Mental Health Nursing - Assessing Mental Health
A physical exam is often part of mental health tests to rule out physical ailments. These can include urine tests, blood testing, or even brain scans.
Psychologists utilize a variety instruments to evaluate mental health. They can use pen and paper test forms to in-depth interviews, or self-complete questionnaires sent to you by post.
Mood and affect
The doctor will first observe the patient's mood and affect. They are the general emotional state, which can range from joy to sadness, or anger to anger. Affect can be assessed by observing facial expressions and overall manner of speaking as well as the 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 is temporary, while mood is a state of sustained emotion. It is usually described as being either euthymic (normal) or dysphoric, meaning depressed. However, psychiatrists should be cautious not to mix the two because they have different definitions and are influenced by a variety of factors.
While the MSE is a useful diagnostic tool, it can be difficult to interpret based on subjective patient reports. It is therefore beneficial to ask patients how they have felt over the past few weeks, instead of using only the observation of a physician. Recent research 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 placed on emotional or cognitive symptoms, as well as differences between time periods and frequency in the reporting of symptoms.
It is possible that the MSE is based solely on self-reporting, which could be biased. For instance, a patient who describes experiencing a headache and anxiety is likely to report less than a patient who reports only an occasional headache. Additionally, there is the tendency for patients to downplay negative emotions and overestimate the severity of positive feelings.
Mood and affect have a direct impact on thoughts which influences decision-making, interpersonal behaviour, and physical functioning. They can be affected by stress, fatigue and social interactions, as well as world events, hormones, and the weather. In actual fact positive moods have been proven to boost thinking and creativity. A mood that is negative can cause confusion and decrease concentration. Therefore, a careful and thorough mental health assessment is required to consider the patient's mood and emotional state as in addition to the underlying causes.
Thought content
Examining the way a patient thinks is among the most important aspects of a mental state examination. Evaluation of thoughts and their content. The thought process is the coherence, logic and structure of a patient's thoughts. Normal thought processes are logical and focused on a goal. In many mental health disorders however, thought processing is distorted. Examples include hallucinations and delusions as well as loose associations.
A mental state examination also assesses the quality of insight and judgement. Insight is the ability to see that there is a problem, and judgement is the ability to make an informed decision when presented with information. Both can be impaired in many mental health conditions like schizophrenia and depression. If a patient is impaired in judgment and/or insight is at greater risk of harming themselves or others. For instance if they are at risk of burning their home down and they have a good sense of judgement, it would be wise for that they should leave the premises immediately. A person with impaired judgment might suggest that they remain in the house to try to get rid of the fire.
Thought content refers to the subject matter, themes and beliefs that a patient has. Examiners will evaluate the clarity, relatedness, and content of thoughts of the patient. They will also note tangential thoughts or circumstantial ones, and in the event that the patient's thoughts diverge (digressions off from the main topic of the conversation). They will also make comments on a person's pace of thinking, such as whether they seem fast or slower.
Other important aspects to consider are whether the patient's thoughts are and in tune with their surroundings. For instance, a person who is depressed may hear voices that are hostile and frightening, whereas someone suffering from schizophrenia could be able to imagine the sound of a calm and soothing voice. A patient should be asked about any suicidal or homicidal thought. They are not common, but they can be life-threatening and should be taken into account in every mental health assessment.
Watching
A nurse's observation skills play an important role in an assessment of mental health. They include a careful examination of appearance, behavior as well as any unusual beliefs or perceptions (such delusions or hallucinations) and mood cognition (including memory, attention, orientation). The mental status exam for nurses also includes the observation of the movement. This includes any physical movement such as eating, drinking and brushing teeth.
The observation component of the mental state exam is essential in determining whether a patient poses a risk to them or others. This is accomplished by determining whether the patient appears to be acting in a way that suggests they're trying to harm themselves or another person.
A detailed assessment of the thought-based content is also made by monitoring the patient during the interview and determining preoccupations. It is particularly important to determine if the patient has any suicidal or homicidal thoughts and to determine if they're experiencing delusions.
Global assessment of functioning (GAF), a numerical rating from 0 to 100, evaluates the ability of an individual to perform in everyday life along with their capacity for managing stressors. The GAF is a vital element of the mental state assessment and aids in making treatment decisions.
It is important to recognize that observing the behaviour of a patient can cause anxiety. It is crucial to conduct the procedure in a manner that does not cause discomfort or cause discomfort. It is also crucial that the patient is aware of the reason for the observation and the length of time it will take.
Nursing observation is a crucial skill that must be the core of any nursing program. It is essential to remember that patients might disagree on the level of observation. If they cannot reach a consensus with staff, they should be able to access an advocate service to represent their interests and aid them in any discussions about their treatment. This should be a fundamental part of the local policy and practice, with the participation of user groups to ensure that patients are a part in the creation of written documents and staff training to support this aspect of governance in the clinic.
Questioning
A lot of people are hesitant to discuss their mental health issues, but family members can usually discern when something isn't right. They can also help the person to get an assessment. These assessments can be very broad and cover a range of topics such as mood, appearance and thought process, memory and much more. In addition to these tests, mental health professionals will also ask the individual questions about their personal life, including what has been going on recently and what their emotions have been like.
The assessment also includes a cognitive assessment that is focused on the ability of the individual to think clearly and recall information. The test taker may be asked to complete a few basic tasks, like focusing their attention on a list of words or objects, memorizing simple lists or solving math problems. The test can also check the ability of the individual to make good decisions and use judgment. The test determines a person's awareness, which is the understanding of their illness and how it affects them.
Another crucial aspect of an assessment of mental health is the patient's attitude towards other people, himself and the illness. The patient's tone of expression, facial expression and body language may convey hostility, anger depression or a feeling of insecurity. It is also important to determine whether the patient is seeking help or just living with their illness.
In mental health assessments , a mental health assessment may include an examination of the patient's mental state that may include hallucinations (false perceptions of sensory stimuli that are not real stimuli) or illusions (misperceptions of real stimuli). It is important to note the presence of these conditions as they can be extremely dangerous and even life-threatening.
In general an assessment of mental health should be holistic and examine the person's connection to their social world. 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 discuss the issues that led to the person to seek help, and assure them there is nothing wrong with seeing a mental health professional.