Dylan Walz has been bought to the mental health unit for assessment. He is accompanied by a work colleague. Dylan presents as a tall, slim man, who looks his stated age. His hair is short and it is evident that he has not shaved for several days. His work clothes are slightly soiled and he is wearing black boots. He mostly gazes downward towards his feet, making eye contact sporadically with staff.! Documents:! 1. The following information is from the letter that was sent to the Mental Health Unit by the GP.! Dear Doctor,! Thank you for seeing 26 year old Dylan Walz. Dylan has been to see me on several occasions this past two months requesting a sick certificate for time off work because he has not been able to sleep. He says that he is not able to sleep because of noises in the ceiling. He says sometimes the noises are like scratching and other times he hears muffled voices. He has not wanted to use medication to assist with sleep. I have noted a slight weight loss but can find no organic cause. He reports that he is concerned by poisons that might be in the food and prefers to eat canned food. At his last visit I noted his mood was euthymic and affect blunted.! He denies illegal drug use and reports he doesn’t drink alcohol. He says he likes his job at Coles and feels they are the only people he can trust.! Regards,! Dr Jean General Practitioner.
2. Registration Form: Dylan firmly refused to complete a Registration form given to him on presentation to the Assessment Unit today. Presentation at the Mental Health Assessment Unit! Dylan became agitated after he was approached to complete the Registration form. He indicated to his friend that he was going to leave but his friend was able to convince him to stay. He reluctantly agrees to follow staff to the interview room.    Question 1 ( 200 words) Discuss three (3) essential skills the nurse will use in the mental state examination. You must include the reasons why these skills are essential and provide an example of the behaviour, question or statement you would use in the interview with Dylan. Here is an example: 1. Suitable introduction and explanation of the purpose of the interview.! It is critical that the nurse establish rapport and introducing yourself is one way in which to begin to establish rapport and also set boundaries related to the nurses’ role. (Elder, Evans & Nizette, 2013).! Example statement! Hello Dylan. Thank you for attending the appointment today. My name is Lilly Deng and I am one of the nurses who work here in the Mental Health Assessment Unit. I would like to ask you some questions about... Question 2 (200 words) Describe the purpose of this mental health assessment for Dylan? Question 3 (600 words) For each of the components of the Mental State Examination listed below, write a question or statement you would use to investigate each component. Include any evidence from the case study to support your work.! Here is an example Affect! The GP has noted that Dylan has a blunted affect. Dylan’s external emotional response would be assessed in regards to its appropriateness and congruence of mood. There is evidence from the GP that Dylan’s affect has decreased in intensity and range of his emotional expression.
 1. Appearance and behaviour !
 2. Affect and Mood ! 3. Speech !
 4. Cognition !
 5. Thought form and Content ! 6. Perception !
 7. Insight !
 8. Judgement ! 9. Risk !