10 Things That Everyone Is Misinformed About Assessing Mental Health
Mental Health Nursing - Assessing Mental Health
A physical exam is often part of mental health assessments to rule out physical conditions. These can include blood tests, urine tests or even brain scans.
Psychologists also employ a variety of tools to assess mental health. These tools can be anything from pencil and paper test forms to more in-depth interviews or self-completed questionnaires via mail.
Affect and mood
Mood and affect are the most important elements of the mental state examination (MSE) and are the first things to be viewed by the clinician. They define a patient's general emotional state. This can range from happiness to sorrow or anger and irritability. The effect can be analyzed through facial expressions, overall attitude and reaction to external or internal stimuli. You can express your feelings by smiling at a joke, or crying when you lose a loved one.
Affect refers to an emotion that is temporary, while mood is a state of sustained emotion. It is usually described as euthymic, or normal, or dysphoric (meaning depression). However, psychiatric specialists should be cautious not to confuse the terms since they have different definitions and are influenced by a variety of factors.
While the MSE is a helpful diagnostic tool but it isn't always easy to interpret based on subjective patient reports. Asking patients about their feelings over the past few weeks is more effective than relying on just physician observations. A recent study found that a significant proportion of symptoms, even those that are grouped under the same disorder category, vary between assessment tools. This can be because of the different emphasis placed on emotional or cognitive symptoms, as well as the different the time intervals and frequency of symptom reporting.
It is possible that the MSE relies solely on self-reporting, which could be biased. For example, a patient who describes experiencing a headache and anxiety will likely have less than a person who describes only the sensation of a headache. Patients tend to minimize negative feelings while exaggerating positive ones.
Affect and mood can have a direct influence on the content of thought. This can impact decision-making, interpersonal behavior, and physical performance. They are influenced by fatigue, stress, social interactions, world events, hormones and the weather. Positive moods can increase creativity and mental strength. A negative mood can lead to confusion and reduce concentration. A thorough and meticulous mental health assessment must be able to consider both the patient's mood and affect and the fundamental factors.
Thought content
One of the most essential elements of a mental status examination is to determine how the patient thinks. Particularly, it is assessing thought process and thoughts. The term "thought process" refers to the coherence, logic, and organization of a patient's thoughts. The normal process of thinking is focused and logic-based. In many mental health disorders, however, thought processing is distorted. Examples include hallucinations, delusions and loose associations.
Insight and judgement are also evaluated during a mental status exam. Insight is the ability to identify a problem. Judgement is the process to make a rational decision after receiving information. Both can be impaired by various mental health conditions such as schizophrenia and depression. If a patient suffers from impaired judgment and/or insight is at a higher chance of harming themselves or others. For instance, if they are in danger of burning their house down the sensible judgment would tell that they should leave the premises immediately. A patient with impaired judgement might suggest they stay in the building to try to put out the flame.
Thought content is the subject matter, themes and beliefs that a patient holds. Examiners generally comment on the clarity, relatedness and content of a patient's thoughts. what is mental health assessment 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 make comments on a person's pace of thinking, such as whether they seem to be more or less fast.
Other important aspects to consider are whether the patient's thoughts are compatible or not in line with their surroundings. For instance, a patient who is depressed could hear voices that sound aggressive and threatening, whereas a person with schizophrenia might be able to imagine a calm and soothing voice. Ask the patient if they've had any thoughts of suicide or homicide. Although they are not common however, they can be life threatening and should be taken into account during every mental health assessment.
Observation
Nurses' observation skills play an important role in an assessment of mental health. They are a thorough examination of behavior, appearance and any unusual beliefs or perceptions (such hallucinations or delusions) mood, cognition (including memory, attention, orientation). The nursing mental status exam is also a way of observing motility. This is any physical activity, such as eating, drinking and brushing your teeth.
The observation component of the mental health examination is a key component of determining if the patient could pose the risk to themselves or others. This is done by assessing whether the patient appears be acting in a way that suggests they are about harm themselves or another person.
In addition, a detailed thought content assessment is made by keeping track of the patient throughout the interview and identifying their thoughts and concerns. It is essential to determine whether the patient is suffering from suicidal, homicidal, or delusional thoughts.
Global assessment of functioning (GAF), an assessment of functioning in numerical form, ranging between 0 and 100, combines the ability of the person to perform in everyday life and their capability of managing stressors. The GAF is an important element of the mental state assessment and aids in making treatment decisions.
It is essential to be aware that watching an individual's behavior could cause anxiety, and it is essential that the process is conducted in a way that does not cause anxiety for the patient and does not be uncomfortable for them. It is important that the patient is aware of the reason for the observation and the duration of the procedure.
Nursing observation is an important ability and should be an integral element of the nursing process. It is important to remember that patients might disagree on the extent of observation. If they cannot reach a consensus with staff members, they must be able access an advocate service that can represent their interests and aid them in any discussions about their treatment. This should be an integral part of local observation policy and practice, including the involvement of user groups to ensure that patients are a part in the development of written documents and staff training to support this aspect of clinical governance.
Questioning
Many people are hesitant to talk about their mental health issues, however family members can usually discern when something isn't right. They can also encourage the person to take a look at an assessment. These tests can be extremely broad and cover a variety of subjects such as mood, appearance as well as memory, thinking process and much more. A mental health professional can also ask questions about the person's personal life. They'll ask them what they've been feeling and what has happened recently.
The assessment includes an evaluation of the cognitive capacity which focuses on an individual's ability think clearly and retain information. The test subject may require the person to complete simple tasks such as focussing on a list or objects, recollecting lists or solving math questions. The test can also be used to check the individual's judgment and ability to make informed choices. The test determines a person's perception, which is their knowledge of their condition and how it affects them.
The attitude of the patient towards himself, others and the illness is an important part of a mental assessment. The tone of voice, the facial expressions, and body language of a patient may indicate depression, anger or a sense of utter powerlessness. It is important to observe whether the patient appears be seeking help or accepting their condition.
In more serious cases an assessment of mental health could include a thorough examination of the patient's thoughts, which could involve 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 risky and even life-threatening.
In general, a mental health assessment should be holistic and consider the person's relationship to their social world. A health professional can use images, music, or art, or any other electronic assessment tool to gain a better understanding of the person. They should also talk about the challenges that led the person to seek help, and assure that there is nothing wrong in seeing a mental healthcare professional.