MSE Breakdown
Clinical Assignments - Mental Status Exam (MSE) Overview
Completion: Individual and in written format, performed during the first 5-6 shifts.
Due Dates: To be determined by clinical faculty.
Purpose of MSE
Assesses client’s current mental state.
Provides insights into:
Appearance
Behavior
Speech
Emotional state
Thought content and processes
Cognitive functioning
Helps identify client’s strengths, capabilities, and support needs.
Grading and Submission Guidelines
Assignment graded as pass/fail.
Unsatisfactory submissions require resubmission of all or parts of the assignment.
Pre-MSE review should include:
Client’s concerns
Medical/psychiatric history
Family history
Stressors
Medications
Education and employment history
Coping strategies and supports.
Conducting the MSE
Maintain a non-judgmental approach.
Consider client factors:
Attention and concentration
Level of education
Cultural background
Abilities in calculation, writing, and reading.
Document findings as per outline and ensure client confidentiality.
Required Texts
Primary: Pollard & Jakubec (2022) - Varcarolis’s Canadian psychiatric mental health nursing
Reference: Austin et al. (2019) - Psychiatric & mental health nursing for Canadian practice.
Assessment Criteria Categories
General Appearance: Dress, grooming, posture, etc.
Speech: Rhythm, rate, volume, characteristics.
Motor Activity: Unusual mannerisms or activity levels.
Client Interaction: Willingness to engage and demeanor.
Mood and Affect Assessment
Mood: Client's subjective description.
Affect: Observed facial expressions (terms include flat, full range, etc.).
Note discrepancies between mood and affect (incongruence).
Thought Content and Processes
Content: Presence of delusions, obsessions, phobias.
Processes: Logical connection of thoughts, verbal conveyance, evidence of thought blocking or other abnormalities.
Perception and Cognition
Perceptions: Presence of hallucinations or illusions.
Cognition: Include assessments of:
Consciousness and orientation
Memory (immediate, recent, remote)
Attention and calculation (e.g., counting backwards).
Insight, Judgment, and Risk Assessment
Insight: Level of understanding of illness.
Judgment: Ability to evaluate and react to situations.
Risk Assessment: Evaluate potential harm to self or others (suicidal/homicidal ideation).