A Full Psychiatric Assessment
A psychiatric evaluation is the first step towards receiving the proper treatment for your mental health. The psychiatrist will ask you a lot of questions about your work and personal life, the causes of stress, major traumatic experiences you have endured, and if you have had any alcohol or drug problems.
Background and Histories
A complete psychiatric evaluation, or psych eval is typically a multi-disciplinary exercise in hospital settings that includes psychiatric nurses, occupational therapists, psychologists and social workers. The psychiatrist is the one who takes an extensive medical record and performs a mental examination. This information can be gathered by direct observation, the person being evaluated and their family members and through specific psychological tests.
The doctor will inquire with the patient about their symptoms and what they've been doing over the past few months, weeks and years. They will also ask questions about personal and family health. This information will allow the doctor to determine what is causing the symptoms and whether they are the result of another condition.
In this stage during this time, the psychiatrist will conduct a medical history and find out whether there is a history of anxiety, depression or other psychiatric disorders in the family. They will also ask if there are any physical problems such as heart disease or diabetes, and what medications the person is taking or was prescribed.
Additionally the psychiatrist will make note of the present symptoms and how long they've been suffering for. They will also inquire about the lifestyle of the patient, including their job and their home. They will also discuss the individual's previous treatment as well as the degree of adherence to it. Carers and families often share information the patient hasn't told them. This is done in a way of respect for confidentiality and does not violate their right to privacy.
Based on the severity, other tests and/or observations may be required. These could include laboratory tests, blood pressure readings or electroencephalography (EEG), which measures brain activity. They could also take IQ tests, which assess cognitive abilities. These can test spatial skills memory, concentration, memory, and communication skills.
All psychiatric assessments must be conducted by professionals who are skilled and knowledgeable. This will ensure that the diagnosis and treatment plan are correct.
Mental Status Test
The mental status examination (MSE) can be a painful experience for both the physician and patient. It is an "snapshot", an image of the patient in an exact moment. It is used to document the patient's thoughts, behavior and attitudes at that particular time. The MSE can also be useful in demonstrating how a patient's state mind changes over time. For instance, it can show the transition from depression to manic episode.
The MSE starts when the doctor makes the first observations about the patient. This is usually taken during the recording of the history. How a patient interacts the examiner as well as their surroundings can reveal crucial information about the underlying psychiatric disturbance. This can be the case with the sloppy appearance of a depressed person or the provocative appearance of manic patients. It can also indicate a lack of motivation or energy, as in a depressed patient or an agitated person taking antipsychotic medication.
If a psychiatric exam is conducted it is best when the patient is calm and cooperative. Both the patient and the examiner may feel uncomfortable during the interview. It is crucial to convey the right impression. The MSE should be a relatively short part of the overall intake assessment and the results should be carefully considered in conjunction with the findings from other sources such as imaging studies or laboratory tests.
The MSE is not as structured as physical examinations and most of the information is gathered by the doctor during the process of taking a history. A thorough MSE will include descriptions of the appearance and behavior as well as alertness and attention, motor and speech activities as well as mood and affect perception and thought and attitude, as well as insight. It should also include an evaluation of higher cognitive capabilities such as parietal-lobe functions (pictorial representation as well as right-left discrimination and localization of objects in space).
It is important that the MSE be viewed as part of a complete intake assessment and that doctors interpret the results with sensitivity and care. A thorough MSE can reveal a broad range of abnormalities, including some that are specific to psychiatric disorders, however, it should be considered as a single point of data in the overall history of the patient and is of little clinical value by itself.
Evaluation of Thought Content
The thought content section is the most extensive of the MSE sections and should contain details about delusional thoughts (thoughts that are untrue) for example, persecutory, grandiose or jealous thoughts as well as hallucinations (hearing or seeing things that others don't) and preoccupations (such as worries, obsessions or fears); and suicidal thoughts. These questions should be clearly asked. The extent and intensity of the psychopathic thoughts should be outlined, along with whether they are mood compatible or incongruous (e.g. a patient who is depressed hearing voices that are angry or encouraging them to kill themselves versus hallucinations that are soothing and calm).
Thought process refers to the logic, relevance, coherence and flow of the client's thinking as they respond to the questions of the examiner during the MSE interview. Physicians also note if the thought process is disorganized or goal-directed and if it is a rapid flow from one topic to the next without any clear connection between them. Disorganized, tangential, and circumstantial associations are thought processes that may be indicators of mental health issues such as mania, schizophrenia and bipolar disorder.
In addition, psychologists and neuropsychologists examine the ability of the client to pay attention and hold information in memory, which can be measured through examiner observations, client self-report or tests like counting here backwards from 100 by 7s. They also can assess the client's coping mechanisms and cognitive performance, which is assessed through direct questions and behavioral observations.
During the MSE psychological evaluation, psychologists look at the client's facial expressions and body language to determine whether they seem withdrawn or aggressive. They also look at the client's fidgeting and restlessness to determine if they are fearful or anxious. Psychologists utilize the MSE together with other tests and assessments to diagnose and develop a treatment plan. Psychologists are also trained to recognize whether the client's behavior is in line with a specific mental illness or is due to another cause like substance abuse, an injury or an adverse reaction to medication. This information is crucial in determining the best treatment option and follow-up.
Evaluation of Mood, Anxiety and Stress
We all have tough times and when those issues begin to affect relationships, daily tasks and even the ability to sleep, it may be time to schedule a mental health assessment. Also called a psych evaluation and a mental health check, this examination is typically conducted by a psychiatrist or doctor. It can be intimidating, and you will have to provide a lot of personal details. It's important to remember that your therapist is looking to gather all the relevant information so that they can come up with a valid diagnosis and recommend the best treatment for you.
A psychiatric assessment will include an examination and review of your medical history. This is to make sure that your symptoms aren't caused by a physical problem such as thyroid disease or an illness of the nervous system.
Your psychiatrist will also ask about any psychiatric or medical problems and if you are currently taking any medication. If the patient is not able to give a history because of their mental health, it's essential that their family and caregivers can answer the questions. This isn't a breach of confidentiality, and it permits the doctor to gather more information than he could in a face-toface interview.
In the psychiatric consultation the doctor will evaluate the patient's emotional state by observing their voice and body language. They will also evaluate their thoughts to see whether they are focused and connected. For example the doctor will look at how the patient is able to focus during the interview, and how easily they switch between various ideas. This is a vital piece to the assessment as psychotic or manic patients might not be able to think clearly and quickly shift their focus.
For many people seeking a psychiatric assessment, it's their first step towards getting the appropriate treatment they require. Despite the stigma associated with mental illness, it's crucial that anyone who suspects they're suffering from the symptoms of a mental disorder seek an evaluation. Don't let your fears or anxiety stop you from seeking help because it could have serious and life-threatening consequences for you and others around you.