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Mental Health Nursing - Assessing Mental Health
A physical examination is typically part of mental health tests to rule out physical conditions. This could involve blood tests and urine tests as well as brain scans.
Psychologists use a variety of tools to assess mental health. They can use tests that are written on paper and pen to deep interviews or self-fill postal questionnaires.
Mood and affect
Mood and affect are among the most crucial components of the mental status examination (MSE) and are the first to be viewed by the medical professional. They are the most accurate indicators of a patient's emotional state. It can vary from joy to sadness or anger and irritability. The affect can be assessed through facial expressions, general demeanor and the response to external or internal stimuli. smiling at an absurd joke or crying over the loss of a loved one).
Affect is an emotion that is temporary, while mood is a long-lasting emotion. It is often described as euthymic (normal) or dysphoric, which translates to depressed. However, psychiatric specialists must be careful not to confuse the terms as they have varying definitions and are affected by a range of factors.
While the MSE is a valuable diagnostic tool however, it can be difficult to interpret based upon subjective patient reports. The process of asking patients to share their experiences over the past few weeks is more effective than relying on just physician observations. Recent research showed that the assessment tools differed in their ability to identify a significant portion of symptoms. This included those that were classified under the same disorder. This can be because of the different emphasis on emotional or cognitive symptoms, as well as differences between time periods and frequency in reporting symptoms.
It is also possible that the MSE is based on self-reporting which is susceptible to bias. For example, a patient who reports anxiety and headaches will likely report a lower score than a person who describes only the sensation of a headache. Patients tend to minimize negative feelings while exaggerating positive feelings.
Mood and affect influence thought content which influences the way we make decisions, our interpersonal behavior and physical functioning. They can be affected by stress, fatigue and social interactions. In actual fact positive moods have been proven to boost creativity and thinking power. A negative mood can cause confusion and lower concentration. Therefore, a careful and thorough mental health evaluation needs to consider the patient's current mood and affect as well as the underlying causes.
Thought content
One of the most crucial elements of a mental status exam is assessing how a patient thinks. Assessment of thoughts and their content. The term "thought process" refers to the coherence, logic, and organization of a patient's thinking. The normal process of thinking is focused and logic-based. In a variety of mental health conditions however, the thought process is distorted. Examples include delusions, hallucinations and loose associations.
Insight and judgement are evaluated during a mental status exam. Insight is the ability to spot problems. Judgment is the capability to make a rational decision after receiving information. Both are impaired in many mental health conditions such as schizophrenia and depression. If a patient has impaired judgment or insight in any way, they are at a higher risk of causing harm to themselves or others. For example if they are in danger 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. However, someone with impaired judgment might recommend staying in the house and attempting to put out the fire.
Thought content is the topics, subject matter, and beliefs that a patient holds. Examiners will comment on the clarity, connection, and content of patient's thoughts. They will note any thoughts that are tangential or circumstantial and also whether the patient is having flashes of ideas (digressions from the conversation subject). They will also provide feedback on the speed at which someone is thinking, such as whether they seem to be more or less fast.
Other important areas to consider are whether the patient's thoughts are mood congruent or incongruent with their environment. For instance, a person who is depressed may hear voices that sound aggressive and threatening, whereas those suffering from schizophrenia may have a hallucination of a calm and soothing voice. A patient should also be asked about any homicidal or suicidal ideation. These are uncommon, but could be life-threatening and should be taken into account in every mental health assessment.
Watching
The observation skills of nurses are crucial in a mental health assessment. They include a careful review of appearance, behaviour and any strange beliefs or perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention, orientation, memory). A mental state examination for nurses also involves observing motility, including any physical activity like eating drinking, eating, brushing teeth, using the toilet and taking off shoes.
The observation component of the mental status exam is an essential element of determining if the patient is posing an imminent risk to themselves or others. This is done by assessing whether the patient is moving deliberately in a way that suggests they are in danger of harming themself or someone else.
Additionally, a thorough thought content assessment is made by observing the patient throughout the interview and determining their thoughts and concerns. It is essential 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 with their ability of coping with stressors. The GAF is an essential part of the mental state examination and assists in making the treatment decisions.
It is essential to be aware that watching a patient's behaviour can cause anxiety and it is crucial to conduct the procedure in a way that does not provoke the patient or make them feel intrusive. It is essential that the patient be fully aware of the goal of the observation and the duration of the procedure.
Nursing observation is an essential skill that must be a central part of any nursing program. However, it should be remembered that patients may 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 that will represent their needs and help their discussions on their care. This should be a fundamental part of the local policy and practice with the involvement of user groups, to ensure that patients are a part in the creation of written documents and staff training to support this aspect of clinical governance.
Questioning
Many people have a difficult to talk about their mental health issues However, loved ones are often able to tell the signs of something being wrong. They can also help the person take steps to obtain an assessment. These assessments be conducted on a variety of topics such as mood, appearance and thought process. In addition to these tests, mental health professionals will also ask the person questions regarding their personal life, such as what's happened recently and what their emotions have been like.
The assessment includes an assessment of cognitive ability that examines a person's ability think clearly and retain information. The person may be asked to complete basic tasks, such as focusing their attention on the list of words or objects and recollecting lists of basic information or solving math problems. The test can also be used to check the ability of the person's judgement and to make sound decisions. The test measures a patient's insight which is their understanding of their condition and how it affects them.
Another vital aspect of a mental health assessment is the person's attitude toward the world, himself and his illness. The tone of voice, facial expressions, and body language of a patient may indicate depression, anger, or a feeling of utter powerlessness. It is important to check whether the patient appears to seek assistance or is accepting their situation.
In more serious situations the mental health assessment could include a thorough assessment of the patient's thinking that may include hallucinations (false sensory perceptions that do not correspond to real stimuli) or illusions (misperceptions of real stimuli). These conditions can be extremely dangerous and even deadly.
In general an assessment of mental health should be holistic and look at the person's interactions with their social world. A health professional may employ images, music, art or a range of electronic assessment tools to help the person understand themselves and their unique perspective on the world around them. They should also speak to the person about the issues that have led them to seek help and assure them that there is nothing wrong with seeking out an expert in mental health.