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Mental Status Exam

The document is a template for conducting a Mental Status Exam, which includes sections for observations, mood, cognition, perception, thoughts, behavior, insight, and judgment. Each section contains various options for clinicians to check off based on their assessment of the client. The template is designed to facilitate a comprehensive evaluation of a client's mental state.

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89 views1 page

Mental Status Exam

The document is a template for conducting a Mental Status Exam, which includes sections for observations, mood, cognition, perception, thoughts, behavior, insight, and judgment. Each section contains various options for clinicians to check off based on their assessment of the client. The template is designed to facilitate a comprehensive evaluation of a client's mental state.

Uploaded by

Guille monster
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Mental Status Exam

Client Name Date

OBSERVATIONS
Appearance □ Neat □ Disheveled □ Inappropriate □ Bizarre □ Other
Speech □ Normal □ Tangential □ Pressured □ Impoverished □ Other
Eye Contact □ Normal □ Intense □ Avoidant □ Other
Motor Activity □ Normal □ Restless □ Tics □ Slowed □ Other
Affect □ Full □ Constricted □ Flat □ Labile □ Other
Comments:

MOOD
□ Euthymic □ Anxious □ Angry □ Depressed □ Euphoric □ Irritable □ Other
Comments:

COGNITION
Orientation Impairment □ None □ Place □ Object □ Person □ Time
Memory Impairment □ None □ Short-Term □ Long-Term □ Other
Attention □ Normal □ Distracted □ Other
Comments:

PERCEPTION
Hallucinations □ None □ Auditory □ Visual □ Other
Other □ None □ Derealization □ Depersonalization
Comments:

THOUGHTS
Suicidality □ None □ Ideation □ Plan □ Intent □ Self-Harm
Homicidality □ None □ Aggressive □ Intent □ Plan
Delusions □ None □ Grandiose □ Paranoid □ Religious □ Other
Comments:

BEHAVIOR
□ Cooperative □ Guarded □ Hyperactive □ Agitated □ Paranoid
□ Stereotyped □ Aggressive □ Bizarre □ Withdrawn □ Other
Comments:

INSIGHT □ Good □ Fair □ Poor Comments:

JUDGMENT □ Good □ Fair □ Poor Comments:

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