Mental Status Exam Worksheet

What is the theory behind this Looking after your mental health worksheet? 

The Mental state examination is a tool for assessing a person’s fundamental cognitive, emotional, and behavioural functioning at a specific time. A planned interview and methodical behavioural observations are typically part of the strategy.

How will the worksheet help?

The mental state examination is used to assess a client’s cognition, emotional and behavioural functioning. It is a useful tool for mental health practitioners to get the idea of a client’s psychological functioning before planning further treatment.   

How to use the worksheet?  

The mental state examination worksheet can be used by therapists during sessions. It is beneficial for therapists to get an idea about a client’s cognitive, emotional and behavioural functioning.    

Mental Status Exam Worksheet

Client name: Age:
Gender:Date of Birth:
Level of consciuosness
How alert, aware, responsive the client is?
AlertHypervigilantDrowsy lethargicstuporous asleep comatose confused Fluctuatingother
Is the client aware of time, place & the nature of stituation? 
Oriented (if knows time, date and situation)Partially oriented (eg, if knows time and situation but not the date)
Quality of movement
Include motor behaviour

normal movement postural instabilitytremors, Restlessnessdelayed movementsother
Include the observation of emotional expressions
Normal rangesituationally relevantMood-appropriateFlat labile TearfulConstrictedblunted or confined (little expressed emotion).other
Include the observation of emotional expressions
Normal or euthymicHopeless  Euthymic Anxious IrritableDepressed Elevatedother
Include the fluency, volume, rate
Normal rateFluent volumeHalting speechword-finding difficultiespressured speech.Loud or soft volume.Monotoneother
Thought process
Include the form and flow of thoughts
Goal oriented LinearTangential flight of ideas,racing thoughtsthought blocking.loosening of associationsother
Thought Content
It includes the nature of ideas.
Normal thought contentFixed ideasdelusionshallucinations Suicidal thoughtsGrandiosityObsessions/compulsionsother
It is the ability to focus

AttentivedistractedHyper-vigilant Variable attentionother
It is Information encoding, storing, and retrieval capabilities
Short term memory intactLong term memory intactAttentiveDistractible Limited for recent memoryOther
How well the client knows him/herself (weakness & strenghts)

Intact insight Limited insight No insight
Include the observation of emotional expressions

Intact Judgement  Fair judgement Poor Judgement

Client effort or motivation of participation in session or towards change.

Good motivationRigidity toward changeNo motivation

Use this space to write a report/summary.


Gaines, J. (2022, March 14). Mental status exams: 10 best templates, questions & examples.

Martin DC. The Mental Status Examination. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 207.

You can download this worksheet here.

Leave a Reply

Your email address will not be published. Required fields are marked *