Mental Health Overview Quiz

Study Notes

Mental Health

Mental health is an important part of overall wellbeing and influences how an individual thinks, feels, and behaves.
Mental health disorders are prevalent, impacting almost 50 million adults in the US, with a stark disparity between those who need treatment and receive it.
Mental health is a significant concern for young people, with 1 in 6 experiencing major depressive episodes.
Suicide is a serious public health issue, being the tenth leading cause of death in the US, and the second leading cause for children and adolescents.

Symptoms of Mental Health Disorders

Psychological: Include changes in thinking, mood, and emotional well-being.
Physical: Can manifest as unexplained pain, fatigue, and physical sensations like palpitations.

Risk Factors for Mental Health Disorders

Biopsychosocial Model: A multifaceted approach that considers biological, environmental, and life experience factors:
- Biological: Genetics, brain chemistry, and chronic illnesses can predispose individuals to mental health issues.
- Environmental: Stress, living arrangements, and work environments can all contribute to mental health challenges.
- Life experiences: Trauma, abuse, neglect, loss, and substance abuse are significant contributors to mental health.

Indications for Mental Health Assessment and Screening

Patients with unexplained physical symptoms, multiple physical complaints, chronic pain, recent stressors, difficult encounters, low self-rated health, frequent healthcare utilization, or substance abuse should be evaluated for potential mental health concerns.

Review of Systems (ROS) for Mental Health

Include inquiries about changes in:
- Attention, Mood, or Speech: Focus, emotional state, and verbal communication.
- Insight, Orientation, or Memory: Self-awareness, understanding of surroundings, and recollection.
- Anxiety, Panic, Ritualistic Behavior, and Phobias: Fear, unwarranted worry, compulsive actions, and irrational fears.
- Delirium or Dementia: Disorientation, confusion, and cognitive decline.

Components of Mental Health Assessment

Appearance & Behavior:
- Level of Consciousness: Alertness and responsiveness.
- Posture and Motor Behavior: Body positioning and movement.
- Dress, Grooming, and Personal Hygiene: Appearance and self-care habits.
- Facial Expression: Emotions displayed through facial cues.
- Manner, Affect, and Relationship to People or Things: Social interaction and response to stimuli.
Speech & Language:
- Quantity: Verbal output (talkative or unusually silent).
- Rate: Speed of speech (fast or slow).
- Volume: Loudness or softness of speech.
- Fluency: Clarity and rhythm of speech.
- Articulation: Pronunciation and clarity of words.
- Evaluation of Aphasia:
  - Word Comprehension: Ability to follow simple commands.
  - Repetition: Ability to repeat phrases and words.
  - Naming: Capacity to identify common objects.
  - Reading Comprehension: Ability to read and understand written text.
  - Writing: Ability to write a sentence.
Mood & Affect:
- Mood: The patient's sustained emotional state, their perception of the world.
- Affect: The outward expression of emotions observed through facial expressions, tone of voice, and demeanor.
Thoughts & Perceptions:
- Thought Process: Logical, relevant, organized and coherent.
- Thought Content: Presence of compulsions, obsessions, phobias, and anxieties.
- Perception: Existence of delusions (fixed false beliefs) or hallucinations (perceptions of nonexistent stimuli).
- Insight & Judgment: Ability to understand and respond to reality, make sound decisions.
Cognitive Functions:
- Orientation: Assessment of orientation to person, place, time, and situation.
- Attention: Ability to focus and concentrate (tested through serial 7's or spelling backward).
- Memory:
  - Digital Span: Repeating sequences of numbers.
  - Remote: Recall of past events (birthdays).
  - Recent: Recall of recent events (today's weather).
  - New Learning Ability: Learning and retaining new information (remembering three words after a short delay).
Higher Cognitive Functions:
- Information & Vocabulary: Knowledge base and language proficiency assessed through conversations about work, hobbies, and current events.
- Calculating Ability: Ability to perform simple arithmetic calculations.
- Abstract Thinking: Conceptual understanding assessed through proverbs or interpretation of figurative language.