Mental Health Nursing - Assessing Mental Health
Mental health assessments typically include a physical exam, to rule out physical problems. what is a mental health assessment can include blood tests, urine testing, or even brain scans.
Psychologists also employ a array of tools to measure mental health. These tools be anything from pencil and paper test forms to more in-depth interviews or self-completed questionnaires for postal mail.
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 irritability and anger. The degree of affect can be determined by observing facial expressions and overall manner of speaking as well as the response to external or internal stimuli (e.g. You can express your feelings by smirking at an absurd joke, or crying when you lose a loved one.
Affect is a temporary emotion, whereas mood is a more long-lasting emotional state. It is typically described as euthymic or normal, or dysphoric (meaning depression). However, psychiatrists 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 useful tool for clinical use, it isn't always easy to interpret based on a subjective patient reports. It is therefore beneficial to inquire about how patients have been feeling over the last few weeks, as opposed to using only the observation of a physician. Recent research showed that the assessment tools differed in their ability to identify a significant portion of symptoms. This included the symptoms that were classified under the same disorder. This can be due to the differing emphasis on cognitive, emotional or physical symptoms, as well as differences in duration and frequency of reporting symptom reports.
It is possible that the MSE relies on self-reporting, which could be biased. Patients who report both a headache and anxiety is likely to have a lower score compared to one who reports only a migraine. Patients tend to minimize negative emotions while exaggerating positive feelings.
Affect and mood influence thoughts and can affect decision-making, interpersonal behaviour and physical functioning. They are affected by stress, fatigue and social interactions. Positive moods can increase creativity and mental strength. However, a mood that is negative can affect concentration and cause confusion. A thorough and careful mental health assessment should consider the patient's mood and affect and the underlying factors.
Thought content
The ability to determine how a patient thinks is among the most important aspects of a mental state exam. Assessment of the thought process and its content. The thought process is the logic, coherence and organization of a patient's thoughts. A normal thought processes is focused and logic-based. In a variety of mental health conditions however, thought processing is altered. Examples include hallucinations, delusions, and loose associations.
A mental state examination also examines judgment and insight. Insight is the ability to identify the presence of a problem, and judgement is the ability to make a rational decision based on information. Both are affected by many mental health conditions such as schizophrenia and depression. If a patient is impaired in judgment and/or insight, they are at greater chance of harming themselves or others. If they are in danger, their sensible judgment would advise them to leave the premises immediately. A person with impaired judgment may suggest that they stay in the building to try and put out the fire.
Thought content includes the subject matter, themes and beliefs that a patient has. Generally, examiners comment on the clarity, relatedness and quality of a patient's thinking. They will take note of any thoughts that are circumstantial or tangential or thoughts, and also if the patient is having flashes of thoughts (digressions from the conversation subject). They will also provide feedback on the pace at which a person is thinking, such as whether they seem fast or slower.
Other important areas to consider are whether the patient's thoughts are and in tune with their surroundings. For example, a patient who is depressed could hear voices that are angry and threatening, while someone suffering from schizophrenia could be able to imagine the sound of a calm and soothing voice. Ask the patient if they are experiencing any suicidal or homicidal ideas. Although these are rare, they can be life threatening and should be taken into consideration in every mental health assessment.
Watching
The observation skills of nurses play an important role in the mental health assessment. They are a thorough examination of behavior, appearance as well as any unusual beliefs or perceptions (such hallucinations or delusions) and mood cognition (including memory, attention and orientation). A nursing mental status examination also involves observing motility, including any physical movement such as eating drinking, eating, brushing teeth or using the toilet, as well as wearing shoes.
The Observation component of the mental health examination is a crucial aspect of determining whether the patient is posing the risk to themselves or others. This is accomplished by determining whether the patient appears be acting in a deliberate manner that suggests they are trying to harm themselves or another person.
A detailed assessment of the thought content is also done by monitoring the patient during the interview and determining the concerns. It is crucial to determine whether the patient has suicidal, homicidal, or delusional thoughts.
Global assessment of functioning (GAF) is a numerical rating from 0 to 100, evaluates the ability of a person to perform in everyday life with their ability of dealing with stressors. The GAF is an essential part of the mental health examination and aids in making treatment decisions.
It is important to understand that observing the behavior of a patient can cause distress. It is therefore important that the procedure is conducted in a manner that does not provoke or cause discomfort. It is important that the patient is fully informed of the purpose of the observations and the length of the procedure.
Nursing observation is a crucial skill that must be a central part of any nursing process. However, it should be noted that patients might be dissatisfied with the quality of observation. If they are unable to come to an agreement with the staff, they should have access to an advocate service which can represent their needs and help their discussions on their care. This should be an integral part of local observation policy and practice with the participation of user groups to ensure that patients are involved in the creation of written information and staff training for this aspect of governance in the clinic.
Questioning
Many people have a hard to talk about their mental health problems However, loved ones will often be able to recognize the signs of something being wrong. They can also help the person to take a look at an assessment. These tests can be extremely broad and cover a wide range of subjects such as mood, appearance as well as memory, thought process and many more. In addition to these tests, mental health professionals will also ask the individual questions regarding their personal life, including what has been going on lately and what their feelings have been like.
The test includes an assessment of cognitive ability that focuses on a person's ability think clearly and retain information. The test subject may require the person to complete simple tasks such as focussing on a list or objects, remembering lists, or solving math questions. The test can be used to test the person's judgment and ability to make sound decisions. The test measures a patient's insight which is their understanding of their illness and how it affects them.
Another crucial aspect of a mental health assessment is the person's attitude toward the world, himself and his illness. The tone of voice, facial expression, and body language of a patient can signal depression, anger or a sense of helplessness. It is also important to note whether the patient appears to be seeking help or resigned to living with their health condition.
In more serious cases the mental health assessment may include an 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 dangerous and even deadly.
A mental health assessment must be holistic and examine the person's interactions with their environment. A health professional could use photographs, music, art or a range of electronic assessment tools to better understand the person and their unique view of the world around them. They should also talk with the person about the challenges that have caused them to seek help and assure them that there is nothing wrong with seeing a mental health professional.
