Components of a Mental Status Examination - Essay Example

Mental Status Exam (Culture) 25 November Components of a Mental Status Examination The mental status examination(MSE) is a basic tool used by psychiatrists to help them determine the current mental state of a patient. The results of the MSE are then combined with the biographical and historical information about the patient to form a broader picture that can help the clinician make an accurate diagnosis, and make a psychiatric formulation and a treatment plan. The key approach of an MSE is seeing the world from a patient's perspective known as descriptive psychopathology which is opposed to the earlier method of the psychoanalytic or interpretive approach made by the psychiatrist.

The MSE is a systematic collection of data gathered from a patient while the patient is in full view of the psychiatrist in order to detect signs and symptoms of a mental disorder. It is structured like an interview or an informal inquiry to put the patient at ease in order to be able to obtain good answers to both closed and open-ended questions. It can be supplemented with a structured written test to further test the patient's mental capacity and cognition. All the data that can be gathered will be recorded under specific headings known as standard domains.

In psychiatry, domains are the specific classifications of a mental state characterized by the following factors which clinicians use to analyze a mental patient: appearance, attitude, mood & affect, thought process, thought content, perception, cognition, insight, and judgment. All these domains are observed in the patient to fully determine the mental status. The other domains include behavior or activity, speech, and language (Gehlert & Browne, 2006, p. 215). The MSE tries to elicit a patient's perspective and also incorporates the observations made by the clinician.

Domains indicate a specific mental function (Frankel & Myatt, 2003, p. 28). Cultural Issues Related to MSEAwareness of a mental patient's cultural background can help to establish rapport and trust right at the outset of the interview process. This is because cultural factors can influence the outcome and results of the data-gathering exercise so it is important clinicians know about a patient's specific culture. For example, some cultures can emphasize the avoidance of any eye contact for prolonged periods of time which may be misinterpreted by the psychiatrist if he is not aware of a patient's cultural background (Hersen & Turner, 2003, p. 22). A patient's culture may also consider avoiding eye contact as a sign of deference to a higher authority and so people got accustomed to not looking a person straight in the eye which in the American or Western culture could mean at best just shyness or at worst a sign of a mental disorder.

There are many other instances where culture can considerably affect the outcomes of an MSE such as some people's beliefs in the supernatural or just being plainly superstitious. In psychiatry, any outward voicing of such belief may be interpreted as delusion or hallucination when in fact, the patient's culture allows these curious beliefs as being normal or ordinary. In the people of Haiti, belief in voodoo is combined with Catholicism in the same way they also combine folk medical beliefs with their more modern medical practices.

Other cultural issues that can possibly affect the MSE outcome is the amount of space physically between the patient and the clinician during the interview (personal space between two persons), body contact such as touching the knees of a patient, speaking in a loud or very animated tone and the use of expressive hand gestures (Colin & Paperwalla, 1996, p. 140). In some instances, it may be necessary to adjust or amend the MSE standard exam a bit to really help people with different cultural backgrounds.

Individualization of the MSE can be useful in situations where it might be necessary to ask embarrassing questions which a patient may try not to answer if his culture is not as frank as the American culture (Carlat, 2005, p. 22).