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Mental Health Assessment (Perceptual abnormalities (Dissociative symptoms:…
Mental Health Assessment
This refers to a person's current capacity to process information and is important because it is often sensitive (though in young people usually secondary) to mental health problems.
level of consciousness (e.g. alert, drowsy, intoxicated, stuporose)
orientation to reality (often expressed in regard to time/place/person - e.g. awareness of the time/day/date, where they are, ability to provide personal details)
memory functioning (including immediate or short-term memory, and memory for recent and remote information or events)
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visuospatial processing (e.g. copying a diagram, drawing a bicycle)
attention and concentration (e.g. observations about level of distractibility, or performance on a mentally effortful task - e.g. counting backwards by 7's from 100)
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language (e.g. naming objects, following instructions)
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ability to identify potentially pathological events (e.g. hallucinations, suicidal impulses)
- Speech
Speech can be a particularly revealing feature of a person's presentation and should be described behaviourally as well as considering its content (see also section on Thought)
Speech rate (Rapid, pressured reduced tempo)
Volume (Loud, normal, soft)
Tonality (Monotonous, tremulous)
Quantity (Minimal, voluble)
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- Thought
A person's thinking is generally evaluated according to their thought content or nature, and thought form or process.
https://en.wikipedia.org/wiki/Thought_disorder
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overvalued ideas (unreasonable belief, e.g. a person with anorexia believing they are overweight)
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self-harm, suicidal, aggressive or homicidal ideation
obsessions (preoccupying and repetitive thoughts about a feared or catastrophic outcome, often indicated by associated compulsive behaviour)
anxiety (generalised, i.e. heightened anxiety with no specific referent; or specific, e.g. phobias)
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Thought process refers to the formation and coherence of thoughts and
is inferred very much through the person's speech and expression of ideas.
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frequent changes of topic (flight of ideas or tangential thinking)-In tangential speech, the speaker drifts and does not return to the focus point of discussion. Tangential thought is less focused than incoherent thought-https://en.wikipedia.org/wiki/Tangential_speech
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- Behaviour
As well as noting what a person is actually doing during the examination, attention should also be paid to behaviours typically described as non-verbal communication. These can reveal much about a person's emotional state and attitude
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Unusual features (Tremors, or slowed, repetitive,or involuntary movements
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the person perceives things as different to usual, but accepts that they are not real, or that
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can affect all sensory modalities, although auditory hallucinations are the most common
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can be evaluated by exploring recent decision-making or by posing a practical dilemma (e.g. what should you do if you see smoke coming out of a house?)