Mental Health Nursing - Assessing Mental Health
A physical exam is usually included in mental health tests to rule out physical ailments. This could include urine tests, blood tests or even brain scans.
Psychologists also employ a range of tools to evaluate mental health. These tools can vary from pencil and paper test forms, to in-depth interviews or self-completed postal questionnaires.
Mood and affect
Mood and affect are among the most crucial elements of the mental state exam (MSE) and are the first thing to be observed by a doctor. 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. smiling at the joke or crying over the loss of a loved one).
Affect is a feeling that lasts only a few minutes but mood is a more long-lasting emotional state. It is often described as being either euthymic (normal) or dysphoric, meaning depressed. However, psychiatrists must be careful not to mix the two because they have different definitions and are affected by a variety of factors.
While the MSE is a valuable clinical tool, it can be difficult to interpret based on subjective patient report. It is therefore important to ask patients how they have been feeling over the last few weeks, rather than using only the observation of a physician. Recent research showed that the assessment instruments differed in their capacity to identify a significant part of symptoms. This included those that were classified under the same disorder. This could be due to the different emphasis on emotional or cognitive symptoms, as well as differences between time periods and frequency of the reporting of symptoms.
It is also possible that the MSE relies on self-report which is susceptible to bias. For example, a patient who describes experiencing anxiety and a headache will likely report an lower score than a person who describes only an occasional headache. Patients tend to minimize negative emotions while exaggerating positive feelings.
The affect and mood of a person directly affect thoughts, which can influence the way we make decisions, our interpersonal behavior and physical functioning. They are affected by stress, fatigue and social interactions. A positive mood can boost creativity and mental energy. A mood that is negative can cause confusion and decrease concentration. A thorough and thoughtful mental health assessment must take into account the patient's mood and affect as well as the underlying factors.
Thought content
Assessing how the patient thinks is among the most important aspects of a mental health exam. Assessment of thought process and content. Thought process refers the coherence, logic and organization of a patient's thinking. Normal thought processes are rational and goal-oriented. In a variety of mental health conditions, however, thought processing can be altered. Examples include hallucinations, delusions, and loose associations.
A mental health assessment also examines judgment and insight. Insight is the ability to see that there is a problem, while judgement is the ability to make a rational decision based on information. Both can be impaired by several mental health conditions like depression and schizophrenia. A patient with impaired insight or judgment is more prone to harm themselves or others. For instance, if they are at risk of burning their house down and they have a good sense of judgement, it would be wise for them to leave the house immediately. However, someone with impaired judgment may recommend staying in the house and trying to put out the fire.
Thought content includes the topics, subject matter, and beliefs that a patient holds. Typically, examiners discuss the clarity, relevance and quality of a patient's thoughts. They will be able to identify tangential ideas or those that are merely circumstantial, and when a patient is digressing (digressions away from the subject of the conversation). They will also comment on a person's pace of thinking, for example, if they seem fast or slower.
It is also important to determine whether the patient's mood matches the environment in which they live. Patients suffering from depression may be able to hear angry voices, whereas those suffering from schizophrenia may have a hallucination that a soothing voice is speaking. The patient should also be asked about any suicidal or homicidal ideation. These are uncommon, but could be life-threatening and should be considered in every mental health assessment.
Observation
The nurse's ability to watch is vital in the mental assessment . They include a careful review of behavior, appearance as well as any unusual beliefs or perceptions (such as hallucinations or delusions) mood, and aspects of cognition (including attention, orientation memory, and orientation). The nursing mental state exam also involves the observation of the movement. This includes any physical movement, like eating, drinking, or brushing your teeth.
The Observation component of the mental state examination is a key component of determining whether or not a patient may pose the risk to themselves or others. This is done by assessing whether the patient appears to be acting in a deliberate way that suggests they are trying to harming themselves or someone else.
A detailed evaluation of the thought-based content is also done by monitoring the patient during the interview and determining their preoccupations. It is particularly important to determine if the patient is having suicidal or homicidal thoughts and to determine if they're experiencing thoughts of suicide or delusions.
Global assessment of functioning (GAF) which is an assessment of functioning in numerical form, ranging from 0 to 100, measures the capacity of a person to perform in everyday life and their capability of dealing with stressors. The GAF is a crucial element of the mental state assessment and aids in making treatment decisions.
It is essential to be aware that observing the behavior of a patient can cause anxiety and it is important that the process is conducted in a way that does not provoke the patient and doesn't feel intrusive. It is crucial that the patient is fully informed of the purpose of the observation and the duration of the process.
Nursing observation is a vital skill that must be the core of any nursing procedure. It is important to remember that patients might disagree on the extent of observation. If they cannot reach an agreement with staff members, they must be able access an advocate service that can represent their interests and assist them in any discussions regarding their treatment. 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 documents and staff training to support this aspect of clinical governance.
Questioning
Many people are hesitant to talk about their mental health issues, however family members are often able to detect if something is not right. They can also help the person to obtain an assessment. These assessments can be very broad and cover a range of subjects including appearance, mood and thought process, memory and many more. A mental health professional can also inquire regarding the person's personal life. They will ask them what they have been feeling and what's happened in the last few days.
The test also includes a cognitive evaluation 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 paying attention to a list of objects, remembering lists or solving math questions. The test can also check the person's ability to make good decisions and use their judgment. The test also assesses the patient's knowledge and understanding of the illness and its effects on them.
The patient's attitude towards himself, others and the illness is an important element of a mental evaluation. The tone of voice, facial expressions, and body expressions of a patient could signal depression, anger, or a feeling of utter powerlessness. It is also important to determine whether the patient is seeking help or resigned to living with their illness.
In more serious cases the assessment of mental health might include a look at the patient's mental state, which may involve illusions or hallucinations. These conditions can be extremely dangerous and even fatal.
In general, a mental health assessment should be holistic and look at the person's connection to their social environment. A health professional might use art, music, photos or a range of electronic assessment tools to better understand the person and their unique view of the world around them. They should also speak to the person about the issues that have caused them to seek assistance and assure them that there is nothing wrong with seeking out an expert in mental health.