under the presence of various domains: appearance, attitude, behaviour,
mood, speech, cognition and insight. In this assignment purpose of MSE will be describing
where it can support in working as a registered nurse. Along with this, all domains will also get
described for assessing an individual (Ihara, Okamoto and Takahash, 2013). There are several
number of ethical approaches and legislative regulations are formed just for a purpose of mental
health assessment. All these things will lead to get evaluated in this assignment by taking the
reference of Lifeline.
PART A
1. Purpose of mental health examination
MSE is a part of clinical assessment process under which a psychiatric practice. This
process is helpful in identifying a person state of mental position under the presence of domain.
There are mainly 11 types of domains are identified in mental state examination. Registered
nurse have to take them all in account which facilitate in working in an appropriate manner. As
with support, adequate decision can be carried down and proper treatment have to provide to
such individual who is suffering from such disability (Leamy and et. al, 2011). The purpose of
this examination is to collect the evidence which are related with the signs and symptoms of
mental disorder in which danger to self and others is high. As this concept is helpful to every
psychiatric for measuring that individual mental state is appropriate or not (J Larner, 2012).
As a registered nurse I have to conduct my practise in several areas in which such number
of individuals are find out. As by examine them proper diagnose will be provided to them.
Following are the clinical setting and standard which are available to nurse practitioner in the
field of mental health:
 Working in rural setting
 Urban areas
 Workplace health centres
 Hospital network
1

Nurses are more required as compared to non care practitioner and doctors because they charged
more fees. For such purpose, these nurses are helpful in providing proper diagnosis to all such
people who are affected by these mental issues.
2. Explanation of domains of MSE
There are few domains are measure in the mental state examination while dealing with
various number of individualise (Lacy, Kaemmerer and Czipri, 2015). According to them, a
person state of mind gets analyse and adequate decision for any disease will be take. Anxiety is
one of a major issue from which a person is suffering. According to these domain, practitioner
can measure the type of disorder from which such person is suffering and as per the proper cure
will be provide to them. Following are the domain which are present in mental state examination
(MENTAL STATE EXAMINATION, 2017): Appearance: An individual presence completely signifies the problem from which an
individual is suffering get measure through its clothing style, posture, grooming and
self-harm. For example, if a person is wearing dirty cloths then he leads to suffer from
depression. According to this, practitioner will lead to provide proper care to such
person so that chances of self-harm get decline and an individual become confident and
make its appearance attractive (MENTAL STATE EXAMINATION, 2017). Behaviour: Sometimes a person behaviour become abnormal and unacceptable in nature
(Larner and Mitchell, 2014). All these are of a result of neurological disorder which
signifies an unaccepted behaviour of a person. Hence, for this nurse or psychiatrist
measure a way for overcoming such issue. For example, Tom is not capable to maintain
an eye contact with senior authority and due to lack of self-confidence. Hence, a major
reason behind this thing is depression or autism which is not appropriate for gaining the
future benefit. Speech: Transformation of information or exchange of information are considering the
part of speech. Sometimes, a person speaks so much loud but on the next move voice
get low down. If an individual is repeating some words again and again then it gets
measure that such body is suffering from Echolalia. This is a reason of rhythm and
fluency. Tom is suffering from Echolalia in which he is repeating words again and again
at the time of presenting something in front of others. Although these are the reason of
depression or anxiety and by taking proper steps such condition has to get improved by
2

the nurse work in which he have to motivate Tom and make a friendly behaviour with
them (Markwick, Zamboni and de Jager, 2012). Mood and affect: Mood is considering as the inner feeling of a person. In such relation
Anxiety is a major state of an individual. Everyone feel a point of anxiety in their life
which signifies that a person has some fear. Affect is signifies as observable inner
feeling of a person. Hence, practitioner have to observe person state of anxiety and ask
several questions which support in curing such thing. Although this fear of losing
something may lead to enforce a person to choose and follow such path which is not
appropriate and adequate. Tom is suffering from serious anxiety in which he thinks that
he will lead to lose his job due to his subordinates. Thus, by asking few questions from
him this fear get removed and make person fear free. Both the term mood and affect are
different in nature in which mood. Mood is a state of feeling, usually temporary,
resulting from specific stimuli. In psychology, affect is used to describe the word mood
in an adequate manner which signifies as the change in mood. This signifies that these
two terminology are completely differ from each other (Difference Between Mood and
Affect, 2017). Perception: It refer to as such things which are not real but a person creates several
perception according to its mood. In perception domain three disturbance are identify
which are: hallucinations, pseudohallucinations and illusion. There are several number
of issues have to suffer by an individual. Tom is making perception by its own in which
he clarifies a fear of losing a job from his subordinates (Morris, Selhub and Jacques,
2012). Along with this he also fell some voices which are consider as auditory
pseudohallucinations is suggested as dissociative disorder. Hence, for such purpose,
psychiatrist have to use adequate method for improving this issues and problem. Cognition: A basic meaning of cognition is awareness or the mental action of acquiring
knowledge and experience. By this a person will get aware and gain experience from
past things. This section of mental state examination includes an individual level of
alertness, orientation, awareness, memory etc. All these things are a part of cognition in
which person have good abilities. In such people decision making ability is high as
compared to others. They are able to easily recognise everything. Cognition refer to the
process of thinking in which an individual will going to think about something. The old
3

metaphor of cognition was computer who used to store all the data and a simple logical
information processing machine (Understanding Cognition, 2017). Insight: On this stage of MSE, all the illness of an individual get evaluated by
explanatory account of problems and measure options of treatment which are associated
with that. Insight have three main components: recognition that someone has mental
illness, compliance with treatment and ability to relabel unusual mental events.
Dementia is a major illness which found in many people. In dementia a person will lead
to suffer from heavy injury and marked as mental disorder (Newman, 2015). Content of speech: It is a sub part of speech in which it gets identified that an individual
is suffering from heavy diseases which is harmful for a person.
 Thoughts: This cannot examine but have to describe by patient or inferred from patient
speech (MENTAL STATE EXAMINATION, 2017). One of a major cause of this domain
is schizophrenia which leads to create dementia in an individual. The presence of
unnecessary thoughts starts taking place in a mind which are harmful for a person.
All these are the domains which are helpful in improving and curing a person who lead to suffer
from mental health problems. Nurse have to work on all issues so that they can provide proper
treatment to all such people who are belong to lower income level people who are not capable to
afford doctors fees.
3. Domains which affected most
There are mainly 9 domains are identify which are related with mental state examination.
With every domain a disease get associated which is harmful for an individual as well as others
4
8 Domains of Mental state examination
Appearance Behaviour Speech
Mood and affect
Perceptio
n Cognition
Content to
speech
Insight

which belong to such person. Two major disease which are identify mainly into a human body
are:
 Anxiety and depression: Both disease are different from each other but if a person who is
suffering from depression have to face some symptoms of anxiety as well which are
nervousness, problem sleeping and concentrating. Both disease have different effect on
human behaviour. As these domains affect the quality of life of a person in social and
psychological manner. Out of 8 domains which discussed above, behaviour is define as
major domain which affect most. As due to anxiety and depression, behaviour of an
individual get changed and start dealing in diverse direction (Schweizer, Al-Khindi and
Macdonald, 2012).
 Psychotic disorder: A major cause of this disease is that an individual cause start thinking
abnormal things and make perceptions which are not real. Psychotic disorder are a group
of serious illness that completely affect on mind and make it hard to take judgements,
think properly and become hard to behave appropriately (What Is a Psychotic Disorder?,
2017). This also affect quality of life of an individual and start behaving awkward. As its
nature got changed and they become abnormally due to making of unreal perception in
real life world.
Hence, from both of these disease a major thing which get conclude is behaviour termed as
major domain which affect most. In both cases, human behaviour get changed which is not
appropriate at all. Thus, a proper treatment have to provide to all people who are suffering from
this diseases.
4. Actions which are taking at the time of such MSE
Nurse have to take proper actions according to disease of an individual. In such relation a
major problem or illness have to encounter and then appropriate action have to get down. By
applying this rule, a person can recover more immediately. Following are the several number of
elements are written which are based on the intervention of such conical mental diseases: Person centred care: A person centred care is one in which an individual taking the cure
according to requirement or as per the illness from which it get affected (Phabphal and
Kanjanasatien, 2011). An individual have to provide their views on taking the service of
health care by providing their own views and a focus lead to completely based on fulfil
needs rather than needs of services (What person-centred care means, 2015). In mental
5

state examination, proper actions have to take by me while dealing with persons who are
suffering from the dementia, anxiety, depression and psychotic disorder. For this
relation, an individual has to care with proper dignity and respect. Culture appropriateness: All culture is different from other one. In such relation, a
person is culture sensitive in which a person is aware about the ethnic, racial
differentiation between each others, this also signifies as a mental illness because these
all are stereotype people who still believe in ancient facts. Proper treatment have to
render to them through which they can sustain in this modern world. These people are
based on perception which formulate in old times. Culture appropriateness aid in
recovering the people of culture sensitiveness through tailoring of public health
interventions to specific culture. Sensitivity get determine through knowledge of
different languages, socio economic realities and many other factors (Cultural
Appropriateness, 2016). The multidisciplinary team: A multidisciplinary team is one in which all type of people
are involved who provide different type of services to patient according to requirement.
It is a team which used to perform different complimentary services, use their skills
which contribute in achievement of organisational objectives (multidisciplinary team,
2017). A sustainable multidisciplinary team is one who aid in design, build and operate
services led by suitable skilled and senior service manager with decision making
responsibility (Digital Service Standard, 2016). As a nurse of Lifeline, I have to work
properly in a multidisciplinary team in which if a person is suffering from any mental
illness then identification of reason is must. Once the reason behind such thing get
measure I have to take some appropriate and adequate steps in such relation which
provide support in making a path for the issue (Leamy and et. al., 2011). Hence, in a
multidisciplinary team there are various number of people work together.
 Psychotropic medications: Medications is one of a tool through which a person get
overcome from any cause which is related with depression, anxiety etc. As per this a
person could become possible to overcome from a serious disease from which it is
suffering (Psychotropic Medications, 2017). Medication for every disease is different
and thus provide support in overcome from that.
6

PART B
1. Mental health assessment tool
There are various number of tools and techniques have to applied to a body through
which they can measure the mental state examination. By considering such tool mental
assessment of an individual get done. By using adequate technique proper treatment can be
provided according to level of disorder or mental illness. The major aim of these mental
assessment tool is one for measuring the level of anxiety and depression in a person. For such
relation several tools are DASS, suicide risk assessment tool and Kessler 10. For a registered
nurse, Kessler 10 is considering as beneficial tool for taking any beneficial decision for such
individual who is suffering from this main problem. The main purpose behind adopting this
technique is just to identify the reason behind the anxiety and depression (Suehiro and Okutai,
2011).
For this relation, Kessler 10 have been chosen as appropriate tool for this purpose.
Kessler 10 is a device in which 10 questions are asked to an individual and a person have to
answer them. Each questions pertains to an emotional state through which emotional level get
measure with five level response scale. By asking such questions, a person level of thinking and
mood from past few years get measure. By measuring them adequate action get taken which is
beneficial for curing a person in frequent manner. As a registered nurse I have to adopt this state
of mental assessment for measuring a patient level of depression and anxiety. Kessler 10 is
considered as useful tool for such a perspective for analysing a human behaviour. This support in
measuring an individual behaviour and attribute for performing the task and its mental stage gets
determine. Thus, it is significant as a useful tool for mental health assessment in which a person
mental state get examined and proper treatment is provided.
2. Ethical and legal consideration
Mental health assessment is a major thing which have to be taken in account by a nurse
so that an adequate decision or judgement can be carried down on that person who is suffering
from this problem (Votruba, Persad and Giordani, 2016). At the time when delivering mental
health care there are several number of ethical and legal considerations are already framed which
enable in delivering of quality services.
7

In this relation, Ethical principle of psychologist and code of conduct 1992 is framed with
a motive to provide and deliver quality based services. Health and safety act 1974 is one of them.
As a registered nurse I have to follow all the safety rules and regulations which are framed under
this. Ethical consideration means delivering of services in an appropriate manner without
harming the interest of a person. Registered nurse has to deliver services according to
requirement of a person so that patient get cure in frequent manner. All ethical and legal
consideration have to be taken in account by me as a nurse so that all things get comply in an
adequate manner.
The ethical and legal consideration which are identified in mental state examination are
regarded as the personal detail of an individual have to kept safe so that another person do not
take advantage of this. The Data protection act 1998 signifies, an health care have to keep their
data safe and secure and do not share it anyone except doctors. Along with this, psychiatrist have
to provide proper treatment to the user and follow all ethical dilemmas. Health and Safety act
1974 signifies that a person has a right to get proper treatment and it is a duty of health care to
treat all patients in a equal manner.
3. Actions for the taking assessment tool
For improving such disease Kessler 10 technique has been used under which 10 questions
get asked to a person and decision carried down for improving the infectious diseases (Kessler
Psychological Distress Scale (K10) (R. C. Kessler, 2017). In such relation proper care have to
provide according to following elements which are as follow: Person-centred care: A person centred care is one in which completion of needs of a
person is major thing rather than focus on needs of services. In such context, an
individual have to take active participation in all such things which are appropriate for
them and which are not (What person-centred care means, 2015). In Kessler 10, a care
has to provide an individual in which 10 questions asked to a person and appropriate
medication have to provide to them in relation to cure him/ her. Culture appropriateness: Various sorts of disease are identified and by using Kessler 10,
several number of questions get asked and on the basis of them, disease get concluded.
Hence, psychiatrist have to provide proper medication according to requirement of a
person and a culture to whom they belong to.
8

 Multidisciplinary team: A group composed of various number of individuals who are
specialised in their own definite area and thus are helpful in attain all targets properly
(multidisciplinary team, 2017). Team have to use such questions and work according to
cause. As this is helpful in curing a person who leads to suffer from depression and
anxiety which is harmful for a person.
 Psychotropic medications: Kessler 10 have to measure the disease and provide proper
medication according to that. As this is beneficial for the long term purpose and proper
treatment can be deliver to such individual (Psychotropic Medications, 2017).
CONCLUSION
Mental health assessment and mental health examination is a one of a major thing which
have to take in account by an individual so that proper services can be deliver. Mental health
examination has some purpose which have to get fulfil according to requirement of an
individual. Along with this there are several number of domains are measure which signifies a
person behaviour. Several actions have to take which are in favour of delivering services to those
mental ill people.
9

REFERENCES
Books and Journals:
Ihara, M., Okamoto, Y. and Takahashi, R., 2013. Suitability of the Montreal cognitive
assessment versus the mini-mental state examination in detecting vascular cognitive
impairment. Journal of stroke and cerebrovascular diseases. 22(6). pp.737-741.
J Larner, A., 2012. Mini-Mental Parkinson (MMP) as a dementia screening test: comparison
with the Mini-Mental State Examination (MMSE). Current aging science. 5(2). pp.136-
139.
Lacy, M., Kaemmerer, T. and Czipri, S., 2015. Standardized mini-mental state examination
scores and verbal memory performance at a memory center: implications for cognitive
screening. American Journal of Alzheimer's Disease & Other Dementias®. 30(2).
pp.145-152.
Leamy, M., Bird, V., Williams, J., 2011. Conceptual framework for personal recovery in mental
health: systematic review and narrative synthesis. The British Journal of Psychiatry.
199(6). pp.445-452.
Larner, A.J. and Mitchell, A.J., 2014. A meta-analysis of the accuracy of the Addenbrooke's
Cognitive Examination (ACE) and the Addenbrooke's Cognitive Examination-Revised
(ACE-R) in the detection of dementia. International psychogeriatrics. 26(4). pp.555-
563.
Markwick, A., Zamboni, G. and de Jager, C.A., 2012. Profiles of cognitive subtest impairment in
the Montreal Cognitive Assessment (MoCA) in a research cohort with normal Mini-
Mental State Examination (MMSE) scores. Journal of clinical and experimental
neuropsychology. 34(7). pp.750-757.
Morris, M.S., Selhub, J. and Jacques, P.F., 2012. Vitamin B‐12 and Folate Status in Relation to
Decline in Scores on the Mini‐Mental State Examination in the Framingham Heart
Study. Journal of the American Geriatrics Society. 60(8). pp.1457-1464.
Newman, J.C., 2015. Copyright and bedside cognitive testing: Why we need alternatives to the
Mini-Mental State Examination. JAMA internal medicine. 175(9). pp.1459-1460.
Phabphal, K. and Kanjanasatien, J., 2011. Montreal Cognitive Assessment in cryptogenic
epilepsy patients with normal Mini-Mental State Examination scores. Epileptic
Disorders. 13(4). pp.375-381.
Schweizer, T.A., Al-Khindi, T. and Macdonald, R.L., 2012. Mini-Mental State Examination
versus Montreal Cognitive Assessment: rapid assessment tools for cognitive and
functional outcome after aneurysmal subarachnoid hemorrhage. Journal of the
neurological sciences. 316(1). pp.137-140.
Suehiro, K. and Okutai, R., 2011. Duration of cerebral desaturation time during single-lung
ventilation correlates with mini mental state examination score. Journal of anesthesia.
25(3). p.345.
Votruba, K.L., Persad, C. and Giordani, B., 2016. Cognitive deficits in healthy elderly
population with “normal” scores on the Mini-Mental State Examination. Journal of
geriatric psychiatry and neurology. 29(3). pp.126-132.
Online:
10

MENTAL STATE EXAMINATION. 2017. [Online]. Available through:
<https://geekymedics.com/mental-state-examination/>. [Accessed on 23rd August
2017].
Kessler Psychological Distress Scale (K10) (R. C. Kessler. 2017. [Online]. Available
through :<http://www.statisticssolutions.com/kessler-psychological-distress-scale-k10/>.
[Accessed on 12th September 2017]
What Is a Psychotic Disorder? 2017. [Online]. Available through
:<http://www.webmd.com/schizophrenia/guide/mental-health-psychotic-disorders#1>.
[Accessed on 18th September 2017]
Psychotropic Medications. 2017. [Online]. Available through
:<https://www.goodtherapy.org/drugs/psychotropic-medication.html>. [Accessed on
18th September 2017]
What person-centred care means. 2015. [Online]. Available through
:<http://rcnhca.org.uk/sample-page/what-person-centred-care-means/>. [Accessed on
18th September 2017]
multidisciplinary team. 2017. [Online]. Available through
:<http://www.businessdictionary.com/definition/multidisciplinary-team.html>.
[Accessed on 18th September 2017]
Digital Service Standard. 2016. [Online]. Available through :<https://www.gov.uk/service-
manual/service-standard/have-a-multidisciplinary-team>. [Accessed on 19th September
2017]
Difference Between Mood and Affect. 2017. [Online]. Available through
:<http://www.differencebetween.net/language/difference-between-mood-and-affect/>.
[Accessed on 20th September 2017]
Understanding Cognition. 2017. [Online]. Available through
:<https://www.psychologytoday.com/basics/cognition>. [Accessed on 20th September
2017]
Cultural Appropriateness. 2016. [Online]. Available through
:<http://www.encyclopedia.com/education/encyclopedias-almanacs-transcripts-and-
maps/cultural-appropriateness>. [Accessed on 20th September 2017]
11

12