Mental Health Nursing - Assessing Mental Health
Mental health assessments often include a physical exam to rule out physical problems. This could involve blood tests or urine tests, as well as brain scans.
Psychologists employ a variety of tools for assessing mental health. They can use tests that are written on paper and pen to in-depth interviews, or self-complete postal questionnaires.
Mood and affect
The affect and mood are the most crucial components of the mental status examination (MSE) and are the first to be observed by the clinician. They describe a patient's general emotional state. This can be anything from sadness to happiness or irritability and anger. The affect can be assessed through facial expressions, general attitude and reaction to internal or external stimuli. You can express your emotions by smiling at the joke or crying when you lose a beloved one.
Affect is a short-term emotion but mood is a longer-lasting emotional state. It is typically described as euthymic, normal, or dysphoric (meaning depressed). However, psychiatric specialists must be careful not to misunderstand the terms since they have different definitions and are affected by a range of factors.
While the MSE is a useful tool for clinical use but it can be difficult to interpret based upon subjective patient reports. Inquiring about the feelings of patients over the past few weeks is more effective than relying on only the observations of a doctor. A recent study showed that a significant proportion of symptoms, including those grouped together under the same disorder category, vary between assessment tools. This could be due to the different emphasis placed on emotional or cognitive symptoms, as well as the different time periods and frequency in symptom reporting.
It is possible that the MSE is based solely on self-reporting, which can be biased. A patient who has a headache and anxiety is likely to get lower scores than a patient reporting only migraine. Additionally there is an inclination for patients to minimize negative feelings and overestimate the severity of positive emotions.
Mood and affect influence the content of thoughts and can affect the way people make decisions, their interpersonal behavior and physical performance. They can be affected by fatigue, stress and social interactions. A positive mood can boost creativity and mental energy. A negative mood can reduce concentration and lead to confusion. A thorough and thoughtful mental health assessment should take into account the patient's mood as well as affect and the underlying factors.
Thought content
One of the most important aspects of a mental state examination is to determine how the patient thinks. Specifically, evaluating thought process and thoughts. The thought process is the coherence, logic and structure of a patient's thoughts. Normal thought processes are rational and goal-oriented. Thought processing can be distorted in a variety of mental health conditions. Examples include hallucinations, delusions and loose associations.
A mental state examination also evaluates insight and judgement. Insight is the ability to see that there is an issue, and judgement is the ability to make a rational decision based on information. Both are affected by a variety of mental health issues such as schizophrenia and depression. If a patient suffers from impaired insight and/or judgement in any way, they are at a higher risk of causing harm to themselves or others. For instance when they are at risk of burning their house down the sensible judgment would tell them to leave the building immediately. However, someone with impaired judgment may decide to stay in the building and trying to put the fire out.
Thought content is the topics, subjects and beliefs that a patient holds. Generally, examiners comment on the clarity, relevance and content of a patient's thoughts. They will note tangential thoughts or circumstantial ones, as well as when a patient is digressing (digressions off from the main topic of the conversation). They will also make comments on the speed of a person's thoughts, such as whether they seem fast or slow.
Other important aspects to consider are whether the patient's thoughts are mood and in tune with their surroundings. For instance, a patient who is depressed may hear voices that are angry and threatening, while a person with schizophrenia might experience a hallucination of the sound of a calm and soothing voice. Ask the patient if they have any suicidal or homicidal ideas. Although these are rare, they can be life-threatening and should be taken into account in every mental health assessment.
Observation
Nurses' observation skills are crucial in a mental health assessment. They are a thorough review of behavior, appearance as well as any unusual beliefs or perceptions (such as hallucinations or delusions) mood, and aspects of cognition (including attention, orientation, memory). A mental health assessment for nursing also involves observing mobility, which includes any physical movement such as eating or drinking, brushing your teeth, using the toilet and taking off shoes.
The observation component of the mental state exam is essential in determining whether the patient is a danger to themselves or anyone else. This is accomplished by determining whether the patient is moving in a way which suggests they are about to harm themself or someone else.
Additionally, a thorough assessment of the content of thoughts is conducted by monitoring the patient throughout the interview and identifying their thoughts and concerns. It is crucial to check if the patient is having suicidal or homicidal ideas and to determine if they are having thoughts of suicide or delusions.
Global assessment of functioning (GAF), a numerical rating from 0 to 100, measures the capacity of a person to perform in everyday life along with their capacity for managing stressors. The GAF is a key part of the mental state exam and helps guide the treatment decisions.
It is important to recognize that observing the behavior of a patient can cause distress. It is therefore important to conduct the procedure in a manner that does not cause discomfort or feel intrusive. It is also crucial 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 should be a central part of the nursing process. However, it should be kept in mind that patients could be dissatisfied with the quality of observation. If they are unable to reach an agreement with staff, then they should be able to access an advocate service which can represent their interests and assist their discussions on their treatment. This should be an integral element of the local observation policy and practice, with the involvement of user groups to ensure that patients are involved in the development of written information as well as staff training on this aspect of clinical governance.
Questioning
A lot of people are hesitant to talk about their mental health issues, but their family members can usually discern when something isn't right. mental health assessments online can also help the person to obtain an assessment. These assessments are broad and cover a range of topics including appearance, mood, memory, thought process and much more. A mental health professional could also ask questions regarding the person's personal life. They will ask them what they feel and what's happened in the last few days.
The test also includes a cognitive test that focuses on the person's ability to think clearly and recall information. The test subject may require the person to complete basic tasks, such as focusing on a list or objects, memorizing lists or solving math questions. The test can also be used to check the person's judgment and ability to make good choices. The test determines a person's insight which is their understanding of their illness and how it affects them.
The attitude of the patient towards himself, others and the illness is an important element of a mental evaluation. The tone of voice, the facial expressions, and body expressions of a patient could signal depression, anger, or a feeling of utter powerlessness. It is important to observe whether the patient seems to be asking for help or accepting their condition.
In more serious instances an assessment of mental health could include a thorough examination of the patient's mental state that could include hallucinations (false sensory perceptions without real stimuli) or illusions (misperceptions of real stimuli). It is important to note the presence of these conditions because they can be extremely dangerous and even life-threatening.
In general an assessment of mental health should take a holistic approach and look at the person's interactions with their social environment. A health professional may employ images, music, art or a range of assessment tools that are electronic to help understand the person and their unique view of the world around them. They should also speak to the person about the challenges that caused them to seek help and assure them that there is nothing wrong with visiting a mental health professional.