Mental Health Nursing - Assessing Mental Health
Mental health assessments often include a physical exam, to rule out physical conditions. These can include urine tests, blood tests or even brain scans.
Psychologists employ a variety of tools for assessing mental health. They can use pen and paper test forms to in-depth interviews, or self-complete questionnaires for postal delivery.
Mood and affect
The clinician will first notice the patient's mood as well as their affect. They describe a patient's general emotional state. It can vary from joy to sadness or anger and irritability. The affect can be assessed through facial expressions, general behavior and reaction to external or internal stimuli. You can express your emotions by smiling at the joke or crying when you lose a beloved one.
Affect is a feeling that is temporary, while mood is a state of sustained emotion. It is often described as being either euthymic (normal) or dysphoric, which translates to depressed. However, psychiatric specialists should be cautious not to mix the two as they have varying definitions and are influenced by a variety of factors.
While the MSE is a valuable tool for clinical use however, it can be difficult to interpret based on a subjective patient report. It is therefore helpful to inquire about how patients have been feeling in the last few weeks, as opposed to relying solely on the observations of doctors. A recent study found that a significant percentage of symptoms, including those that fall within the same disorder category, vary between assessment tools. This could be due the differing emphasis on emotional, cognitive or physical symptoms as along with differences in the duration and frequency of reporting symptom reports.
It is possible that the MSE relies on self-reporting, which could be biased. For instance, a person who reports anxiety and a headache will likely report a lower score than someone who has only a headache. Patients tend to minimize negative feelings while exaggerating positive feelings.
Affect and mood can have a direct influence on the content of thought. This can affect decision-making, interpersonal behavior, and physical performance. They are affected by stress, fatigue and social interactions. In fact, a positive mood has been proven to boost creativity and thinking power. A negative mood can reduce concentration and lead to confusion. Therefore, a careful and thorough mental health assessment is required to consider the patient's mood and state of mind as in addition to the underlying causes.
Thought content
Assessing how the patient thinks is among the most crucial aspects of a mental health examination. Particularly, it is assessing thought process and thoughts. The thought process is the logic, coherence and organization of a patient’s thoughts. Normal thought processes are rational and focused on goals. In many mental health disorders however, the thought process can be altered. Examples include hallucinations and delusions as well as loose associations.
A mental status examination also evaluates insight and judgement. Insight is the ability to see that there is an issue, and judgement is the ability to make a considered decision based on information. Both are affected by various mental health conditions, such as schizophrenia and depression. A patient with impaired insight or judgement is more prone to harm themselves or others. If they are in danger, their rational judgment would advise them to leave the premises immediately. A person with impaired judgment may suggest that they stay in the building to try to get rid of the fire.
The thoughts of a patient includes their themes, subject matter and beliefs. Examiners will assess the clarity, relevance and the content of the thoughts of the patient. They will take note of any thoughts that are tangential or circumstantial or thoughts, and also if the patient is having flashes of ideas (digressions from the conversation subject). They will also make comments on the speed of a person's thoughts, such as whether they seem fast or slow.
Other important aspects to consider are whether the patient's thoughts are and in tune with their surroundings. For instance, a patient who is depressed might hear voices that are hostile and frightening, whereas someone suffering from schizophrenia could have a hallucination of the sound of a calm and soothing voice. A patient should be questioned about any homicidal or suicidal ideation. These are rare but can be life-threatening and should be taken into consideration in every mental health assessment.
Watching
assessment mental health IamPsychiatry to observe is essential in a mental assessment. They include a careful examination of appearance, behavior and any peculiar beliefs or perceptions (such hallucinations or delusions), mood, and cognition (including memory, attention, orientation). A nursing mental status examination also incorporates observation of motility, including any physical movement, such as eating drinking, eating, brushing teeth, using the toilet and wearing shoes.
The observation component of the mental health examination is vital in determining if the patient is a danger to themselves or others. This is done by assessing if the patient appears to be acting in a deliberate way that suggests they're planning to harming themselves or someone else.
A detailed assessment of the thought-based content is also made by monitoring the patient during the interview and determining their thoughts and concerns. It is crucial to determine whether the patient is experiencing suicidal, homicidal or delusional thoughts.
A global assessment of functioning (GAF) is an assessment of a numerical score on a scale ranging from zero to 100 that evaluates a person's ability to function in daily life along with their capacity to handle the stressors in their life. The GAF is a crucial component of the mental health examination and helps guide treatment decisions.
It is important to recognize that observing the behavior of a patient may cause anxiety. Therefore, it is essential that the procedure is conducted in a manner that does not cause discomfort or feel intrusive. It is also essential that the patient is informed about the purpose of the observation and the amount of time it will take.
Nursing observation is an essential skill that should be an integral element of the nursing process. However, it must be noted that patients might not agree with the degree of observation and if they cannot reach 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 part of the local policy and practice, with the involvement and support of user groups.
Questioning
Many people have a hard to discuss their mental health problems However, loved ones can often notice when something is wrong. They can also help the person take steps to take an assessment. These assessments are broad and cover a variety of topics including appearance, mood, memory, thinking process and more. A mental health professional may also inquire about the person's private life. They'll ask them what they have been feeling and what has happened recently.
The test also includes a cognitive assessment that is focused on the ability of the individual to think clearly and retain information. The person could be asked to complete basic tasks, such as focussing on a list or objects, remembering lists or completing math problems. The test may also test the person's ability to make informed decisions and use their judgment. The assessment also determines the patient's knowledge, which reflects their understanding of the illness and its effects on them.
Another vital aspect of an assessment of mental health is the person's attitude towards other people, himself and the illness. The tone of voice, facial expressions, and body expressions of a patient could indicate depression, anger, or a feeling of utter powerlessness. It is also important to know whether the patient appears to be seeking help or resigned to living with their health condition.
In more serious cases the assessment of mental health might include an examination the patient's mental state which could include hallucinations or illusions. It is important to note the presence of these conditions because they can be extremely dangerous and even life-threatening.
A mental health assessment should be holistic and examine the person's interactions with their environment. A health professional can use images, music, or art or any other electronic assessment tool to gain a better understanding of the individual. They should also speak to the person about the challenges that caused them to seek help and assure them that there is nothing wrong with seeing a mental health professional.