Mental Health Nursing - Assessing Mental Health
A physical exam is often part of mental health assessments to rule out physical conditions. This can include urine tests, blood tests test or even brain scans.
Psychologists also utilize a variety of tools to assess mental health. These tools range from paper and pencil test forms to more in-depth interviews or self-completed questionnaires for postal mail.
Affect and mood
Mood and affect are the most important components of the mental status examination (MSE) and are the first to be observed by a doctor. They are the general mood, which can range from joy to sadness or irritability to anger. Affect can be measured by observing facial expressions and overall manner of speaking as well as the response to external or internal stimuli (e.g. smiling at an absurd joke or crying over the loss of a loved one).
Affect refers to an emotion that is only temporary, whereas mood is a long-lasting emotion. It is often described as euthymic (normal) or dysphoric, which translates to depressed. Professionals in psychiatry must be careful to not confuse the two terms, as they are different in their definition and can be affected by many factors.
The MSE is a helpful tool for clinical diagnosis however, it can be difficult to interpret based on a subjective patient report. Asking patients about their feelings in the last few weeks is more helpful than relying on only the observations of a doctor. Recent research has revealed that assessment tools differed in their ability to capture a significant part of symptoms. This included the symptoms that were classified under the same disorder. This can be because of the different emphasis on cognitive or emotional symptoms as well as the different time periods and frequency of the reporting of symptoms.
It is possible that the MSE relies on self-reporting which could be biased. For instance, a person who complains of a headache and anxiety will likely report a lower score than a patient who reports only the sensation of a headache. Patients tend to minimize negative feelings while exaggerating positive ones.
Affect and mood influence the content of thoughts and can affect the way people make decisions, their interpersonal behavior and physical performance. They can be affected by stress, fatigue and social interactions, as well as world events, hormones and weather. Positive moods can increase creativity and mental strength. A negative mood can affect concentration and cause confusion. Therefore, a careful and thorough mental health assessment needs to take into account the patient's current mood and state of mind as well as the underlying causes.
Thought content
Examining the way a patient thinks is among 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. The normal process of thinking is focused and rational. In many mental health disorders, however, thought processing can be altered. Examples include hallucinations and delusions as well as loose associations.
A mental status examination also assesses the quality of insight and judgement. Insight is the ability to recognize that there is a problem, while judgement is the ability to make a considered decision when presented with information. Both are impaired in various mental health conditions, such as depression and schizophrenia. If a patient has impaired judgment and/or insight, they are at a higher risk of harming themselves or others. For instance if they are at risk of destroying their home, sensible judgement would tell them to leave the building immediately. However, a patient with impaired judgment may recommend staying in the house and trying to put the fire out.
Thought content refers to the topics, subject matter, and beliefs that a patient has. Examiners generally comment on the clarity, relatedness and content of a patient's thinking. They will note any thoughts that are circumstantial or tangential or thoughts, and also if the patient has flights of thoughts (digressions from the subject of conversation). They will also comment on the speed of someone's thoughts, such as whether they seem fast or slow.
assess your mental health to consider are whether the patient's thoughts are and in tune with their environment. A person suffering from depression could hear angry voices, whereas a person suffering from schizophrenia may have a hallucination that a soothing voice is speaking. A patient should also be asked about any suicidal or homicidal thought. They are not common, but they can be life-threatening and should be considered during every mental health assessment.
Watching
The ability of nurses to observe is crucial in a mental assessment. They involve a thorough evaluation of behavior, appearance, any unusual beliefs or perceptions (such delusions or hallucinations) and mood cognition (including memory, attention, orientation). The nursing mental status exam also involves observing the movement. This is any physical activity, like eating, drinking and brushing teeth.
The observation component of the mental state exam is essential in determining whether the patient is a danger to them or others. This is determined by assessing whether the patient appears to be acting in a manner that suggests they are trying to harming themselves or someone else.
In addition, a comprehensive assessment of thought content is done by monitoring the patient throughout the interview and identifying their thoughts and concerns. It is crucial to determine whether the patient is experiencing suicidal, homicidal or delusional thoughts.
Global assessment of functioning (GAF) is which is a numerical score ranging from 0 to 100, evaluates the ability of an individual to function in daily life along with their capacity for managing stressors. The GAF is a crucial part of the mental status exam and assists in guiding treatment decisions.
It is important to understand that observing the behavior of a patient could cause distress. It is crucial that the process be conducted in a way that doesn't cause or cause discomfort. 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 essential skill that must be the core of any nursing process. However, it should be kept in mind that patients could be dissatisfied with the quality of observation. If they are unable to come to an agreement with staff, then they should be able to access an advocate service that can represent their interests and support them in any discussions regarding their treatment. This should be a fundamental part of the local policy and practice, with the involvement of user groups to ensure that patients are involved in the creation of written documents and staff training on this aspect of clinical governance.
Questioning
Many people have a hard to discuss their mental health problems however, family members are often able to tell when something is wrong. They can also assist the person to take an assessment. These assessments are broad and cover a range of subjects such as mood, appearance and thought process, memory and much more. A mental health professional can also ask questions regarding the person's personal life. They'll ask them what they have been feeling and what has happened recently.
The assessment also includes a cognitive evaluation, which focuses on the person's ability to think clearly and remember information. The person may be asked to complete simple tasks, such as focusing their attention on a list of words or objects as well as storing lists and lists for solving math problems. The test can also check the ability of the individual to make good decisions and use judgment. The test measures a patient's perception, which is their knowledge of their condition and how it affects them.
Another crucial aspect of an assessment of mental health is the person's attitude toward the world, himself and his illness. The patient's tone of expression, facial expression and body language can convey hostility, anger, depression or a sense of helplessness. It is also important to know whether the patient appears to be seeking help or is content living with their health condition.
In more serious instances, an assessment of mental health may include a thorough examination of the patient's mental state that may include illusions or hallucinations. These conditions can be harmful and even fatal.
A mental health assessment must be comprehensive and look at the person's interaction with their environment. A health professional might use photographs, music, art or a range of assessment tools using electronic technology to help understand the person and their unique view of the world around them. They should also talk to the person about the issues that have caused them to seek assistance and reassure them that there is nothing wrong with seeing a mental health professional.