Mental Health Nursing - Assessing Mental Health
A physical examination is typically included in mental health tests to rule out any physical issues. This could involve blood tests or urine tests, as well as 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
Mood and affect are among the most crucial elements of the mental state exam (MSE) and are the first to be observed by the doctor. They describe the patient's general mood, which can range from happiness to sadness, or even irritability to anger. The degree of affect can be determined by observing facial expressions and overall demeanour as well as the response to external or internal stimuli (e.g. smiling at the joke or crying over the loss of a loved one).
Affect is a feeling that is only temporary, whereas mood is a state of sustained emotion. It is usually described as euthymic or normal, or dysphoric (meaning depressed). However, Iam Psychiatry must be careful not to mix the two as they have varying definitions and are affected by a variety of factors.
The MSE can be a useful tool for clinical diagnosis, but it is difficult to interpret from the subjective report of a patient. It is therefore beneficial to ask patients how they've been feeling over the last few weeks, rather than using only the observation of a physician. Recent research revealed that assessment tools were different in their ability to identify a significant portion of symptoms. This included the symptoms that were classified under the same disorder. This could be due to the different emphasis placed on cognitive or emotional symptoms as well as the different time periods and frequency of symptom reporting.
It is also possible that the MSE relies on self-reports which could be susceptible to bias. For instance, a person who complains of anxiety and headaches is likely to report a lower score than someone who has only a headache. Patients tend to minimize negative emotions while exaggerating positive ones.
The affect and mood of a person directly affect thoughts, which can influence decision-making, interpersonal behaviour, and physical functioning. They can be affected by stress, fatigue and social interactions, as well as global events, hormones and even the weather. A positive mood can actually enhance creativity and mental power. A negative mood can cause confusion and lower concentration. A thorough and careful mental health assessment must be able to consider the patient's mood and affect and the fundamental factors.
Thought content
Assessing how the patient thinks is one the most important aspects of a mental state examination. Specifically, evaluating thought process and thought content. The thought process is the coherence, logic, and organization of a patient’s thoughts. Normal thought processes are rational and focused on a goal. Thought processing can be altered when a person suffers from mental health issues. Examples include hallucinations, delusions and loose associations.
A mental status examination also examines judgment and insight. Insight is the ability to recognize that there is a problem, and judgement is the ability to make an informed decision based on information. Both are affected by several mental health conditions such as depression and schizophrenia. If a patient suffers from impaired insight and/or judgement in any way, they are at greater risk of harming themselves or others. For instance, if they are in danger of burning their house down and they have a good sense of judgement, it would be wise for them to leave the building immediately. A patient with impaired judgment might suggest that they remain in the building to try and put out the flame.
Thought content is the topics, subjects and beliefs that a patient has. Examiners will assess the clarity, relatedness, and content of thoughts of the patient. They will note any thoughts that are circumstantial or tangential, and whether the patient is prone to having a flurry of thoughts (digressions from the subject of conversation). They will also discuss the pace of a person's thoughts, for instance, whether they seem to be fast or slow.
It is also essential to determine if the patient's mood is similar to their environment. For example, a patient who is depressed could hear voices that sound angry and threatening, while those suffering from schizophrenia may have a hallucination of an ethereal and calm voice. Ask the patient if they've had any thoughts of suicide or homicide. They are not common, but they can be life-threatening and should be considered in every mental health evaluation.
Observation
The nurse's ability to watch is crucial in a mental assessment. They involve a thorough evaluation of behavior, appearance, any peculiar beliefs or perceptions (such hallucinations or delusions), mood, and cognition (including memory, attention and orientation). A mental health assessment for nursing also involves observing the ability to move, which includes physical activity like eating drinking, eating, brushing teeth using the toilet and putting on shoes.
The Observation element of the mental state examination is a crucial aspect of determining if the patient is posing a risk to themselves or others. This is done by assessing whether the patient appears to be moving in a deliberate way that suggests they're planning to harming themselves or someone else.
In addition, a comprehensive thought content assessment is made by monitoring the patient throughout the interview and determining their preoccupations. It is essential to determine whether the patient has suicidal, homicidal or delusional thoughts.
Global assessment of functioning (GAF) is which is a numerical score ranging between 0 and 100, evaluates the ability of a person to function in daily life with their ability of coping with stressors. The GAF is an essential part of the mental state examination and assists in making treatment decisions.
It is important to be aware that watching an individual's behavior can cause distress and it is important that the procedure is carried out in a way that doesn't provoke the patient and does not be uncomfortable for them. It is also vital that the patient is aware of the reason for the observation and the amount of time it will last.
Nursing observation is an important skill and it must be a central element of the nursing process. It is important to remember that patients can disagree with staff about the extent of observation. If they are unable to reach an agreement with the staff, they should be able to access an advocate service to represent their interests and assist them in any discussions regarding their care. This should be a part of the local policy and practice, with the involvement and the support of groups of patients.
Questioning
Many people have a difficult to discuss their mental health issues however, family members can often notice the signs that something is not right. They can also encourage the person to seek an assessment. These tests can cover a wide range of topics that include mood, appearance and the thought process. A mental health professional can also inquire regarding the person's personal life. They will ask what they have been feeling and what has happened recently.
The test consists of an assessment of cognitive ability that examines a person's ability to think clearly and retain information. The person could be asked to complete basic tasks, such as paying attention to a list of objects, recollecting lists, or solving math questions. The test can also check the ability of the individual to make sound decisions and make good judgments. The test measures a patient's perception, which is their knowledge of their illness and how it affects them.
The attitude of the patient toward others, himself and the illness is also an important aspect of a mental evaluation. The tone of voice, facial expression, and the body language of a patient can convey anger, depression or a sense of utter powerlessness. It is crucial to determine whether the patient appears seek help or accepting their condition.
In more serious situations, an assessment of mental health could include a thorough examination of the patient's mental state which could include hallucinations or even illusions. These conditions can be harmful and even deadly.
In general the mental health assessment should take a holistic approach and look at the person's relationship to their social life. A health professional may employ images, music, art or a variety of assessment tools that are electronic to help the person understand themselves and their unique view of the world around them. They should also talk about the issues that led to the person to seek help, and assure them that there is nothing wrong with seeking out an expert in mental health.