Mental Health Nursing - Assessing Mental Health
Mental health assessments often include a physical exam, to rule out physical conditions. This may include blood tests or urine tests, as well as brain scans.
Psychologists also use a wide range of tools to evaluate mental health. These tools vary from pencil and paper test forms to in depth interviews or self-completed postal questionnaires.
Affect and mood
Mood and affect are among the most important components of the mental status exam (MSE) and are the first things to be viewed by the medical professional. They are the most accurate indicators of a patient's emotional tone. This could vary from joy to sadness or anger and irritability. The affect can be assessed through facial expressions, general behavior and reaction to internal or external stimuli. You can express your emotions by smirking at a joke, or crying when you lose a beloved one.
Affect is a feeling that lasts only a few minutes but mood is a more long-lasting emotional state. It is typically described as euthymic or dysphoric or normal (meaning depressed). However, assessment mental health should be cautious not to misunderstand the terms since they have different definitions and are affected by a range of factors.
The MSE is a helpful tool for diagnosing clinical problems, but it is difficult to interpret from a subjective patient report. It is therefore helpful to ask patients how they have been feeling over the last few weeks, instead of using only the observation of a physician. Recent research showed that the assessment tools were different in their ability to detect a substantial portion of symptoms. This included those that were grouped under the same disorder. This could be due to the differing emphasis on emotional, cognitive or physical symptoms as well as differences in duration and frequency of symptom reporting.
It is possible that the MSE relies on self-reports which is susceptible to bias. A patient who reports both a headache and anxiety is likely to report an lower score than those who report only headache. Patients tend to minimize negative feelings while exaggerating positive ones.
Affect and mood can have an impact on the thought content. This can affect the way people make decisions, their interpersonal behavior and physical functioning. They are influenced by fatigue, stress social interactions, world events, hormones and weather. A positive mood can boost creativity and mental energy. However, a mood that is negative can reduce concentration and lead to confusion. A thorough and thoughtful mental health evaluation must take into account the patient's mood as well as affect, as well as other factors.
Thought content
Examining the way a patient thinks is one the most important aspects of a mental state examination. Assessment of the thought process and its content. Thought process refers the coherence, logic, and organization of a patient's thinking. Normal thought processes are rational and goal-oriented. In many mental health disorders however, the thought process can be altered. Examples include hallucinations, delusions, and loose associations.
Insight and judgement are also assessed in a mental status test. Insight is being able to recognize a problem. Judgment is the ability to make a rational decision after receiving information. Both are affected by a variety of mental health issues such as depression and schizophrenia. Patients with impaired insight or judgment is more likely to harm themselves or others. For example if they are in danger of burning their house down, sensible judgement would tell them to leave the building immediately. However, someone with impaired judgment may decide to stay in the building and trying to put out the fire.
Thought content includes the subject matter, themes and beliefs that a patient holds. Generally, examiners comment on the clarity, connection and content of a patient's thoughts. They will also note any thoughts that are circumstantial or tangential and also whether the patient has flights of ideas (digressions from the conversation subject). They will also provide feedback on the speed at which someone is thinking, such as whether they seem to be more or less fast.
Other important areas to consider are whether the patient's thoughts are compatible or not in line with their surroundings. For instance, a person who is depressed might hear voices that sound hostile and frightening, whereas a person with schizophrenia might be able to imagine the sound of a calm and soothing voice. A patient should also be asked about any homicidal or suicidal ideation. Although they are not common but they could be life threatening and should be taken into account in every mental health evaluation.
Watching
A nurse's observation skills are crucial in a mental health assessment. They involve a thorough evaluation of appearance, behavior as well as any peculiar beliefs or perceptions (such hallucinations or delusions), mood, and cognition (including memory, attention, orientation). A nursing mental status examination also involves observing motility, including any physical movement such as eating, drinking, brushing teeth or using the toilet, as well as wearing shoes.
The Observation component of the mental state examination is essential in determining whether a patient poses a risk to themselves or others. This is determined by assessing whether the patient appears to be moving deliberately in a way that suggests they are in danger of harming themselves or someone else.
Additionally, a thorough assessment of the content of thoughts is conducted by monitoring the patient throughout the interview and determining their main concerns. It is essential to determine whether the patient has suicidal, homicidal or delusional thoughts.
A global assessment of functioning (GAF) is a numerical rating on a scale ranging from zero to 100 that evaluates a person's ability to function in daily life with their ability to cope with the stresses that come with life. The GAF is a crucial part of the mental status examination and helps to guide treatment decisions.
It is crucial to be aware of the fact that observing an individual's behavior can cause distress and it is important to conduct the procedure in a manner that does not cause anxiety for the patient and doesn't be uncomfortable for them. It is also crucial that the patient is fully informed about the purpose of the observation and the amount of time it will take.
Nursing observation is a vital skill that should be a central part of any nursing process. However, it should be kept in mind that patients could be dissatisfied with the quality of observation and if they are unable to reach an agreement with staff then they should be able to access an advocate service that will represent their needs and help patients in any discussions about their treatment. This should be a part of local policy and practice, with the participation and participation of groups of patients.
Questioning
Many people have a hard time talking about their mental health problems, but loved ones are often able to tell the signs of something being wrong. They can also encourage the person to take a look at an assessment. These assessments are broad and cover a range of subjects such as mood, appearance, memory, thinking process and many more. In addition to these tests, the mental health professional will also ask the person questions about their life, including what has been going on recently and what their feelings have been like.
The test also includes a cognitive evaluation, which focuses on the ability of the individual to think clearly and recall information. The person may be asked to complete simple tasks, like focusing their attention on an alphabet of objects or words, memorizing simple lists or solving math problems. The test may also test the ability of the individual to make good decisions and use their judgment. The assessment determines a patient's perception, which is their knowledge of their illness and how it affects them.
Another crucial aspect of the mental health assessment is the person's attitude toward the world, himself and his illness. The tone of voice, the facial expression, and body language of a patient can convey anger, depression or a sense of utter powerlessness. It is important to check whether the patient appears be asking for help or accepting their condition.
In more serious situations, an assessment of mental health might include a look at the patient's thoughts which could include illusions or hallucinations. It is important to note the presence of these conditions as they can be extremely risky and even life-threatening.
In general an assessment of mental health should take a holistic approach and consider the person's connection to their social life. A health professional can use art, music or photos or any other assessment tool to better understand the person. They should also discuss the difficulties that prompted the person to seek help, and reassure them that there is nothing wrong with seeking out an expert in mental health.