Mental Health Nursing - Assessing Mental Health
A physical examination is typically part of mental health tests to rule out any physical ailments. This can include urine tests, blood tests or even brain scans.
Psychologists employ a variety of instruments to evaluate mental health. These tools vary from pencil and paper test forms to in depth interviews or self-completed questionnaires via mail.
Mood and affect
The affect and mood are the most important components of the mental status examination (MSE) and are the first to be observed by the clinician. They define a patient's general emotional tone. This could be anything from sadness to happiness or irritability and anger. Affect can be measured by looking at facial expressions and attitude as well as response to external or internal stimuli (e.g. smiling at a joke or crying at the loss of a loved one).
Affect is a short-term emotion, whereas mood is a longer-lasting emotional state. It is often described as euthymic (normal) or dysphoric, which translates to depressed. However, psychiatrists should be cautious not to mix the two because they have different definitions and are influenced by a variety of factors.
The MSE can be a valuable tool for clinical diagnosis, but it is difficult to interpret from the subjective report of a patient. Asking patients about their feelings over the past few weeks is more helpful than relying on just physician observations. A recent study revealed that a significant proportion of symptoms, even those that fall within the same disorder category, differ between assessment tools. This can be because of the different emphasis placed on emotional or cognitive symptoms, as well as differences between time periods and frequency in the reporting of symptoms.
It is also possible that the MSE is based on self-reporting which is susceptible to bias. For example, a patient who describes experiencing anxiety and headaches will likely report an lower score than someone who has only a headache. Furthermore, there is a tendency for patients to minimize negative feelings and overestimate the severity of positive ones.
Mood and affect have a direct impact on thoughts which influences the way people make decisions, their interpersonal behavior and physical functioning. They are affected by fatigue, stress and social interactions. In fact positive moods have been proven to boost thinking and creativity. Conversely, a negative mood can affect concentration and cause confusion. A thorough and careful mental health assessment should consider the patient's mood and affect and the fundamental factors.
Thought content
One of the most important aspects of a mental state examination is assessing how the patient thinks. Particularly, it is assessing thought process and thoughts. The thought process is the logic, coherence and organization of a patient's thoughts. The normal process of thinking is goal directed and logic-based. Thought processing can be distorted in a variety of mental health conditions. Examples include hallucinations and delusions as well as loose associations.
A mental health assessment also assesses the quality of insight and judgement. Insight is the ability to recognize a problem. Judgment is the capability to make a rational decision after receiving information. Both are impaired in many 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 might suggest they stay in the building to try to get rid of the flame.
Thought content includes the topics, subject matter, and beliefs that a patient holds. Examiners will comment on the clarity, relatedness, and content of thoughts of the patient. They will also note any tangential or circumstantial thoughts and also whether the patient is having flashes of thoughts (digressions from the topic of conversation). They will also comment on the pace at which a person is thinking, such as if they seem to be faster or slower.
Other important aspects to consider are whether the patient's thoughts are mood compatible or not in line with their surroundings. Patients suffering from depression may hear voices of anger, while someone suffering from schizophrenia might experience an illusion that a calm voice is speaking. Ask the patient if they have any suicidal or homicidal ideas. Although they are not common, they can be life-threatening and must be taken into account during every mental health assessment.
Observation
The nurse's ability to watch is essential in an assessment of mental health. They are a thorough review of the appearance, behavior, any unusual beliefs and perceptions (such as hallucinations or delusions) mood, and aspects of cognition (including attention, orientation, memory). mental health assessments near me for nurses also includes observing motility, including any physical movement such as eating drinking, eating, brushing teeth or using the toilet, as well as putting on shoes.
The observation component of the mental health examination is crucial in determining if a patient poses a risk to them or anyone else. This is accomplished by determining whether the patient appears be moving in a deliberate way that suggests they are trying to harm themselves or another person.
A detailed evaluation of the thought-based content is also accomplished by observing the patient during the interview and determining preoccupations. It is crucial to check if the patient is having suicidal or homicidal ideas and to determine if they're experiencing thoughts of delusion.
Global assessment of functioning (GAF) is a numerical rating from 0 to 100, combines the ability of an individual to perform in everyday life with their ability of dealing with stressors. The GAF is a crucial component of the mental state examination and assists in making treatment decisions.
It is crucial to be aware that watching the behavior of a patient can cause distress and it is important to conduct the procedure in a way that does not cause anxiety for the patient and does not make them feel uncomfortable. It is also crucial that the patient is fully informed about the purpose of the observation and the amount of time it will last.
Nursing observation is an essential ability and should be a key element of the nursing process. It is important to remember that patients can disagree with staff about the level of observation. If they are unable to come to an agreement with staff members, they should be able to access an advocate service that can represent their interests and aid them in any discussions regarding their care. This should be a fundamental part of the local policy and practice, including the involvement of user groups, to ensure that patients are a part in the development of written information as well as staff training for this aspect of clinical governance.
Questioning
Many people are reluctant to discuss their mental health issues, however family members can usually detect if something is not right. They can also help the person get an assessment. These assessments be a variety of topics that include mood, appearance and thought process. 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 assessment that focuses on the ability of the person to think clearly and recall information. The test subject may ask to complete basic tasks, such as keeping their attention on a list of words or objects and recollecting lists of basic information or solving math problems. The test can also check the ability of the individual to make good decisions and make good judgments. The assessment also determines the patient's understanding, which reflects their understanding of the illness and its effects on them.
Another crucial aspect of the mental health assessment is the person's attitude toward other people, himself and the illness. The tone of voice, facial expression, and body expressions of a patient could convey anger, depression, or a feeling of helplessness. It is important to check whether the patient appears be asking for assistance or is accepting their situation.
In more serious instances the mental health assessment could include a thorough examination of the patient's mental state that may include hallucinations (false perceptions of sensory stimuli that are not real stimuli) or illusions (misperceptions of real stimuli). These conditions can be extremely dangerous and even deadly.
A mental health assessment must be holistic and focus on the person's interaction with their environment. A health professional can use photographs, music, art or any other assessment tool to better understand the person. They should also speak to the person about the challenges that have caused them to seek assistance and reassure them that there is nothing wrong with seeing a mental health professional.