Mental Health Nursing - Assessing Mental HealthA physical examination is typically part of mental health tests to rule out physical issues. This could include urine tests, blood tests test or even brain scans.
Psychologists employ a variety of tools to assess mental health. These range from tests that are written on paper and pen to in-depth interviews, or self-complete questionnaires for postal delivery.
Mood and affect
Mood and affect are among the most crucial elements of the mental state exam (MSE) and are the first to be observed by a medical professional. They describe a patient's general emotional state. This can be anything from sadness to happiness or anger and irritability. Affect can be assessed by watching facial expressions and manner of speaking as well as the reaction to external or internal stimuli (e.g. smiling at the joke or crying over the loss of a loved one).
Affect is an emotion that is temporary, whereas mood is a long-lasting emotion. It is usually described as being either euthymic (normal) or dysphoric, meaning depressed. However, psychiatric professionals should be cautious not to confuse the terms since they have different definitions and are affected by a variety of factors.
While the MSE is a useful clinical tool however, it can be difficult to interpret based on a subjective patient report. Inquiring about the feelings of patients in the last few weeks is more helpful than relying solely on the observations of a doctor. A recent study revealed that a large proportion of symptoms, which includes those grouped together within the same disorder category, differ between assessment tools. This could be due the different emphasis placed on emotional, cognitive or physical symptoms as and also the different the duration and frequency of symptom reporting.
It is possible that the MSE relies on self-reports, which may be prone to bias. For example, a patient who describes experiencing a headache and anxiety will likely have a lower score than a patient who reports only an occasional headache. Patients tend to minimize negative feelings while exaggerating positive ones.
Mood and affect directly affect thoughts, which can influence decision-making, interpersonal behaviour and physical functioning. They can be influenced by fatigue, stress and social interactions, as well as world events, hormones, and weather. In fact, a positive mood has been shown to enhance creativity and thinking power. A mood that is negative can cause confusion and reduce concentration. A thorough and thoughtful mental health evaluation must be able to consider both the patient's mood and affect as well as the fundamental factors.
Thought content
Examining the way a patient thinks is among the most crucial aspects of a mental state examination. Specifically, evaluating thought process and thought content. The thought process is the coherence, logic, and organization of a patient's thoughts. The normal process of thinking is objective-oriented and logical. In a variety of mental health conditions however, the thought process can be altered. Examples include hallucinations, delusions and loose associations.
A mental health assessment also assesses the quality of insight and judgement. Insight is the ability to identify the presence of an issue, and judgement is the ability to make a considered decision when presented with information. Both can be impaired by a variety of mental health issues such as depression and schizophrenia. If a patient suffers from impaired judgment and/or insight in any way, they are at greater risk of causing harm to themselves or others. If they are in danger, their sensible judgment would advise them to leave the premises immediately. A person with impaired judgment may suggest that they stay in the house to try to put out the flame.
Thought content includes the topics, subjects and beliefs that a patient has. Examiners will evaluate the clarity, connection, and content of patient's thoughts. They will also note tangential thoughts or circumstantial ones, and in the event that the patient's thoughts diverge (digressions away from the subject of the conversation). They will also discuss the pace of a person's thoughts, for instance, whether they appear fast or slow.
It is also essential to determine if the patient's mood matches their surroundings. For example, a patient who is depressed might hear voices that are hostile and frightening, whereas a person with schizophrenia might be able to imagine an ethereal and calm voice. The patient should also be asked about any suicidal or homicidal ideation. These are rare but can be life-threatening and should be taken into consideration in every mental health evaluation.
Watching
The nurse's ability to observe is essential in a mental assessment. They include a careful review of the appearance, behavior, any unusual beliefs and perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention, orientation, memory). The nursing mental state exam is also a way of observing motility. This includes any physical movement like eating, drinking or brushing your teeth.
The Observation component of the mental state examination is crucial in determining if a patient poses a risk to them or anyone else. This is determined by assessing whether the patient appears be acting in a deliberate way that suggests they're about harm themselves or another person.
A detailed assessment of the thought content is also made by monitoring the patient during the interview and determining thoughts and concerns. It is important to check whether the patient is experiencing suicidal, homicidal or delusional thoughts.
A global assessment of functioning (GAF) is an evaluation of the numerical value on a scale from zero to 100 that evaluates the ability of a person to function in daily life along with their capacity to handle the stresses in their lives. The GAF is a crucial component of the mental health exam and assists in guiding the treatment decisions.
It is important to recognize that observing the behavior of a patient can cause anxiety. It is crucial that the process be conducted in a way that does not cause discomfort or cause discomfort. It is also essential that the patient is fully informed about the purpose of the observation and the amount of time it will last.
Nursing observation is a crucial skill and it must be an integral element of the nursing process. However, it should be kept in mind that patients could disagree with the level of observation and if they are unable to come to an agreement with staff then they should be able to access an advocate service that can represent their interests and support patients in any discussions about their treatment. This should be a fundamental element of the local observation policy and practice, including the participation of user groups to ensure that patients are involved in the creation of written documents and staff training on this aspect of clinical governance.
Questioning
Many people are reluctant to talk about their mental health issues, but family members are often able to detect if something is not right. They can also help the person get an assessment. These assessments can be very broad and cover a wide range of subjects including appearance, mood, memory, thinking process and more. In addition to these tests, a mental health professional will also ask the individual questions about their personal life, including what has been going on recently and what their emotions have been like.
The assessment includes an evaluation of the cognitive capacity that focuses on a person's ability to think clearly and remember information. The test taker may be asked to complete basic tasks, like focusing their attention on a list of words or objects and recollecting lists of basic information or solving math problems. The test can also be used to check the individual's judgment and ability to make informed choices. The test measures a patient's insight which is their understanding of their illness and how it affects them.
The attitude of the patient towards others, himself and the illness is also an important aspect of a mental evaluation. The tone of voice, facial expressions, and body language of a patient can indicate depression, anger, or a feeling of powerlessness. It is crucial to determine whether the patient appears to seek help or accepting their situation.
In more serious instances, a mental health assessment could include a thorough functional status assessment mental health of the patient's thinking that may include hallucinations (false sensory perceptions that do not correspond to real stimuli) or illusions (misperceptions of real stimuli). It is important to note the presence of these disorders because they can be extremely risky and even life-threatening.
In general, a initial mental health assessment health assessment should take a holistic approach and look at the person's connection to their social life. A health professional could use art, music, photos or a variety of electronic assessment tools to better understand the person and their unique perspective on the world around them. They should also speak to the person about the difficulties that have caused them to seek assistance and reassure them that there is nothing wrong with visiting an expert in mental health.