Mental Health Assessment

A mental health assessment gives your doctor an overall picture of how well you feel emotionally and how well you are able to think, reason, and remember (cognitive functioning). Your doctor will ask you questions and examine you. You might answer some of the doctor's questions in writing. Your doctor will pay attention to how you look and your mood, behavior, thinking, reasoning, memory, and ability to express yourself. Your doctor will also ask questions about how you get along with other people, including your family and friends. Sometimes the assessment includes laboratory tests, such as blood or urine tests.

A mental health assessment for a child is geared to the child's age and stage of development.

A mental health assessment is done to:

• Find out about and check on mental health problems, such as anxiety, depression, schizophrenia, Alzheimer's disease, and anorexia nervosa.
• Help tell the difference between mental and physical health problems.
• Evaluate a person who has been referred for mental health treatment because of problems at school, work, or home. For example, a mental health assessment may be used to find out if a child has learning disabilities or behavior disorders such as attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), or obsessive-compulsive disorder (OCD).
• Check the mental health of a person who has been placed in an institution or arrested for a crime, such as drunken driving or physical abuse.

If you are having a mental health assessment because you have specific symptoms, you may be asked to keep a diary or journal for a few days before your appointment. A family member or friend may be able to describe your symptoms better than you can. If possible, bring that person with you to your appointment.

If your child is being checked for behavior problems, you may be asked to keep a diary or journal of how he or she acts for a couple of days. Your child's teacher may need to answer questions about how your child acts at school.

Many medicines can cause changes in your ability to think, reason, and remember. Be sure to tell your doctor about all the nonprescription and prescription medicines you take.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will indicate. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?).

Health professionals often do a brief mental health assessment during regular checkups. If you are having symptoms of a mental health problem, your doctor may do a more complete assessment or refer you to another doctor, such as a psychologist or psychiatrist.

A mental health assessment includes an interview with a doctor and may also involve a physical exam and written or verbal tests.

Interview

During the interview, your doctor pays attention to how you look (for example: Are you standing up straight? Are your shoes tied? Are you neat and clean?), how you move, what type of mood you seem to be in, and how you behave. You will be asked to talk about your symptoms and complaints. Be as detailed as possible. If you have kept a diary or journal of your symptoms, share this with your doctor.

Your doctor may ask you questions to check how well you think, reason, and remember (your cognitive functioning). He or she may ask you questions to find out how you think, how you feel about life, and whether you are likely to commit suicide.

Physical exam

A mental health assessment may include a physical exam. Your doctor will review your past medical history, as well as that of your family members, and the medicines you currently take.

Your doctor may test your reflexes, balance, and senses, such as hearing, taste, sight, smell, and touch.

Lab tests

The mental health assessment sometimes includes lab tests on a blood or urine sample. If a nervous system problem is suspected, tests such as magnetic resonance imaging (MRI), electroencephalogram (EEG), or computed tomography (CT) may be done. Lab tests to detect other problems may include thyroid function tests, electrolyte levels, or toxicology screening (to look for drug or alcohol problems).

Written or verbal tests

A mental health assessment may include one or more verbal or written tests. You will be asked some questions and will either answer out loud or write your answer on a piece of paper. Your answers are then rated and scored by your doctor.

Written questionnaires generally contain 20 to 30 questions that can be answered quickly, often in a "yes" or "no" format. They usually don't take long to finish and you can do them by yourself at a regular office visit.

Many mental health questionnaires are available. They look at:

• Specific problems. For example, for depression, the Hamilton Rating Scale for Depression, the Beck Depression Inventory, or the Geriatric Depression Scale can be used to evaluate your symptoms.
• How well you are able to think, reason, and remember (cognitive function). The Mini Mental State Examination can be used to check your cognitive function.
• How well you are able to carry out routine activities, such as eating, dressing, shopping, or banking.

Sometimes a more extensive mental health test, such as the Wechsler Adult Intelligence Scale, may be needed. The test may need to be given by a specialist such as a psychologist.

Children

How a child's mental health is assessed varies depending on the age of the child and the suspected problem. Young children may be asked to draw pictures to express their feelings, or they may be asked to look at pictures or images of common subjects and talk about how the pictures make them feel. Parents or teachers may be asked to answer questions about a child using a checklist.

How long does it take?

The time it takes for a mental health assessment varies depending on the reason for the assessment. An interview with written or verbal tests may lasts 30 to 90 minutes, or longer if several different tests are done. An in-depth test such as the Wechsler Adult Intelligence Scale may take 1 to 2 hours.

A mental health assessment is used to find out how you think and feel.

• If you are being checked for a problem, such as alcohol dependence, you may feel resentment, anger, or hostility and may not want to have the assessment.
• If you are being evaluated for a health condition, such as Alzheimer's disease, you may be afraid.
• Because some mental health problems are hard to diagnose, you may worry or become upset if your condition is not quickly or easily identified.

Lab tests do not usually cause much discomfort. A blood sample will be taken from a vein in your arm. An elastic band is wrapped around your upper arm and may feel tight. You may feel nothing at all from the needle, or you may feel a quick sting or pinch. Collecting a urine sample does not cause pain.

Your doctor may not be able to find the cause of your symptoms; some mental health problems are hard to diagnose. Also, more than one mental health assessment or other tests may be needed to accurately diagnose your problem.

A mental health assessment gives your doctor an overall picture of how well you feel emotionally and how well you are able to think, reason, and remember (cognitive functioning). Your doctor may discuss some results of the mental health assessment with you right after the assessment. Complete results may not be available for several days.

Many conditions can change the results of a mental health assessment. Your doctor will talk with you about how your results relate to your symptoms and medical history.

A mental health assessment can help diagnose:

• Mental health problems, such as anxiety disorders, depression, schizophrenia, attention deficit hyperactivity disorder, conduct disorder, bipolar disorders, and eating disorders.
• Developmental problems, such as learning disabilities, mental retardation, and autism.
• Substance abuse, including alcohol and drug abuse and dependence.
• Diseases of the nervous system, such as Alzheimer's disease, Huntington's disease, Parkinson's disease, and epilepsy.
• Other problems, such as thyroid disease and brain tumors.

You may not be able to have the test or the results may not be helpful if you:

• Are not able to cooperate with and trust your doctor.
• Are not willing to have a mental health assessment.
• Have physical or emotional problems that interfere with your ability to complete a written test. In most cases, other testing instruments and tools are used if this is a problem for you.
• Use some medicines, alcohol, or illegal drugs.

• Some mental health problems can be difficult to diagnose. You may need more than one mental health assessment and other tests to accurately diagnose your problem.
• What your family and friends see or think about your symptoms can sometimes help your doctor diagnose a mental health problem. Consider having a family member or friend come with you to your appointment.
• Contact your human resources department or local health department to find out what support services are available in your area.

Other Works Consulted

• Hales RE, Yudofsky SC, eds. (2003). Textbook of Clinical Psychiatry. Washington, DC: American Psychiatric Publishing.

• Smeltzer SC, Bare BG (2005). Textbook of Medical-Surgical Nursing. Philadelphia: Lippincott Williams and Wilkins.

• U.S. Preventive Services Task Force (2003). Screening for dementia: Recommendation and rationale. Annals of Internal Medicine, 139(11): 925–926.

Author:	Sydney Youngerman-Cole, RN, BSN, RNC	Last Updated March 13, 2006
Medical Review:	Adam Husney, MD - Family Medicine Malin K. Clark, MD, FRCPC - Psychiatry
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