Assessments and evaluations for mental illness treatment

If you or someone you know is worried about a mental health issue, the first step is talking to a healthcare professional. Your local doctor (general practitioner or GP) can conduct an initial mental health assessment and may refer you to a counsellor, psychologist or psychiatrist depending on your needs.

The purpose of a mental health assessment

Having a mental health assessment gives your doctor a picture of the way you think, feel, reason and remember. The mental health test assesses your emotional wellbeing via a series of questions and also includes a physical examination.

As a priority your doctor will determine if you are at risk of hurting yourself or others. For children, the mental health assessment will be tailored to the child's age and stage of development.

A mental health assessment is designed to:

• diagnose mental health conditions such as anxiety, depression, schizophrenia, postnatal depression, eating disorders and psychotic illnesses
• differentiate between mental and physical health problems
• assess a person referred because of problems at school, work or home.

Preparing for a mental health assessment

Before your appointment, think about the reasons for the assessment:

• What are your mental illness symptoms?
• What are the thoughts, feelings or behaviours that have been troubling you?
• Has a particular event, such as the death of a loved one, brought on these symptoms?
• How often do you have the symptoms and what are you doing when you have them?
• How long do the symptoms last?

Keeping a diary in the days or week leading up to your mental health assessment may be helpful. It may also help to bring a friend or family member who can describe your mental illness symptoms from their perspective. If the assessment is for a child, make some notes about their behaviour. It might help to ask their teachers about any observations they have made.

Prepare a list of any prescription or illicit drugs you are taking – some drugs can affect the way you think or reason, so this could explain some of your symptoms.

How a mental health assessment works

A mental health examination undertaken by your doctor is likely to include a combination of questions and a physical examination, and possibly a written questionnaire.

Interview with your doctor (GP)

While your doctor is asking about your mental illness symptoms, they will be paying attention to how you look, the way you speak and your mood to see if this gives any clues to explain your symptoms. This will be subtle and you probably will not notice they are doing it.

The doctor will ask about your personal history, including your work history, marital history, family history and your current social situation (what supports you have at home). They will want to know about any traumatic events you have experienced (recently or in the past), about your childhood, and any issues with alcohol or drugs. They may ask about religious beliefs and your ambitions and aspirations.

Try to answer all questions as truthfully and accurately as possible. This will give your doctor the best chance of making an accurate diagnosis. Depending on your underlying medical problem, some of these questions may upset or anger you. Some mental health problems are hard to diagnose so you may not get a definitive diagnosis or explanation for your symptoms straightaway.

Physical examination

A mental health assessment often includes a physical examination. Your doctor will look at your past medical history and the medicines you are currently taking. You will also be asked about any history of mental illness or mental disorders in your family.

The purpose of the examination is to exclude physical causes for your current mental health issues.

Other medical tests

Your doctor may send you for lab tests such as a blood or urine test if they suspect a certain cause, for example, anaemia or B12 deficiency. They might test your thyroid function or electrolyte levels. If a nervous system problem is suspected, you might be sent for magnetic resonance imaging (MRI), an electroencephalogram (EEG) or a computed tomography (CT) scan.

You might also be asked to complete a standardised written questionnaire or to undertake a verbal test. These tests are generally designed to assess:

• specific problems such as depression
• how well you can think, reason and remember
• how well you can carry out daily living activities such as eating, dressing and shopping.

Mental health tests for children will depend on their age but might include drawing pictures to express their feelings or looking at pictures and talking about how the images make them feel.

Specialist mental health assessments

Some mental health conditions are hard to diagnose so your GP may not be able to find the cause of your symptoms. Even for specialists, more than one mental health assessment or other tests may be needed to accurately identify your condition.

Your GP may refer you to a mental health specialist such as a psychiatrist. The psychiatrist might use any one of a number of common tests. One example is the Mini Mental State Examination (MMSE), which is a short questionnaire used to measure cognitive impairment.

Other assessments are used to help diagnose:

• mental health disorders such as anxiety disorders, schizophrenia, attention deficit hyperactivity disorder, conduct disorder and bipolar disorder
• developmental problems such as learning disabilities and autism spectrum disorders
• alcohol and other drug issues
• other problems such as thyroid disease and brain tumours.

Help in a crisis – the Acute Community Intervention Service

For people who need immediate mental health help in a crisis, the police, ambulance staff or a doctor might call the Acute Community Intervention Service (ACIS) to help. Previously referred to as a crisis and assessment (or ‘CAT’) team, the ACIS can provide:

• support, advice and referral over the phone
• assessment and treatment in a hospital emergency department
• treatment in a person’s home.The service operates out of Victoria’s area mental health services and is available 24 hours a day.

Where to get help

• Your GP (doctor)
• Mental healthcare professional
• Kids Help Line, call 1800 55 1800
• Mensline Australia, call 1300 789 978.