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Mental Health Nursing - Assessing Mental Health
A physical exam is usually included in mental health assessments to rule out any physical conditions. These can include blood tests, urine testing, or even brain scans.
Psychologists employ a variety of tools to assess mental health. These range from pen and paper test forms to in-depth interviews, or self-complete postal questionnaires.
Affect and mood
The affect and mood are the most crucial components of the mental status examination (MSE) and are the first thing to be viewed by the medical professional. They define the patient's general emotional state that can range from joy to sadness, or anger to anger. Affect can be measured by looking at facial expressions and demeanour as well as the reaction to external or internal stimuli (e.g. smiling at a joke or crying at the loss of a loved one).
Affect refers to an emotion that is temporary, whereas mood is a state of constant emotion. It is usually described as euthymic or dysphoric, or normal (meaning depression). However, psychiatrists must be careful not to misunderstand the terms because they have different definitions and are influenced by a variety of factors.
While the MSE is a helpful clinical tool but it can be difficult to interpret based on a subjective patient reports. It is therefore beneficial to ask patients how they've been feeling over the last few weeks, as opposed to relying on physician observation only. private mental health assessment near me 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 could be due to the different emphasis on emotional or cognitive symptoms, as well as differences between time periods and frequency in symptom reporting.
It is possible that the MSE relies on self-report which is susceptible to bias. A patient who reports both anxiety and headache is likely to have an lower score than a patient reporting only migraine. Patients tend to minimize negative feelings while exaggerating positive feelings.
Mood and affect directly affect thoughts and can affect decision-making, interpersonal behaviour, and physical functioning. They are affected by stress, fatigue and social interactions. In reality, a positive mood has been proven to increase thinking and creativity. A negative mood can cause confusion and reduce concentration. Therefore, a careful and thorough mental health assessment needs to take into account the patient's current mood and affect as well as their underlying factors.
Thought content
Examining the way a patient thinks is one of the most important aspects of a mental state examination. Particularly, it is assessing thought process and thoughts. Thought process refers the logic, organization and coherence of a patient's thought processes. The normal process of thinking is focused and logical. In many mental health disorders however, the thought process is distorted. Examples include hallucinations and delusions as well as loose associations.
A mental status examination also examines judgment and insight. Insight is the ability to spot problems. Judgement is the process to make a well-considered choice after receiving information. Both can be impaired by several mental health conditions such as depression and schizophrenia. If a patient is impaired in judgment or insight in any way, they are at greater risk of causing harm to themselves or others. For instance if they are at risk of burning their home down the sensible judgment would tell that they should leave the premises immediately. However, someone with impaired judgment may recommend staying in the house and attempting to put out the fire.
The content of a patient's thoughts includes the subject matter, themes, and beliefs. Examiners generally comment on the clarity, relatedness and the content of a patient's thoughts. They will note tangential thoughts or those that are merely circumstantial, and in the event that the patient's thoughts diverge (digressions away from the topic of the conversation). They will also comment on a person's pace of thinking, for example, if they seem to be more or less fast.
It is also important to determine if the patient's mood is similar to their environment. For example, a patient who is depressed might hear voices that sound angry and threatening, while someone suffering from schizophrenia could 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 but they could be life-threatening and must be taken into consideration in every mental health evaluation.
Observation
The nurse's ability to watch is crucial in the mental assessment. They are a thorough 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 the environment, orientation memory). The nursing mental status exam also involves the observation of the movement. This includes any physical movement, like eating, drinking and brushing your teeth.
The observation component of the mental state examination is vital in determining if a patient poses a risk to themselves or anyone else. This is accomplished by determining whether the patient appears be acting in a deliberate way that suggests they're trying to harming themselves or someone else.
In addition, a detailed assessment of thought content is done by monitoring the patient throughout the interview and determining their thoughts and concerns. It is important to check whether the patient is suffering from suicidal, homicidal or delusional thoughts.
Global assessment of functioning (GAF) which is which is a numerical score ranging between 0 and 100, measures the capacity of an individual to function in daily life with their ability of coping with stressors. The GAF is a crucial component of the mental state exam and helps guide treatment decisions.
It is essential to be aware of the fact that observing an individual's behavior can cause anxiety and it is crucial to conduct the procedure in a manner that does not cause anxiety for the patient and does not make them feel uncomfortable. It is important that the patient be fully aware of the reason for the observations and the duration of the process.
Nursing observation is an essential skill and it must be a central element of the nursing process. However, it must be remembered that patients may disagree with the level of observation and if they are unable to come to an agreement with staff then they should be able to access an advocate service which can represent their needs and help patients in any discussions about their care. This should be a fundamental part of the local policy and practice, including the involvement of user groups, to ensure that patients are included in the creation of written documents and staff training to support this aspect of governance in the clinic.
Questioning
Many people are hesitant to discuss their mental health issues, but family members are often able to detect if something is not right. They can also help the person to take a look at an assessment. These assessments are broad and cover a wide range of topics including mood, appearance as well as memory, thinking process and more. A mental health professional can also ask questions about the person's personal life. They will ask what they've been feeling and what's happened in the last few days.
The test consists of a cognitive evaluation that examines a person's ability to think clearly and remember information. The test taker may be asked to complete simple tasks, such as keeping 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 person's ability to make good decisions and make good judgments. The assessment determines a patient's perception, which is their knowledge of their illness and how it affects them.
The person's attitude towards others, himself and the illness is an important part of a mental evaluation. The patient's tone of voice, facial expression and body language can indicate anger, hostility depression or a feeling of insecurity. It is also important to determine whether the patient is seeking help or is content living with their health condition.
In more serious instances the evaluation of mental health may include a look at the patient's thoughts, which may involve hallucinations or illusions. These conditions can be dangerous and even deadly.
In general, a mental health assessment should take a holistic approach and examine the person's relationship to their social life. A health professional can use art, music or photos or any other electronic assessment tool to gain a better understanding of the individual. They should also discuss the difficulties that prompted the person to seek help, and assure that there is nothing wrong with seeing an expert in mental health.