If you or someone you know is worried about a mental health issue, the first step is to talk to a healthcare professional. Your doctor can carry out an initial mental health assessment and may refer you to a counsellor, psychologist or psychiatrist depending on your needs.
A mental health assessment gives your doctor a picture of how you think, feel, reason and remember. It looks at your emotional wellbeing through a series of questions and usually includes a physical examination. As a priority, your doctor will work out whether you are at risk of hurting yourself or others. For children, the assessment is tailored to the child’s age and stage of development.
The purpose of a mental health assessment#
An assessment is designed to:
- diagnose conditions such as anxiety, depression, schizophrenia, postnatal depression, eating disorders and psychotic illnesses
- assess someone referred because of problems at school, work or home
- help tell the difference between mental and physical health problems
Preparing for an assessment#
Before your appointment, think about the reasons for it:
- What are your symptoms — the thoughts, feelings or behaviours that have been troubling you?
- Has a particular event, such as the death of a loved one, brought them on?
- How often do you have the symptoms, and what are you doing at the time?
- How long do they last?
Keeping a diary in the days or week before your assessment may help. It can also help to bring a friend or family member who can describe your 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 anything they have noticed.
Prepare a list of any prescription or non-prescription drugs you are taking. Some drugs can affect the way you think or reason, so this may explain some of your symptoms.
How an assessment works#
A mental health examination is likely to include a combination of questions and a physical examination, and possibly a written questionnaire.
Interview with your doctor#
While your doctor asks about your symptoms, they will also pay attention to how you look, how you speak and your mood, as these can offer clues. This is subtle, and you probably will not notice they are doing it.
Your doctor will ask about your personal history, including your work history, relationships, family history and current social situation (what support 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 about any issues with alcohol or drugs. They may also ask about your beliefs and your hopes and goals.
Try to answer all questions as honestly and accurately as you can. This gives your doctor the best chance of making an accurate diagnosis. Depending on what is happening, some questions may upset or anger you. Some mental health problems are hard to diagnose, so you may not get a definitive answer straight away.
Physical examination#
An assessment often includes a physical examination. Your doctor will look at your past medical history and the medicines you currently take, and will ask about any history of mental illness in your family. The aim is to rule out physical causes for your symptoms.
Your doctor may send you for laboratory tests, such as a blood or urine test, if they suspect a particular cause — for example, anaemia or vitamin B12 deficiency. They might also check your thyroid function or electrolyte levels.
Other medical tests#
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 complete a standardised written questionnaire or a verbal test. These are generally designed to assess things such as how well you can carry out daily activities — eating, dressing and shopping — and how well you can think, reason and remember.
Tests for children 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 conditions are hard to diagnose, so your doctor may not be able to find the cause of your symptoms straight away. Even for specialists, more than one assessment or other tests may be needed to identify a condition accurately.
Your doctor may refer you to a mental health specialist, such as a psychiatrist, who might use one of several common tests. One example is the Mini Mental State Examination (MMSE), a short questionnaire used to measure cognitive impairment.
Other assessments 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#
If you or someone else needs immediate mental health help in a crisis, contact your local emergency or crisis service straight away. Crisis services can provide support, advice and referral over the phone, and arrange assessment and treatment, including in a hospital emergency department, when it is needed. If there is an immediate risk to life, call your local emergency number.
Key points#
- As a priority, your doctor will work out whether you are at risk of hurting yourself or others
- A physical examination helps rule out physical causes for your mental health symptoms
- Some mental health conditions are hard to diagnose, so the cause may not be found straight away
- A psychiatrist might use one of several common tests as part of a specialist assessment
Where to get help#
Sources & further reading
For evidence-based global guidance on this topic, consult authoritative public-health bodies such as the World Health Organization (WHO), CDC, NHS, and ECDC.