Mental State Examination example questions

Examples:General self neglect

Working in remote Aboriginal communities has taught me how much my culture has shaped perception of mental state. Learning about Aboriginal culture, being guided by Aboriginal people together with building on my mental state examination skills has been required, and it is an ongoing process of learning. There are similarities and differences between Aboriginal and nonAboriginal culture in how mental disorders are manifest in the mental state. In a different culture it is sometimes difficult know what is the societal 'norm' for such parameters as appearance, behaviour, expression of certain affects, speech patterns and so on. In a different culture which is changing, these norms also change, making it doubly hard for the clinician. The result is that it was difficult to pick up subtleties of mental state and more difficult to make confident interpretations of the findings. The following discussion focuses mainly on the differences in mental state examination that I encountered.


My white sensibilities and objective neutrality were challenged by the very different interview setting that the households would provide, as described in the chapter on interview setting. It is a setting which could easily create value judgements in the white clinician and taken out of the cultural context a patient from such a community could be labelled 'dishevelled' or 'unkempt'. Misinterpretations could be drawn about poor social function, or the possible presence of chronic mental illness or cognitive decline.

Conversely, it is possible to become totally desensitised, to the extent that any degree of poor hygiene or neglect is dismissed as being non-pathological, and hence signs of mental disorder may be missed. There are some Aboriginal communities which are spotless (one in particular keeps winning the Northern Territory Tidy Town Award) and even within one community there may be tidy homes with well kept litter-free gardens which are side by side with dilapidated premises.

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