Psychiatric Interview Guide

Importance

• Essential for clinicians evaluating mental health concerns
• Focuses on psychological and social aspects of health
• Similar to general medical history and physical but specialized

Mnemonic: CHAMPION PSYCHE VOWEL

C: Chief Complaint

• Introduce yourself, ask about primary reason for visit
• Open-ended questions: e.g., "Tell me about what's been going on"
• Determine patient’s expectations from the clinician

H: How Can We Help?

• Clarify why the patient sought medical attention
• Focus interview on appropriatness of the patient's request

A: Additional Information

• Elaborate on the Chief Complaint
• History of Present Illness (HPI): Onset, duration, severity, triggers, etc.

M: Medical History

• Include physical health, past medical history
• Screen for current health threats
• Determine suitable psychiatric treatments given comorbidities

P: Psychiatric History

• Past psychiatric events: hospitalizations, therapy, medication, self-harm
• Psychiatric review of systems for common disorders

I: Ideation

• Suicidal Ideation: Screen all mental health patients
• Homicidal Ideation: Screen when relevant

O: Orientation

• Assess current level of orientation: person, place, time, situation

N: Navigation

• Evaluate patient’s ability to safely navigate their environment
• Consider transportation and support for post-visit care

S: Social Support

• Understand patient's support system: friends, family
• Impact on mental health management and discharge decisions

PSYCH Elements

P: Prescriptions

• Document names, dosages, schedules, indications for all medications
• Include over-the-counter drugs and supplements
• Past psychiatric medication trials: duration, efficacy, side effects
• Allergic reactions

S: Substances

• Ask about alcohol, cigarettes, recreational drug use
• Full substance history: type, first use, amount, frequency, last use, effects, treatment

Y: Youth and Development

• Assess developmental history: prenatal, speech, motor milestones
• Focus when dealing with children/adolescents

C: Collateral

• Obtain outside perspective from family, friends, other healthcare providers
• Critical for diagnosis and treatment planning

VOWELS Elements

Housing

• Determine living situation: traditional homes, group homes, facilities, homelessness
• Important for diagnostics and interventions

Employment

• Assess employment status, financial situation
• Focus on daily support rather than precise income

Victimization

• Inquire about abuse, neglect, domestic violence
• Important for dependents: children, elderly, disabled

Ancestry

• Screen for family history of mental disorders
• Aids in diagnosis and treatment planning

Legal Issues

• Understand past/present legal interactions
• May reveal substance use disorders, mania, antisocial behavior

Summary

• Ensure all elements are covered during an interview
• Mnemonic helps double-check areas before concluding encounter

Further Reading

• Recommended book: Memorable Psychiatry on Amazon