This paper will include a discussion on the goals and objectives on the practicum experience plan, a reflection of three challenging patients, learned practicum experiences, resources available, evidenced based practice used, new skills learned, what would've been done differently, and how patient flow and volume were managed. My objectives for this quarter included independently performing a mental health status exam. The second objective included developing a list of potential diagnoses. The final objective was to appropriately select a screening exam for the clients. The first objective was somewhat reached. I have some difficulty remembering each part of the MSE as I tend to miss at least one part. The second objective was completed; I was able to give report on my patients and give suggestions on their diagnoses. We discussed why the chosen diagnoses would not be the most correct and why they would be. Most of the patients all received a depression or anxiety screening. I believe that many of the patients would have benefited from the use of other screening tools. However, the psychiatrist I was with does not use the screening scales very often. I saw a patient that was hard for me to communicate with; her speech was pressured and short worded. I ended the interview earlier as it appeared she would rather talk to the provider. Another patient was autistic, and he would yell and hurt himself during the interview. It was difficult to watch the parents must handle that situation and then also trying to get the patient the help they need. I had a patient who appeared to be very young and autistic to me during my assessment. It was determined that she was acting the way she was due to having such an increased level of stress that she was functioning at a lower level than she would be without anxiety.