What is a mental health assessment?

When the Bowral Mental Health Service staff are asked to attend the hospital, the community health centre or a person's home to make an assessment of a person's current mental state there is a set procedure used that is common to all mental health services.However, it is important to understand that when a non-medical clinician is carrying out an assessment they are not able to make a formal diagnosis of the person. Instead, they may offer a provisional diagnosis based on their observations and on the content of the discussion they may have with the patient or those who care for the patient. In the absence of family or carers, there may be some past history or there may be reports or observations by members of the police or ambulance services. The more formal diagnosis may not be able to be determined until the person is seen by a medical specialist such as a psychiatrist or psychiatric registrar. Even so, it may be that those doctors may wish to wait until there has been a period of stabilisation, observation, and treatment before a more formal diagnosis can be made.Generally, during the assessment of a person with a mental illness or disorder there are about eleven features noted during the mental state examination. These are: Appearance, Behaviour, Mood, Affect, Speech, Thought Form, Thought Content, Perception, Orientation, Insight/judgement, and memory. In more detail these features are:Appearance: is grooming, posture, clothing, and build.Behaviour: e.g. psychomotor activity, mannerisms, gait.Mood: is what he/she describes, e.g. depressed, anxious, irritable, cheerful.Affect: is what an observer might describe, e.g. restricted, blunted, labile, euthymic.Speech: is rate, volume, flow, e.g pressured, loud, slurred, mumbled.Thought form: e.g. flight of ideas, derailment.Thought content: e.g. delusions, suicidal thoughts.Perception: hallucinations, illusions, e.g. visual, auditory, olfactory, gustatory, tactile.Orientation: time, person, place.Insight/Judgement: cognition, understanding of their illness.Memory: short and long-term.Obviously, the most essential aspect of the assessment of a person's mental state is their willingness (or their ability) to engage with the mental health worker doing the assessment. Therefore, a person who is currently intoxicated with an excessive use of alcohol or other medications or illicit drugs is not able to be appropriately assessed. Likewise, someone who is medically compromised with, say, dementia or delirium, or some other organic cause cannot be appropriately assessed for their mental state. Only when the intoxication or the delirium passes would there be potential for a mental state examination by staff of the Bowral Mental Health Service. Where intoxication or other impediments to an assessment are noted, the staff member will advise the admitting doctor and nursing staff that the assessment will be delayed. In the case of police or ambulance service bringing an intoxicated person to the hospital, they would be advised of any delay in performing the assessment. If police, for example, are wanting to press charges against the person in their custody, the assessment can be done later, by Mental Health Court Liaison staff, and a report prepared for the magistrate, before the person attends the Court.