Mental Health Nursing - Assessing Mental Health
Mental health assessments often include a physical exam to rule out physical problems. This could include blood tests, urine testing, or even brain scans.
Psychologists use a variety of tools to assess mental health. These tools be anything from pencil and paper test forms to more in-depth interviews or self-completed questionnaires for postal mail.
Mood and affect
Mood and affect are the most significant components of the mental health examination (MSE) and are the first thing to be observed by a medical professional. They describe the patient's general mood that can range from joy to sadness, or even irritability to anger. The affect can be assessed by facial expressions, overall behavior and response to external or internal stimuli. smiling at an absurd joke or crying over the loss of a loved one).
Affect is a short-term emotion, whereas mood is a longer-lasting emotional state. It is typically described as euthymic, or dysphoric or normal (meaning depressed). However, psychiatric specialists must be careful not to confuse the terms since they have different definitions and are affected by a variety of factors.
While the MSE is a valuable tool for clinical use but it can be difficult to interpret based upon subjective patient reports. It is therefore important to ask patients how they've been feeling over the last few weeks, as opposed to relying on physician observation only. A recent study revealed that a significant proportion of symptoms, even those that are grouped under the same disorder category, vary between assessment tools. This can be because of the different emphasis placed on cognitive or emotional symptoms and also the differences between the time intervals and frequency of symptom reporting.
It is possible that the MSE relies on self-reports which could be susceptible to bias. For instance, a person who describes experiencing a headache and anxiety will likely have less than a person who describes only the sensation of a headache. Furthermore, there is a tendency for patients to minimize negative emotions and underestimate the severity of positive emotions.
Affect and mood can have an impact on thought content. This can impact the way people make decisions, their interpersonal behavior and physical performance. They can be influenced by fatigue, stress, social interactions, world events, hormones, and the weather. In reality positive moods have been proven to boost creativity and thinking power. A negative mood can cause confusion and decrease concentration. Therefore, a careful and thorough mental health evaluation needs to take into account the patient's mood and affect as well as their underlying factors.
Thought content
One of the most important aspects of a mental state examination is to determine how the patient thinks. Evaluation of thoughts and their content. The thought process is the coherence, logic, and organization of a patient's thoughts. Normal thought processes are focused and logic-based. In many mental health disorders however, thought processing is distorted. Examples include hallucinations, delusions and loose associations.
assessment for mental health examines judgment and insight. Insight is being able to recognize problems. Judgment is the capability of making a well-considered decision after receiving information. Both can be impaired by various mental health conditions such as depression and schizophrenia. If a patient suffers from impaired judgment and/or insight in any way, they are at greater risk of harming themselves or others. For instance when they are in danger of burning their home down the sensible judgment would tell them to leave the building immediately. A patient with impaired judgement might suggest they stay in the building to try to put out the fire.
The contents of a patient's mind encompasses the subject matter, themes and beliefs. Examiners generally comment on the clarity, relatedness and quality of a patient's thinking. They will also note any tangential or circumstantial thoughts or thoughts, and also if the patient is prone to having a flurry of thoughts (digressions from the conversation subject). They will also comment on the pace of a person's thoughts, including whether they appear fast or slow.
Other important areas to consider are whether the patient's thoughts are mood compatible or not in line with their environment. A patient with depression might hear angry voices, whereas a person suffering from schizophrenia may have a hallucination that a soothing voice is speaking. The patient should be questioned about any suicidal or homicidal thought. Although they are uncommon, they can be life threatening and should be taken into consideration in every mental health evaluation.
Watching
The nurse's ability to watch is essential in an assessment of mental health. They are a thorough review of appearance, behaviour, any unusual beliefs and perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention to orientation, attention, memory). A mental state examination for nurses also incorporates observation of mobility, which includes any physical movement such as eating drinking, eating, brushing teeth, using the toilet and putting on shoes.
The Observation element of the mental status exam is an essential element of determining whether or not the patient is posing an imminent risk to themselves or others. This is accomplished by determining whether the patient is acting in a manner that suggests that they are in danger of harming themselves or anyone else.
Additionally, a thorough assessment of thought content is done by monitoring the patient throughout the interview and determining their preoccupations. It is important to check whether the patient has suicidal, homicidal, or delusional thoughts.
Global assessment of functioning (GAF), a numerical rating from 0 to 100, measures the capacity of a person to function in daily life and their capability of coping with stressors. The GAF is an essential part of the mental state examination and aids in making treatment decisions.
It is crucial to be aware that observing an individual's behavior can cause anxiety and it is essential to conduct the procedure in a manner that does not cause anxiety for the patient and does not make them feel uncomfortable. It is also essential that the patient is informed about the purpose of the observation and the length of time it will last.
Nursing observation is a crucial skill and it must be a central element of the nursing process. However, it must be kept in mind that patients could not agree with the degree of observation and if they cannot reach an agreement with staff, then they should have access to an advocate service that can represent their needs and help their discussions on their care. This should be a fundamental element of the local observation policy and practice, with the participation of user groups to ensure that patients are included in the development of written information and staff training for this aspect of clinical governance.
Questioning
Many people are hesitant to discuss their mental health issues, however family members can usually detect if something is not right. They can also help the person to seek an assessment. These assessments can cover a wide range of subjects, including mood, appearance and the thought process. A mental health professional can also ask questions about the person's personal life. They'll ask them what they feel and what's happened recently.
The assessment also includes a cognitive evaluation that is focused on the person's ability to think clearly and remember information. The person could be asked to complete simple tasks such as focussing on a list or objects, recollecting lists, or solving math questions. The test can be used to test the individual's judgment and ability to make informed choices. The test also assesses the patient's knowledge that reflects their understanding of their illness and its impact on them.
Another vital aspect of an assessment of mental health is the person's attitude toward others, himself and his illness. The tone of voice, the facial expressions, and body language of a patient can convey anger, depression or a sense of helplessness. It is important to check whether the patient appears to be seeking help or accepting their condition.
In more serious cases an assessment of mental health might include an assessment of the patient's thinking that may include hallucinations (false perceptions of sensory stimuli that are not real stimuli) or illusions (misperceptions of real stimuli). These conditions can be extremely dangerous and even fatal.
A mental health assessment should be comprehensive and look at the person's relationship with their social world. A health professional could use art, music, photos or a range of assessment tools that are electronic to help the person understand themselves and their unique view of the world around them. They should also speak to the person about the difficulties that caused them to seek assistance and reassure them that there is nothing wrong with seeking out a mental health professional.