Clinical guides
Writing the mental state examination, formulating risk after NG225, interviewing for psychosis, and the language that goes into a psychiatric record. Written for people who do this work, not for exam revision.
All guides
How to write a mental state examination
The eight domains, what belongs in each, and why the difference between what you observed and what you were told is the most important line in the note.
Thought form and thought content
Flight of ideas or loosening of associations? Delusion or overvalued idea? The vocabulary, the questions, and the conviction field everyone forgets.
Risk formulation after NG225
NICE says not to stratify risk into low, medium and high. The evidence behind that, and what a formulation looks like in practice.
Words that carry bias in clinical records
Black patients had 2.54 times the odds of a negative descriptor in their notes. The ten words that matter most, and neutral wording that keeps the finding.
Asking about psychosis
The exact wording for screening hallucinations by modality, delusions and passivity phenomena — and how to record a negative finding.
Mood and affect
Mood is reported, affect is observed. Two domains routinely collapsed into one line, and why congruence is a finding in itself.
Mental Health Act sections, explained
Who does what in the room, what sections 2, 3, 136 and the holding powers authorise, and what the Mental Health Act 2025 changes.
Notes that hold up months later
Attribute every account, record the negatives, say what you did not assess. Nine habits that cost nothing at the time.
Appearance and behaviour
What to observe before the interview starts, akathisia versus agitation, and describing behaviour without loaded language.
Bedside cognitive testing
The MMSE is not free to reproduce. Which instruments are, and how to test orientation, attention and memory without any of them.
Safety plans people actually use
The six parts, why generic plans fail at 2am, how to raise means restriction, and a worked example in the person’s own words.