Mental State Exams provide guidelines for examining an individual’s mental disposition in order to figure out his character and determine a case. The taste is highly subjective as noted by Goldberg; they require adjustments and good judgment for the psychologists to apply it objectively and obtain reliable results (2008). Conditions that interfere with a patient’s mental status require special attention to diagnose and customize to get the right results. Cognitive impairment is a critical mental disorder that can interfere with a person’s cognitive ability and perception while an individual accused of aggravated sexual assault may be having an episode of mania or may be a normal person committing a crime. The MSE needs to be applied to suit each situation.
In people with cognitive impairment, the MSE should be adopted to exclude questions that deal with understanding. Alternatively, the text can be simplified to symbolic levels which the patient can understand. The physician should also recognize the cognitive challenges of the patient and interpret the result objectively without the patient’s ability affecting the outcome (Gordon, 2011).
MSE observation on general appearance will be applicable in both cases, however, a patient with cognitive impairment may require a different approach due to their inability to display the model traits even under normal circumstances. The patient accused of aggravated sexual assault, can go through all the observations to determine his state of mind. To get objective results, this patient may require follow-up questions on behavior and memory to establish a pattern and make reliable conclusions (Goldberg, 2008). As stated by Goldberg, it is also critical that the physician recognize possible personal prejudice and cultural different so that they can adjust their expectations to suit the patient.
References
Gordon, N. J., & Fleisher, W. L. (2011). Effective Interviewing and Interrogation Techniques. London, England. (pp.279–282).
Goldberg, C. (2008). A practical guide to clinical medicine: The mental status exam. The Regents of the University of California. Accessed on 16 June 2016 from http://meded.ucsd.edu/clinicalmed/mental.htm
