Tim Webb – PESI – Completing the Mental Status Exam Practical, Hands-On Lessons from the Field

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Tim Webb – PESI – Completing the Mental Status Exam Practical, Hands-On Lessons from the Field

Perform and Document the MSE Correctly to Improve Treatment and Liability Protection

Completing the mental status exam is the most important task assumed by any behavioral health clinician. Accurate evaluation can be difficult because psychiatric symptoms often mask life-threatening substance withdrawal and/or serious medical conditions including brain tumors, delirium, head injury, diabetes, thyroid disease, etc. However, many graduate programs do not teach clinicians enough about recognizing and differentiating such symptoms. An accurate and efficient MSE is essential to discerning the patient’s true condition, developing an effective treatment plan, and, in extreme cases, saving his or her life.

This practical recording will help you improve your ability to perform the MSE by teaching you critical information generally not covered in graduate school as well as the American Psychiatric Association (APA) guidelines on the necessary elements for a full examination. Instruction on proper evaluation and keys to differential diagnosis will be a central theme of the recording. Included will be information on the assessment of various psychotic symptoms and how to understand their etiology, the use of drug and alcohol screens, clients’ medication lists, and more.

You’ll discover ways of quickly assessing clients at risk for suicide, homicide, and medical compromise. Additional discussion will focus on the role of various information sources for accurate assessment of patients in each age group, including lab values, family members, and medical records. Ultimately, this essential recording will teach you to perform and document the MSE correctly and efficiently to improve both clinical care and liability protection.

Speaker
Tim Webb, M.A. Ed., LPC, is the founder and CEO of The FOCUS Group, PLLC, a Clemmons, North Carolina based clinical training and consultation agency specializing in developing comprehensive programs for mental health crisis management. FOCUS Group helps systems ensure clinician safety, improve treatment of trauma and sexual aggression, performance enhancement and manage facility growth. His professional experiences include intake director and managing crisis services in the community, clinics and emergency rooms. As a clinical director, he has been responsible for program development, hiring/supervising clinicians and direct care staff, and all clinical operations for residential facilities. His unique combination of clinical and management experiences allow him to understand both the needs of administrative and front-line staff as he speaks to professionals in various settings.

In addition to holding Masters in Counseling from Wake Forest, Mr. Webb is a 2nd degree black belt in Mu Duk Kwan and an instructor in that martial art. He has provided clinical services in a number of jail settings and also has a background in firefighting. Mr. Webb’s unique combination of martial arts, teaching, emergency services and clinical experience have allowed him to develop the Stay Safe system of managing physically aggressive clients in a non-violent but safe and effective system.

Speaker Disclosures:
Financial:  Tim Webb is the Founder/CEO and author for The FOCUS Group, PLLC. He has an employment relationship with Daymark Recovery Services.  He receives a speaking honorarium from PESI, Inc. Tim has no relevant financial relationships with ineligible organizations.

Non-financial:  Tim Webb has no relevant non-financial relationship to disclose.

Objectives

1. Utilize multiple sources of information in considering differential diagnoses and determine how to apply this information in clinical practice
2. Assess psychotic symptoms and determine if they indicate psychiatric, substance abuse, or medical illness
3. Administer evaluative tools appropriately and understand their utility in the clinical setting
4. Determine which questions to ask, observations to make, and elements to assess in clients according to American Psychiatric Association guidelines
5. Evaluate risk for suicide and violence quickly and effectively, and apply this knowledge in clinical practice
6. Differentiate mental health conditions from substance abuse and medical presentations
7. Discuss the professional, ethical, and legal guidelines to be followed when conducting the MSE and recommending treatment

Outline

APA GUIDELINES ON NECESSARY ELEMENTS

• Differences in mood and affect
• When to ask open-ended vs. closed-ended questions
• When to become more directive, structured and observational
• Speech abnormalities and differential diagnosis
• Role of sleep and mood
• Role of appetite and mood

COMPONENTS OF A MORE COMPREHENSIVE MENTAL HEALTH SCREENING

• Sources of information
  Client medication list
  Family members and friends
  Alcohol and drug screens
  Other providers
  Medical records
• Documentation
• Special populations

ASSESS AND UNDERSTAND PSYCHOTIC SYMPTOMS

• Importance of distinguishing auditory hallucination type
• Relationship of visual hallucinations and medical conditions
• Hallucinations and substance abuse
• Importance of type of delusions on differential diagnosis
• Recognizing the over-medicated patient
• Determining legal competency to make decisions
  Case studies and scenarios

KNOWING WHICH TOOLS TO EMPLOY

• Using and scoring common evaluative tools
  St. Louis University Mental Status Examination (SLUMS)
  Folstein Test/Mini-Mental Status Exam (MMSE)
  Clinical Institute Withdrawal Assessment (CIWA)
  Suicide/Self-Harm Scale

APA GUIDELINES ON NECESSARY ELEMENTS

• Differences in mood and affect

Target Audience

• Psychologists
• Psychiatrists
• Nurses
• Nurse Practitioners
• Social Workers
• Counselors
• Marriage and Family Therapists
• Case Managers
• School Counselors
• Alcoholism and Drug Abuse Counselors

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