Mental Status Form
Mental Status Form
Appearance:
Well-groomed
Dishevelled
Unshaven and poor hygiene
Inappropriate clothing
Speech:
Normal
Pressured
Minimal
Slurred
Mood:
Euthymic
Low
Elevated
Anxious
Irritable
Affect:
Appropriate
Flat
Labile
Restricted
Thought Process:
Linear and logical
Flight of ideas
Circumstantial
Tangential
Thought blocking
Thought Content:
Normal
Delusional
Suicidal ideation
Paranoid
Perception:
Normal
Auditory hallucinations
Visual hallucinations
Responding to internal stimuli
Insight:
Good
Partial
No insight
Risk:
No risk
Risk to self
Risk to others
Abscond/self-neglect
Food & Fluids:
Full intake
Poor intake
Refused intake
Normal intake
Sleep:
Slept throughout
Intermittent sleep
No sleep
Minimal sleep
Additional Observations:
Generate Handover