Mental Health Essay

Mental Status Examination (MSE) Assessment

Rick
In appearance and behavior, he was wearing t-shirt, short and no shoes, which were not appropriate for the cold (7 degrees) weather, which means he was disoriented with the present. He was also hostile (although not directly at the people around but the people in her head) and acted restless and bizarre. His speech was pressured. On mood and affect, he was suspicious of those around him (including his father, his friend and the examiners). In terms of form and content of thought, he displayed a continuity of thought and was delusional, hearing voices not there and believing in a threat that was not present. His perception was unrealistic, hallucinating voices in his head. In relation to this, his sensorium and cognition was marked by abstract thinking. Finally, in terms of insight, he was not compliant with examiners and had to be restrained to the stretcher.

Alice

Alice’s clothes (i.e. appearance and behavior) looked clean but not neat. It seemed she had not changed clothes since the attempted suicide the night before. She also looked haggard and exhausted. She also seemed accommodating and allowed Dr. Pannu to pull up a chair next to her. On speech, she was quite at first, only nodding her head in response. But when she got to talk, she spoke softly and clearly. She looked depressed (i.e. mood and affect). In terms of form and content of thought, she was dejected and hopeless, and had suicidal thoughts and intent (having tried to kill herself). In terms of perception, she displayed heightened anger and dejection. However, she was aware of her environment and what she had done (i.e. sensorium and cognition) and in terms of insight, she seemed compliant, answering Dr. Pannu’s questions. However, she was not offering details and unwilling to answer some questions.

Summary of Key MSE Areas

MSE covers a number of areas. However, some of these are more important than others in the sense that they may explain others. Content of thought, perception, and sensorium and cognition explain physical appearance, mood and affect. When the intervention and treatment manages to change these, others will generally follow.
The content of thought concerns what and/or how the patient thinks. It explains what drives them (obsessions, phobias, preoccupations, etc) and why they do what they do. For Alice, for example, that she has given up on life explains why she tries to commit suicide and now Dr. Pannu is trying to find out what exactly it is that made her give up on life. Answers to these questions would explain her appearance. Perception is about whether the patient is struggling with real fear or entertaining delusions (including hallucinations), which determines the direction of treatment to take. Sensorium or cognition covers her attention and concentration, memory, orientation and judgment. All these, among others, are key to intervention and treatment.

Potential Risk Factors

Risk Factors
Rick and Alice, like many other mental ill persons, are subject to a number of risk factors. These include socio-economic status (including finance and family) (Patel et al., 2006). For example, financial status can affect the value of care that the patient gets. Social factors include stigma, which may impact the type and quality of care one gets. Domestic violence may also affect care (Kumar et al., 2005; Patel et al., 2006). Psychological factors (in relation to the aspects of MSE) can pose risks such as self-harm (Patel et al., 2006). Failure to take medication as Rick did is one of the risks. In relations to this, there are risks associated with objects and tools around. Rick, for instance, readily got himself a hammer and could have hurt himself or someone else. For Alice, women may experience these problems in a unique way (Piccinelli & Wilkinson, 2000; Kumar et al., 2005; Patel et al., 2006).

Protective Factors

In this regard, it is important to look for proactive solutions. This involves taking a holistic approach, including identification of multiple risks and establishing solutions before a problem occurs. It is important to focus on improving compliance with medication, adopting social and education perspectives to enhance self-management programs. In other words, the central solution is absolute care. This involves family, but also patient self-care (Kramer et al., 2003; The Department of Health, 2006).

References

Kramer, P., Anthony, W.A., Rogers, E.S., Kennard, W.A. (2003). Another Way of Avoiding the
“Single Model Trap”. Psychiatric Rehabilitation Journal, 26(4), 413-415
Kumar, S., Jeyaseelan, L., Suresh, S.,et al (2005). Domestic Violence and its Mental
Health Correlates in Indian Women. British Journal of Psychiatry, 187, 62-67
Patel,V., Kirkwood, B. R., Pednekar, S.,et al. (2006). Gender Disadvantage and
Reproductive Health Risk Factors for Common Mental Disorder in Women: a Community Survey in India. Archives of General Psychiatry, 63, 404-413
Patel, V., Kirkwood, B.R., Pednekar,, S., Weiss, H. & Mabey, D. (2006). Risk Factors
for Common Disorders in Women: Population-Based Longitudinal Study. British Journal of Psychiatry, 189, 547-555
Piccinelli, M. & Wilkinson, G. (2000). Gender Differences in Depression. Critical
Review. British Journal of Psychiatry, 177, 486-492
The Department of Health (2006). Risk and Protective Factors. Australian
Government. Retrieved 24 March 2015, http://health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-p-mono-toc~mental-pubs-p-mono-kno~mental-pubs-p-mono-kno-cur~mental-pubs-p-mono-kno-cur-ris