Mental Status Exam

What is a Mental Status Exam?

Used to evaluate the client’s current mental functioning.

Information can be gathered informally over the course of an interview/ assessment or formally through direct questions

Things to Remember for the Exam

-You want to be mindful of not choosing ‘complete a mental status exam’ as the answer unless there is a reason to do so in the question stem (such as the client having loose associations, not making sense in their speech, experiencing tangential thoughts, possible dementia, etc.).

-Age on its own is not a reason to do a MSE; the test may offer this answer option with elderly clients to see if we incorrectly choose it based on age bias.

Abstract Reasoning

Ask the client to interpret a proverb or identify a theme between 3 or 4 objects.

Appearance

How does the client look? Dressed with attention to detail? Well groomed? Age appropriate?

Attitude

Is the client cooperative? Resistant? Fearful?

Behavior

What is the client’s activity level? Are there tics or stereotyped movements? How alert is the client? What are the client’s facial expressions? Do they match the content discussed?

Mood/ Affect

What is the client’s prevailing mood? Is there observable mood lability? Does the client show a range of affect? Is it appropriate to the content discussed?

Speech

Is the client understandable? Are there any speech abnormalities (e.g., stuttering)? Is the client’s speech pressured?

Thought Process

Is the client’s thought process circumstantial? Tangential? Is there evidence of flight of ideas? Is there poverty of thought? Perseverations?

Thought Content

Does the client exhibit delusions? Phobias? Obsessions? Is the client preoccupied? Does the client have suicidal thoughts? Thoughts of harming others?

Perceptions

Is the client experiencing hallucinations or illusions?

Cognition

Is the client alert and oriented? Can the client demonstrate attention and concentration? Is the client’s memory (short- and long-term) intact?

Insight

Does the client demonstrate understanding of his or her own symptoms or situation?

Judgement

Does the client demonstrate the ability to make sound, responsible decisions?