Word count: 1,000 word (±10%) including in-text citation, but excluding reference list.
SILO 3. Demonstrate mental health assessment skills.
Rationale. Mental state examination and therapeutic communication skills are fundamental skills of a nurse working with consumers with mental illness. By completing this report, students will be able to observe a consumer’s mental state, and document it appropriately. Furthermore, the student will learn by reflecting on helpful and unhelpful therapeutic communication skills.
Part A. MSE documentation Write a comprehensive Mental State Examination on the consumer in the video that you selected. [500 words]
Part B. Therapeutic communication Reflect on the interviewer’s (clinician’s) therapeutic communication skills. Discuss what components of this communication you thought were helpful and/or not helpful, and support with literature. [500 words]
Read the instruction and rubric thoroughly, then read it again!
• Watch the example video & refer to the written MSE, found in the assessment resource folder.
• You do not need to write introduction and conclusion for this written report; however, you still need an APA cover.
• You do not need to write a timecode.
• This assessment is to be completed using academic writing style. Do not write MSE in dot points. Use complete sentences.
The video included a general practitioner who attends a patient who is suffering from depression. The patient's name was Alison, was a 38-year-old woman. The video was all about how the GP diagnosis Alison’s low mood, tearfulness, reduced energy, and decreased motivation. This segment echoes a comprehensive mental state examination that the consumer in the selected video was undergone. It will include appearance, attitude, behaviour, speech, affect (emotion), and the content of both Alison and GP's thoughts (YouTube, 2012).
Appearance is referred to as the way that someone looks. It is mostly a physical aspect and not a mental perception (Goodman, 2012). The client, Alison, is found to be sad and depressed in terms of appearance. She echoes that she has a hunched type of posture with fidgets in her finger. Alison also found to be looking downwards throughout the medical process. On the other hand, Alison’s eyes seem to be bloodshot, and her facial expressions are found to be blotchy and red. It has been observed in the video that throughout the session, her eyes were full of tears, and Alison was also wiping them off while talking. For this purpose, the GP also handovers Alison tissue paper to wipe her tears off her eyes (YouTube, 2012).
Attitude can be defined as the way an individual thinks. The attitude of a person affects his or her behaviour as well (Ajzen, 2015). Alison is found to possess a negative attitude towards life. During the video, Alison also echoes that she is hopeless towards her life and helpless regarding her situation. Thus, it could be echoed aloud that she feels negative about her life getting better in terms of situation and incidents. As a result, it is observed that Alison is sad because of her past experiences and her shortcomings. She often blames herself regarding her symptoms, mistakes, and failure in life (YouTube, 2012).
Behaviour could be defined as the way one possesses himself or herself in front of other people. It includes both aspects of physical behaviour and mental behaviour (Dolan et al., 2012). Through the video, it has been found that Alison exhibits a negative reflection of her life that expresses much of her behaviour. She reports and claims to have a loss of interests, loss of appetite, disturbed sleeping patterns, and energy and motivation loss. As a result, Alison is found to be taking less interest and enjoyment in her daily activities, which was not the same in the past. Despite having unhealthy sleeping patterns, Alison claims that she wakes up early and has also noticed a severe drop in her body weight (YouTube, 2012).
Speech can be defined as the ability to express one's thought processes or perception (Ozyurek, 2014). After looking at the video, Alison’s speech can be bifurcated into two broad sections. These include her style and content. In regards to her style, Alison is found to be talking with low pitch and softer volume. Similarly, in regards to the content, Alison is found to be mostly using terms such as ‘I’ and ‘myself’, which helps echoing that she is less connected to the rest of the people (YouTube, 2012).
Emotion can be defined as a feeling reflected from an individual's life experience and circumstances (Scherer & Ekman, 2014). Alison is found to possess a low mood and lower self-esteem in terms of emotion. That is why the emotion and her behaviours have become one of the severe concerns. As a result, Alison’s emotion has started impacting her family, work-life balance, and her social life as well. That is probably why she claims to have tiredness and frustration throughout her day (YouTube, 2012).
The content in regards to the video is found to be emphasizing more on suicidal actions. It has been observed that Alison claims to have harmful thoughts as she is unable to cope-up with the feelings and experiences she had in the past. Although it takes a lot of effort and negative motivation to attempt suicide, and that is the reason why Alison has not planned any such attempts to give up on her life (YouTube, 2012).
While the video reflects how Alison describes her current situation in life, it also echoes how the GP explores various symptoms of depression. In this section, some components will be discussed in terms of communication that sounded helpful. The first thing that can be echoed as helpful was how the GP welcomes her patient and introduced herself. While MSE can be threatening for the patients cannot be ignored, GP established a strong character and established a therapeutic relationship with her patient (Arnfred et al., 2018). It has also been found that the patient's mental state plays an essential role in determining the direction of the treatment and the assessment. In this regard, communication is playing an essential role (Ali & Boyle, 2018). The GP established a strong sense of understanding, due to which Alison discussed all the on-going things in her mind openly. In this regard, the gestures also play an essential role in echoing the unheard communication between two persons. This was especially observed when GP offered Alison a tissue to wipe her tear off. In such places, most of the diagnosis processes surrender to talk any further, but in this case, the GP insisted more by echoing, “would you like to tell more about it” (YouTube, 2012). This establishes a polite request instead of exaggerating a command over the patient.
Another component that influenced the MSE processes in terms of communication factors was when the GP asked Alison whether she would allow her to ask for more details. This was evident when the GP echoed, "shall we start by asking some questions about your mood”. This helps the other person feel respected and boosts the medical session uninterruptedly (Matuszak et al., 2016). A similar component can be echoed as patience. It has been found an essential role in making communication more effective and informative. Throughout the video, the GP never insisted Alison reply faster and instead, and she allowed her time to respond to her questions. Appreciating this communication component during MSE might help effective process evaluations and a piece of detailed information (Otte et al., 2016). One of the few areas where communication components were reflected suddenly included following-up on what the patient uttered. This component of communication helps to gather accuracy and persistence during the diagnosis. Lastly, sensitivity as a component played an essential role that helped GP assessing comfort from Alison’s end. However, the intervention was not easy to process as Alison was mostly crying and hopeless with her life; the GP handled the situations was worth exposure (YouTube, 2012). Thus, the entire video has echoed the importance of communication and report while processing MSE interventions and diagnosis.