How to Give a Mental Status Exam

Physicians and psychologists routinely evaluate their patients' mental status. If you work in a helping occupation such as teaching, the clergy or counseling, you too can benefit from learning to perform a mental status exam. Knowledge of mental status helps you deal with clients rather than react to them. Follow a few basic steps to perform the exam quickly and easily.

Instructions

Difficulty: Challenging

1. Observe your client's dress and cleanliness. Note untidy appearance, poor hygiene and inappropriate clothes for the season. These can be signs of abnormal mental status.
2. Determine if your client is situated in the present. Ask an open-ended question to determine if the client understands the purpose of your meeting, the place, time and date. If your client is unsure, it could indicate poor mental status.
3. Assess your client's nonverbal communication and attitude. Normal eye contact should be consistent but not a glare. Facial expressions should be appropriate to the topic being discussed. Voice volume, tone and pace should modulate accordingly. Make a statement to confirm what you observe. For example, "You seem depressed."
4. Follow your client's train of thought. Determine if subjects flow logically and relate reasonably. Areas indicating poor mental status include disconnected thoughts, obsession with one topic, delusions and paranoia.
5. Gauge your client's memory. Ask specifics about family and education or work background. Lack of details can indicate a long-term memory problem.
6. Present a hypothetical dilemma. Find out how your client would resolve it. For example, "If the person ahead of you in a check-out line left his purchase behind, what would you do?" Look for a logical response to this mental status exam question.
7. State a proverb. For example, "The squeaky wheel gets oiled." Ask your client to interpret it. Clients with normal mental status should be able to assign higher order meanings that go beyond the obvious.