Mental Health Nursing - Assessing Mental Health
Mental health assessments often include a physical exam, to rule out physical problems. This may include blood tests and urine tests as well as brain scans.
Psychologists also use a wide array of tools to measure mental health. They can use pen and paper test forms to in-depth interviews, or self-complete questionnaires sent to you by post.
Affect and mood
The clinician will first notice the patient's mood as well as their affect. They define a patient's general emotional state. It can range from happiness to sorrow or anger and irritability. The effect can be analyzed through facial expressions, general behavior and reaction to internal or external stimuli. smiling at a joke or crying at the loss of a loved one).
Affect is a temporary emotion, whereas mood is a more sustained emotional state. It is often described as being either euthymic (normal) or dysphoric, which translates to depressed. However, psychiatric professionals must be careful not to misunderstand the terms since they have different definitions and are affected by a range of factors.
While the MSE is a useful diagnostic tool but it can be difficult to interpret based upon subjective patient report. It is therefore beneficial to inquire about how patients have felt over the past few weeks, rather than using only the observation of a physician. A recent study showed that a large proportion of symptoms, including those that are grouped under the same disorder category, vary between assessment tools. This can be because of the different emphasis on emotional or cognitive symptoms, and also the differences between time periods and frequency of the reporting of symptoms.
It is possible that the MSE relies solely on self-reporting, which can be biased. For example, a patient who complains of anxiety and headaches will likely have less than a patient who reports only the sensation of a headache. Patients tend to minimize negative feelings while exaggerating positive feelings.
Mood and affect can have a direct influence on the content of thought. This can affect decision-making, interpersonal behavior, and physical function. They can be influenced by fatigue, stress social interactions, world events, hormones and weather. Positive moods can boost creativity and mental energy. A negative mood can affect concentration and cause confusion. Therefore, a careful and thorough mental health assessment is required to consider the patient's current mood and state of mind as well as their underlying factors.
Thought content
One of the most important aspects of a mental health exam is assessing how a patient thinks. Evaluation of thoughts and their content. The thought process is the coherence, logic, and organization of a patient’s thoughts. The normal process of thinking is objective-oriented and rational. In many mental health disorders however, the thought process is distorted. Examples include hallucinations, delusions and loose associations.
Insight and judgment are evaluated during a mental status exam. Insight is the ability to identify the presence of a problem, while judgement is the ability to make a considered decision when presented with information. Both are affected by several mental health conditions such as depression and schizophrenia. If a patient has impaired judgment and/or insight is at a higher risk of harming themselves or others. If they are in danger, their sensible judgement would tell to leave the premises immediately. However, a person with impaired judgment might suggest staying in the building and attempting to put the fire out.
The content of a patient's thoughts encompasses the subject matter, themes and beliefs. Examiners generally comment on the clarity, relatedness and quality of a patient's thought. They will also note tangential thoughts or circumstantial ones, as well as in the event that the patient's thoughts diverge (digressions away from the topic of the conversation). They will also discuss the speed of a person's thoughts, including whether they seem to be fast or slow.
Other important aspects to consider are whether the patient's thoughts are mood compatible or not in line with their surroundings. A person suffering from depression could hear angry voices, whereas those suffering from schizophrenia may experience an illusion that a calm voice is speaking. Ask the patient if they are experiencing any suicidal or homicidal thoughts. Although mental health assessment test are rare, they can be life-threatening and must be considered in every mental health evaluation.
Watching
The nurse's ability to observe is vital in a mental assessment. They involve a thorough evaluation of appearance, behavior as well as any unusual beliefs or perceptions (such delusions or hallucinations) and mood cognition (including memory, attention, orientation). The mental status exam for nurses is also a way of observing the movement. This includes any physical movement, like eating, drinking and brushing your teeth.
The Observation component of the mental health examination is a key component of determining whether the patient could pose an imminent risk to themselves or others. This is determined by assessing whether the patient appears to be moving in a deliberate manner that suggests they are trying to harming themselves or someone else.
A thorough assessment of the thought-based content is also done by monitoring the patient during the interview and determining the concerns. It is essential to determine whether the patient is suffering from 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 the capacity of a person to function in everyday life and their ability to cope with the stressors in their life. The GAF is an essential part of the mental state examination and helps guide treatment decisions.
It is important to recognize that observing the behavior of a patient could cause distress. Therefore, it is essential that the process be conducted in a way that does not cause discomfort or make the patient feel uncomfortable. It is important that the patient be fully informed of the purpose of the observations and the duration of the procedure.
Nursing observation is an essential skill that should be an integral part of the nursing process. It is important to remember that patients might disagree on the degree of observation. If they cannot reach an agreement with staff members, they must be able access an advocate service to represent their interests and assist them in any discussions regarding their treatment. This should be a fundamental part of the local policy and practice, including the involvement of user groups, to ensure that patients are involved in the development of written documents and staff training to support this aspect of clinical governance.
Questioning
Many people are hesitant to talk about their mental health issues, but their family members can often detect if something is not right. They can also help the person take an assessment. These assessments can be very broad and cover a wide range of topics such as mood, appearance and memory, thinking process and many more. A mental health professional may also ask questions regarding the person's personal life. They'll ask them what they've been feeling and what has happened recently.
The test includes a cognitive evaluation that examines a person's ability to think clearly and retain information. The person may be asked to complete basic tasks, like focusing their attention on the list of objects or words, memorizing simple lists or solving math problems. The test can also be used to check the individual's judgment and ability to make good choices. The assessment also determines the patient's insight, which reflects their understanding of their illness and its impact on them.
Another crucial aspect of a mental health assessment is the person's attitude towards the world, himself and his illness. The patient's tone of expression, facial expression and body language can indicate anger, hostility, depression or a sense of powerlessness. It is also important to know whether the patient is seeking help or just living with their health condition.
In more serious instances the mental health assessment could include a thorough examination of the patient's thoughts, which could involve hallucinations (false sensory perceptions without real stimuli) or illusions (misperceptions of real stimuli). These conditions can be extremely dangerous and even fatal.
In general, a mental health assessment must be holistic and examine the person's connection to their social environment. A health professional can use art, music or photos or any other assessment tool to gain a better understanding of the person. They should also discuss the difficulties that prompted the person to seek help, and assure them that there is nothing wrong with seeing an expert in mental health.