Mental Health Nursing - Assessing Mental Health
Mental health assessments often include a physical exam to rule out physical ailments. This can include blood tests, urine test or even brain scans.
Psychologists utilize a variety tools for assessing mental health. These range from pen and paper test forms to in-depth interviews or self-complete questionnaires sent to you by post.
Mood and affect
Mood and affect are the most significant components of the mental health exam (MSE) and are the first thing to be observed by a clinician. They are the general emotional state, which can range from happiness to sadness or irritability to anger. Affect can be measured by observing facial expressions and overall attitude as well as reactivity to internal or external stimuli (e.g. smiling at the joke or crying over the loss of a loved one).
Affect is a feeling that lasts only a few minutes while mood is a more sustained emotional state. It is typically described as euthymic, normal, or dysphoric (meaning depression). However, psychiatric specialists should be cautious not to confuse the terms because they have different definitions and are affected by a variety of factors.
While the MSE is a valuable diagnostic tool however, it isn't always easy to interpret based on a subjective patient reports. It is therefore helpful to ask patients how they've felt over the past few weeks, as opposed to relying on physician observation only. A recent study showed that a significant percentage of symptoms, which includes those grouped together within the same disorder category, differ between assessment tools. This could be due to the different emphasis placed on emotional or cognitive symptoms, and also the differences between the time intervals and frequency of reporting symptoms.
It is also possible that the MSE is based on self-reporting which could be susceptible to bias. A patient who has a headache and anxiety is likely to get an lower score than those who report only migraine. Additionally there is an inclination for patients to minimize negative emotions and underestimate the severity of positive emotions.
Affect and mood can have an impact on thought content. This could affect the way people make decisions, their interpersonal behavior and physical performance. They are affected by stress, fatigue and social interactions. In actual fact positive moods have been proven to increase thinking and creativity. A mood that is negative can cause confusion and lower concentration. A thorough and meticulous mental health assessment must take into account both the patient's mood and affect, as well as underlying factors.
Thought content
Examining the way a patient thinks is one of the most crucial aspects of a mental health exam. Assessment of the thought process and its content. The term "thought process" refers to the coherence, logic and organization of a patient's thinking. Normal thought processes are logical and goal-oriented. Thought processing can be distorted when a person suffers from mental health issues. Examples include delusions, hallucinations and loose associations.
Insight and judgement are also evaluated during a mental status exam. Insight is being able to spot problems. Judgment is the capability to make a well-considered choice after receiving information. Both can be impaired in several mental health conditions, such as schizophrenia and depression. If a patient suffers from impaired judgment or insight, they are at a higher chance of harming themselves or others. If they are in danger, their rational judgment would advise them to leave the home immediately. A patient with impaired judgment may suggest that they stay in the building to try and get rid of the flame.
Thought content is the topics, subjects and beliefs that a patient holds. Examiners will comment on the clarity, connection and the content of the thoughts of the patient. They will take note of any thoughts that are circumstantial or tangential or thoughts, and also if the patient has flights of ideas (digressions from the subject of conversation). They will also make comments on a person's pace of thinking, such as whether they seem to be faster or slower.
Other important areas to consider are whether the patient's thoughts are mood and in tune with their environment. For instance, a person who is depressed may hear voices that are aggressive and threatening, whereas a person with schizophrenia might be able to imagine a calm and soothing voice. The patient should be questioned about any homicidal or suicidal thoughts. These are rare but can be life-threatening and should be taken into account during every mental health assessment.
Observation
The observation skills of nurses play an important role in a mental health assessment. They include a careful review of appearance, behaviour as well as any unusual beliefs or perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention to orientation, attention, memory). The nursing mental state exam also involves the observation of motility. This includes any physical movement, such as eating, drinking, or brushing your teeth.
The observation component of the mental state examination is a crucial aspect of determining whether a patient may pose a risk to themselves or others. This is accomplished by determining if the patient appears to be acting in a manner that suggests they are trying to harm themselves or another person.
A detailed assessment of the content of thoughts is also accomplished by observing the patient during the interview and determining preoccupations. It is particularly important to check if the patient is having suicidal or homicidal thoughts and to determine if they're having thoughts of delusion.
Global assessment of functioning (GAF) is a numerical rating between 0 and 100, measures the capacity of an individual to function in daily life with their ability of dealing with stressors. The GAF is an important component of the mental health assessment and aids in making the treatment decisions.
It is crucial to realize that observing the behavior of a patient may cause anxiety. Therefore, it is essential to conduct the procedure in a manner that does not cause discomfort or feel intrusive. It is essential that the patient be fully aware of the reason for the observations and the duration of the process.
Nursing observation is an important ability and should be an integral part of the nursing process. However, it must be remembered that patients may disagree with the level of observation. If they cannot reach an agreement with staff, then they should have access to an advocate service that can represent their interests and assist them in any discussions regarding their treatment. This should be a part of the local policy and practice, with the participation and the support of groups of patients.
Questioning
Many people have a difficult to discuss their mental health issues, but loved ones are often able to tell the signs of something being wrong. They can also assist the person take steps to take an assessment. These assessments can be very broad and cover a variety of topics including appearance, mood as well as memory, thinking process and many more. In addition to these tests, a mental health professional will also ask the individual questions about their life, including what's been happening 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 a few basic tasks, such as focusing their attention on a list of objects or words and recollecting lists of basic information or solving math problems. The test can be used to test the individual's judgment and ability to make informed choices. The test also assesses the patient's understanding that reflects their knowledge of their condition and its effects on them.
Another crucial aspect of an assessment of mental health is the person's attitude toward others, himself and his illness. The tone of voice, the facial expressions, and body language of a patient may convey anger, depression or a sense of utter powerlessness. mental illness assessment is important to observe whether the patient seems to seek help or accepting their condition.
In more serious situations the evaluation of mental health could include a look at the patient's mental state, which may involve illusions or hallucinations. It is important to note the presence of these conditions as they can be extremely hazardous and even life-threatening.
In general an assessment of mental health must be holistic and consider the person's relationship to their social life. A health professional may use art, music or photos or any other assessment tool to gain a better understanding of the individual. They should also speak to the person about the issues that have caused them to seek assistance and reassure them that there is nothing wrong with seeking out an expert in mental health.