Mental Health Nursing - Assessing Mental Health
A physical exam is usually part of mental health tests to rule out any physical ailments. These can include blood tests, urine testing, or even brain scans.
Psychologists use a variety of instruments to evaluate mental health. These tools can range from paper and pencil test forms, to in-depth interviews or self-completed questionnaires for postal mail.
Affect and mood
Mood and affect are the most important components of the mental status examination (MSE) and are the first things to be observed by the clinician. They are the most accurate indicators of a patient's emotional state. It can vary from joy to sadness or anger and irritability. The affect can be assessed through 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 but mood is a more long-lasting emotional state. It is usually described as euthymic, dysphoric or normal (meaning depressed). However, psychiatric professionals should be cautious not to misunderstand the terms because they have different definitions and are influenced by a variety of factors.
While the MSE is a valuable diagnostic tool, it isn't always easy to interpret based on a subjective patient report. It is therefore helpful to ask patients how they have felt over the past few weeks, as opposed to relying on physician observation only. A recent study found that a significant proportion of symptoms, which includes those that fall under the same disorder category, vary between assessment tools. This could be due to the different emphasis placed on cognitive or emotional symptoms as well as the different time periods and frequency in reporting symptoms.
It is possible that the MSE relies solely on self-reporting, which could be biased. Patients who report both anxiety and a headache is likely to have a lower score compared to a patient reporting only headache. Patients tend to minimize negative emotions while exaggerating positive ones.
The affect and mood of a person directly affect the content of thoughts which influences decision-making, interpersonal behaviour and physical performance. They can be affected by stress, fatigue and social interactions. Positive moods can boost creativity and mental energy. A negative mood can cause confusion and lower concentration. Therefore, a careful and thorough mental health assessment needs to consider the patient's current mood and emotional state as well as their underlying factors.
Thought content
Assessing how the patient thinks is one of the most important aspects of a mental health examination. Assessment of thought process and content. The thought process is the coherence, logic and structure of a patient's thoughts. Normal thought processes are focused and logical. In a variety of mental health conditions, however, thought processing is distorted. Examples include hallucinations, delusions and loose associations.
Insight and judgement are also evaluated during a mental status exam. Insight is the ability to recognize that there is a problem, while judgement is the ability to make a considered decision based on information. Both can be impaired by a variety of mental health issues like depression and schizophrenia. If a patient suffers from impaired insight and/or judgement is at a higher risk of causing harm to themselves or others. If they are in danger, their rational judgement would tell to leave the premises immediately. A patient with impaired judgment may suggest that they stay in the building to try and put out the fire.
Thought content refers to the topics, subjects and beliefs that a patient holds. Typically, examiners discuss the clarity, connection and quality of a patient's thoughts. They will note tangential thoughts or circumstantial ones, as well as if the patient has digressions (digressions off from the main topic of the conversation). They will also provide feedback on the speed at which someone is thinking, such as if they seem to be faster or slower.
It is also crucial to determine if the patient's mood matches their surroundings. A patient with depression might hear voices of anger, while those suffering from schizophrenia might experience the illusion that a peaceful voice is speaking. A patient should be questioned about any suicidal or homicidal thought. Although these are rare, they can be life threatening and should be taken into consideration in every mental health assessment.
Observation
A nurse's observation skills are essential to the mental health assessment. They involve a thorough evaluation of appearance, behavior, any peculiar beliefs or perceptions (such delusions or hallucinations), mood, and cognition (including memory, attention and orientation). A nursing mental status examination also includes observing the ability to move, which includes physical movement, such as eating, drinking, brushing teeth or using the toilet, as well as wearing shoes.
The observation component of the mental health examination is essential in determining whether the patient poses a risk to themselves or anyone else. This is determined by assessing whether the patient appears be acting in a deliberate way that suggests they are planning to harm themselves or another person.
A detailed assessment of the thought content is also accomplished by observing the patient during the interview and determining the concerns. It is particularly important to determine if a patient is suffering from suicidal or homicidal thoughts and to determine if they are experiencing thoughts of suicide or delusions.
Global assessment of functioning (GAF) is which is a numerical score ranging from 0 to 100, evaluates the ability of the person to function in daily life and their capability of dealing with stressors. The GAF is a crucial component of the mental health examination and helps guide treatment decisions.
It is crucial to be aware of the fact that observing an individual's behavior could cause anxiety, and it is essential to conduct the procedure in a manner that does not provoke the patient and doesn't make them feel uncomfortable. It is also vital that the patient is fully informed about the purpose of the observation as well as the length of time it will take.
Nursing observation is a crucial ability that should be at the heart of any nursing program. However, it must be remembered that patients may not agree with the degree of observation. If they are unable to come to 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 part of the local policy and practice with the involvement of user groups, to ensure that patients are involved in the creation of written information as well as staff training to support this aspect of clinical governance.
Questioning
A lot of people are hesitant to discuss their mental health issues, but their family members are often able to discern when something isn't right. They can also help the person to take a look at an assessment. These assessments can be conducted on a variety of subjects that include mood, appearance and the thought process. A mental health professional may also inquire about the person's private life. They will ask what they have been feeling and what's happened recently.
The assessment includes an assessment of cognitive ability which focuses on an individual's ability to think clearly and remember information. The test subject may ask to complete basic tasks, like focusing their attention on the list of objects or words as well as storing lists and lists for solving math problems. The test may also test the person's ability to make sound decisions and use judgment. The assessment determines a patient's awareness, which is the understanding of their illness and how it affects them.
Another important component of a mental health assessment is the patient's attitude towards the world, himself and his illness. this hyperlink of voice, the facial expression, and the body language of a patient may signal depression, anger, or a feeling of utter powerlessness. It is important to observe whether the patient seems to be seeking help or accepting their condition.
In more serious cases the assessment of mental health may include a look at the patient's thinking which could include hallucinations or even illusions. These conditions can be dangerous and even deadly.
A mental health assessment should be comprehensive and look at the person's relationship with their social world. A health professional might use photographs, music, art or a range of assessment tools that are electronic to better understand the person and their unique view of the world around them. They should also speak to the person about the challenges that have caused them to seek help and reassure them that there is nothing wrong with visiting a mental health professional.