Be aware also that not all aggressive behaviour is associated with mental illness. Some aggressive behaviour is associated with organic illnesses such as hypoglycaemia, delirium, acquired brain injury or intoxication. These organic causes of unusual or disturbing behaviour may look like mental illness when in fact they are not. The interplay of biological, psychological and socio-cultural factors related to ageing sometimes makes it difficult to clearly identify mental health problems.
The ABCs of mental health assessment 44
The ABCs of a mental health assessment are as follows.
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Appearance What does the patient look like?
• Are they dishevelled, unkempt or well presented?
• Are they wearing clothing appropriate for the weather?
• Do they look malnourished or dehydrated?
• Are they showing any visible injuries?
• Do they appear intoxicated, flushed, with dilated or pinpoint pupils?
• Are they tense, slumped over, displaying bizarre postures or facial grimaces? This information provides cues when assessing the person’ s mood, thoughts and ability to self-care.
Affect What is your observation of the patient’ s current emotional state?
• Are they flat, downcast, tearful, distressed or anxious?
• Is their expression of emotion changing rapidly?
• Is their emotion inconsistent with what they are talking about?
• Are they excessively happy? This information provides cues when assessing the person’ s mood.
Behaviour How is the patient behaving?
• Are they restless, agitated, hyperventilating or tremulous?
• Are they displaying bizarre, odd or unpredictable actions?
• Are they orientated?
How is the patient reacting?
• Are they angry, hostile, uncooperative, over-familiar, suspicious, guarded, withdrawn, inappropriate or fearful?
• Are they responding to unheard voices or sounds, or unseen people or objects?
• Are they attentive or refusing to talk?
Department of Health and Ageing – Emergency Triage Education Kit