International Mental Health Examination

Question: Discuss about the International Mental Health Examination. Answer: Introduction: Thought form refers to the verbal record of how and not what the patient thinks about. In a normal situation, the thought form is supposed to be goal directed and logical (Martin, 2012). On the other hand, thought content is what the patient thinks about with minimal emphasis on the process or form (Martin, 2012). To interpret Annabelles thought disturbance, we have to briefly record an extract of her conversation so that we can understand the way her thoughts are produced. Moreover, it helps us understand the way she associates one subject with another in the conversation (Faber, 2011). For instance, she does not associate well the responses as she says the sores are everywhere, even under her skin, then she adds that everyone is falling, a statement that totally disqualifies her thought form (Emedicine.medscape.com, 2016). Thus, it can be referred to as a tangentiality in thought form because her responses are off the topic and her answers do not correspond with the asked questions (Faber, 2011). The thought content can be a basis of determination of the disturbance of Annabelles feelings (Faber, 2011). First, it is imperative to delineate certain features by asking specific questions. For instance, you may inquire why she is brought to the hospital or what she is seeing and feeling. In addition to specific questions, a reality testing assessment can be effective to look for more psychotic symptoms like hallucinations and delusions (Faber, 2011). Clearly, Annabelle has delusions and hallucinations because she believes that people are falling and also hears some sounds, screams and holds her ears after looking at the ceiling. Additionally, she converses with children that the nurses and the guard cannot see. In summary, Annabelle has tangentiality in her thought form. Moreover, she has hallucinations and delusions in the content of her thoughts. Perception is the identification, interpretation and organisation of information that is sensory so that one can understand and represent the environment (Martin, 2012). Furthermore, it can be defined as a set of subconscious cognitive processes of the brain that detects, interprets, relates and searches cognitive information in the brain. Thus, it mainly relates to the nervous system (Martin, 2012). The major disturbances in perception that can be observed are hallucinations and delusions. The interpretation of the senses is based on asking questions and observing the behaviour and movements of the patient. First off, we can ask her if she has some powers so that we can determine delusions of grandeur, reference or persecution. Annabelle believes that children are falling. Moreover, she is determined to ask for forgiveness from the nurse. She has auditory hallucination because she asks the nurse to shut up as if there is someone that she is listening to (Nordgaard and Parnas, 2012). An understanding of Annabelles sensory misperceptions can help the assessors to be keen on specific areas so that the characteristics are determined. For instance, the nurse may ask her to describe the nature of the things that she is seeing or feeling. This way, we may classify her delusions and hallucinations (Nordgaard and Parnas, 2012). Because she has auditory hallucinations, I may ask further questions. For example, when do the voices come? Are they clear, loud or subdued? Do you recognise the sources? Are they unpleasant or they are just good? And many others. Delusions would also attract questions like the sources and the reasons why she believes so. The further probe helps us interpret the sensory changes that Annabelle is having and thus propel us closer to the right diagnosis and interventions(Emedicine.medscape.com, 2016). Mood refers to the general state of emotions from the clients subjective point of view, and involves the feelings that are present during the examination time and a few days or hours preceding it. Additionally, it is assessed by a direct questioning of the patient and recording a verbatim answer (Thompson, 2016). On the other hand, affect is the objective examination of the immediate expression of emotions that is flows with the interview (Thompson, 2016). Annabelles mood is a mixture of fright and anxiety. In terror, she looks at the ceiling and then reverts to smiles and giggles after a short while. This mood is not stable and changes over time. When the other two nurses and a guard enter the room, Annabelle looks at the ceiling then later begins to sob in despair, in a mood that is sad after telling them that the children have been hurt. Moreover, her speech describes her mood (Crighton, 2011). It is pressured, loud and rapid. Here, it describes an anxious mood (Cummings, 2014). The qualitative description of Annabelles affect is that it is elated, suspicious and aloof. It can also be described as fearful and anxious. Furthermore, she exhibits a full range of emotions according to the expression of the feelings outwardly. For example, she sobs when depressed about the children and giggles when thinking of a good thing. Her emotional reactions change quickly and are somehow labile because of the time taken for tears to come out. Again, her affect is appropriate and compatible to the ideas, the thought content and the motor activities that she exhibits (Hooper, 2014). Also, it is consistent with the mood that she has. Therefore, the domain of the appropriateness to the situation and content is confirmed as far as affect is concerned. Thus, Annabelles mood and affect are congruent with her condition and its expression. Annabelles general appearance is not as expected of a young adult especially a lady who has been in college. She has a jeans that is dirty and a t-shirt. She walks barefooted. This is an indication of the inability to take care of herself. The hair that is decorated in blue and yellow is matted and unkempt. Moreover, it shows how careless she has become lately due to her mental condition (Varcarolis, Halter and Varcarolis, 2010). The dressing is not appropriate for her considering that she is 22 years old. Again, she appears restless, bizarre, and tense in her posture. Moreover, she rarely takes a sit unless her mother convinces her. She wrings her hands as she paces around the corridors. Her facial expression is fearful and elated, as evidenced by the refusal to follow a nurse but just the mother. Furthermore, she has an increased psychomotor activity (Australian College of Mental Health Nursing 41st International Mental Health Nursing Conference - Mental Health Nurses: shifting cul ture, leading change, 2015). Her actions are also spontaneous because she just giggles and then sobs after a few minutes. Again, she quickly tells the nurse that it is not in her veins. Her motor activities are also appropriate considering that she moves around and wrings her hands. However, there are no tics present (Varcarolis, Halter and Varcarolis, 2010). Annabelles behaviours are bizarre. First, she is not oriented to time, place and person. Additionally, she repeatedly wrings her hands. Her gaze and manner are evidence of fear and intrigue. Again, there is sudden show of happiness through light laughter and then she sobs after staring at the ceiling. Other evident behaviours are delusions and hallucinations. Here, she hears sounds that even prompt her to guard her hears. She also believes that children are hurt and people may be falling. These behaviours are generally described as being bizarre (Varcarolis, Halter and Varcarolis, 2010). 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