Physical Health Assessment

The Foundation Programme Curriculum explicitly emphasises the need for physical and mental health to be considered in tandem.

A physical health assessment is an essential part of a full mental health assessment. This generally includes:

• A systems review in the history
• Physical examination
• Bloods (the tests you need to request may vary between health boards)
• An ECG

You should check your health board's policy to find out the details of what is expected in your local area. 

Reasons for doing a physical health assessment on a patient presenting with apparent mental illness: 

• Physical examination is an essential part of the process of formulating a differential diagnosis for psychiatric presentations and ruling out organic causes (e.g. endocrine, infectious or neurological conditions) 
• Psychotropic medications can have significant physical effects, including metabolic syndrome, hyponatremia and extra-pyramidal side effects
• Regular physical health monitoring is an essential part of treatment
• Patients with mental illness may be at risk of neglecting their physical health, or of being less able to communicate their concerns about their physical health
• Patients with mental illness are also at increased risk of being stigmatised and having difficulty accessing services.

Adapted from the 'Physical Health in Psychiatry' article in the MyPsych Student Toolkit.