Mental Health Nursing - Assessing Mental Health
Mental health assessments often include a physical exam to rule out physical ailments. This could involve blood tests or urine tests, as well as brain scans.
Psychologists also use a wide range of tools to evaluate mental health. These range from tests that are written on paper and pen to deep interviews or self-fill postal questionnaires.
Affect and mood
The affect and mood are the most crucial elements of the mental state exam (MSE) and are the first things to be viewed by the doctor. They define the patient's general emotional tone, which can range from happiness to sadness, or anger to anger. The degree of affect can be determined by watching facial expressions and demeanour as well as the reaction to external or internal stimuli (e.g. smiling at the joke or crying over the loss of a loved one).
Affect is a short-term emotion while mood is a more long-lasting emotional state. It is often described as euthymic (normal) or dysphoric, which means depressed. However, psychiatric professionals should be cautious not to misunderstand the terms as they have varying definitions and are influenced by a variety of factors.
While the MSE is a helpful tool for clinical use but it can be difficult to interpret based upon subjective patient report. It is therefore helpful to ask patients how they have been feeling over the last few weeks, rather than using only the observation of a physician. A recent study revealed that a significant percentage of symptoms, even those that are grouped within the same disorder category, vary between assessment tools. This can be due to the different emphasis placed on cognitive, emotional or physical symptoms, as along with differences in the duration and frequency of reporting symptom reports.
It is possible that the MSE is based on self-reporting which could be susceptible to bias. For example, a patient who complains of anxiety and a headache is likely to report an lower score than a patient who reports only an occasional headache. In addition there is an inclination for patients to minimize negative feelings and overestimate the severity of positive ones.
Affect and mood have a direct impact on the content of thoughts which influences the way we make decisions, our interpersonal behavior and physical functioning. They can be influenced by fatigue, stress social interactions, global events, hormones and the weather. A positive mood can increase creativity and mental strength. A negative mood can reduce concentration and lead to confusion. Therefore, a thorough and thorough mental health assessment needs to consider the patient's mood and state of mind as well as their underlying factors.
Thought content
Examining the way a patient thinks is among the most crucial aspects of a mental state exam. Evaluation of thoughts and their content. The thought process is the coherence, logic and structure of a patient’s thoughts. Normal thought processes are goal directed and logical. In a variety of mental health conditions however, thought processing is altered. Examples include hallucinations, delusions and loose associations.
A mental status examination also examines judgment and insight. Insight is being able to recognize a problem. Judgement is the process to make a well-considered choice after receiving information. Both can be impaired by a variety of mental health issues like depression and schizophrenia. A person who isn't able to see or judgement is more likely to harm themselves or others. For instance, if they are at risk of burning their house down, sensible judgement would tell them to leave the building immediately. A person with impaired judgment might suggest they stay in the house to try to put out the fire.
The thoughts of a patient encompasses their themes, subject matter, and beliefs. Examiners will comment on the clarity, relatedness, and content of thoughts of the patient. They will be able to identify tangential ideas or circumstantial ones, as well as if the patient has digressions (digressions away from the subject of the conversation). They will also make comments on the pace at which a person is thinking, such as if they seem to be faster or slower.
It is also crucial to determine whether the patient's mood is similar to the environment in which they live. mental health assessment test suffering from depression could hear angry voices, whereas a person suffering from schizophrenia may have a hallucination that a soothing voice is speaking. Ask the patient if they've had any thoughts of suicide or homicide. These are rare but can be life-threatening and should be taken into account in every mental health evaluation.
Watching
The ability of nurses to observe is essential in a mental assessment. They include a careful review of behavior, appearance and any strange beliefs or perceptions (such as hallucinations or delusions) mood, as well as aspects of cognition (including attention, orientation memory). The nursing mental status exam also includes the observation of motility. This includes any physical movement like eating, drinking or brushing your teeth.
The observation component of the mental health exam is an essential element of determining whether or not a patient may pose the risk to themselves or others. This is accomplished by determining whether the patient appears to be acting in a manner that suggests they are planning to 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 important to check whether the patient is suffering from suicidal, homicidal, or delusional thoughts.
Global assessment of functioning (GAF) is a numerical rating between 0 and 100, combines the ability of the person to function in daily life with their ability of coping with stressors. The GAF is a crucial component of the mental state examination and helps guide treatment decisions.
It is important to understand that observing the behavior of a patient could cause distress. Therefore, it is essential to conduct the procedure in a manner that doesn't cause or cause discomfort. It is also essential that the patient is informed about the purpose of the observation and the length of time it will last.
Nursing observation is a vital skill that should be the core of any nursing process. It is important to remember that patients can disagree with staff about the level of observation. If they cannot come to an agreement with the staff, they should be able to access an advocate service that can represent their interests and assist them in any discussions regarding their treatment. This should be a fundamental element of the local observation policy and practice with the involvement of user groups, to ensure that patients are included in the creation of written information and staff training on this aspect of clinical governance.
Questioning
Many people are hesitant to discuss their mental health issues, but their family members are often able to tell when something is amiss. They can also help the person to get an assessment. These tests can be extremely broad and cover a variety of topics including mood, appearance and thought process, memory and more. In addition to these tests, mental health professionals will also ask the person questions regarding their personal life, such as what's happened recently and what their emotions have been like.
The test also includes a cognitive assessment that focuses on the ability of the individual to think clearly and recall information. The test subject may ask to complete simple tasks, like focusing their attention on an alphabet of words or objects and recollecting lists of basic information or solving math problems. The test may also test the person's ability to make sound decisions and use judgment. The test determines a person's insight which is their understanding of their illness and how it affects them.
The person's attitude toward others, himself and the illness is an important part of a mental assessment. The tone of voice, the facial expression, and the body expressions of a patient could convey anger, depression or a sense of powerlessness. It is also important to know whether the patient is seeking help or resigned to living with their illness.
In more serious cases, an assessment of mental health could include a thorough examination of the patient's thinking which could include hallucinations or illusions. These conditions can be harmful and even fatal.
In general an assessment of mental health should take a holistic approach and look at the person's interactions with their social life. A health professional can use art, music or photos or any other assessment tool to gain a better understanding of the person. They should also discuss the issues that led to the person to seek help, and reassure them that there is nothing wrong with seeking out an expert in mental health.