Mental Health Nursing - Assessing Mental Health
Mental health assessments typically include a physical exam, to rule out physical ailments. These can include blood tests, urine tests or even brain scans.
Psychologists also employ a range of tools to evaluate mental health. These tools vary from pencil and paper test forms, to in-depth interviews or self-completed questionnaires via mail.
Affect and mood
The clinician will first notice the patient's mood and affect. They define the patient's general emotional state, which can range from joy to sadness, or anger to anger. Affect can be measured by watching facial expressions and manner of speaking as well as the reaction to external or internal stimuli (e.g. You can express your feelings by smirking at the joke or crying when you lose a beloved one.
Affect refers to an emotion that is temporary, whereas mood is a long-lasting emotion. It is often described as euthymic (normal) or dysphoric, meaning depressed. 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 valuable tool for clinical use but it isn't always easy to interpret based upon subjective patient reports. It is therefore beneficial to inquire about how patients have been feeling over the last few weeks, as opposed to using only the observation of a physician. Recent research revealed that assessment instruments differed in their capacity to detect a substantial part of symptoms. This included those that were grouped 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 the reporting of symptoms.
It is possible that the MSE relies on self-reporting, which can be biased. For assessing mental health , a person who describes experiencing anxiety and headaches is likely to report less than a person who describes only a headache. In addition there is a tendency for patients to minimize negative emotions and overestimate the severity of positive emotions.
The affect and mood of a person directly affect thoughts which influences the way we make decisions, our interpersonal behavior and physical functioning. They can be affected by stress, fatigue and social interactions, as well as global events, hormones and weather. In fact positive moods have been shown to enhance creativity and thinking power. A negative mood can lead to confusion and reduce concentration. Therefore, a careful and thorough mental health assessment is required to consider the patient's current mood and emotional state as in addition to the underlying causes.
Thought content
One of the most important aspects of a mental state examination is assessing how the patient thinks. Evaluation of thoughts and their content. Thought process refers to the coherence, logic, and organization of a patient's thinking. The normal process of thinking is objective-oriented and logic-based. In many mental health disorders, however, thought processing is altered. Examples include hallucinations, delusions and loose associations.
Insight and judgement are also assessed during a mental state exam. Insight is being able to identify a problem. Judgment is the ability of making a well-considered decision after receiving information. Both are affected by various mental health conditions such as depression and schizophrenia. If a patient suffers from impaired judgment and/or insight, they are at a higher risk of harming themselves or others. For example, if they are at risk of burning their house down and they have a good sense of judgement, it would be wise for them to leave the building immediately. However, someone with impaired judgment may recommend staying in the house and attempting to put the fire out.
Thought content is the topics, subject matter, and beliefs that a patient holds. Examiners will evaluate the clarity, relatedness and content of a patient's thoughts. They will also note any tangential or circumstantial thoughts, and whether the patient is prone to having a flurry of thoughts (digressions from the conversation subject). They will also make comments on the speed of someone's thoughts, for instance, whether they seem to be fast or slow.
Other important areas to consider are whether the patient's thoughts are mood compatible or not in line with their surroundings. For instance, a person who is depressed may hear voices that are hostile and frightening, whereas a person with schizophrenia might have a hallucination of the sound of a calm and soothing voice. Ask the patient if they've had any thoughts of suicide or homicide. Although these are rare however, they can be life threatening and should be taken into consideration in every mental health evaluation.
Watching
The nurse's ability to observe is vital in a mental assessment. They are a thorough examination of appearance, behavior as well as any peculiar beliefs or perceptions (such hallucinations or delusions), mood, and cognition (including attention, memory, orientation). A nursing mental status examination also incorporates observation of motility, including any physical movement, such as eating or drinking, brushing your teeth, using the toilet and taking off shoes.
The Observation portion of the mental health examination is crucial in determining if the patient is a danger to themselves or anyone else. This is determined by assessing whether the patient appears to be moving in a way which suggests they are in danger of harming themselves or anyone else.
In addition, a comprehensive assessment of the content of thoughts is conducted by keeping track of the patient throughout the interview and identifying their main concerns. It is essential to determine if the patient is having suicidal or homicidal ideas and to determine if they are having thoughts of delusion.
A global assessment of functioning (GAF) is an evaluation of the numerical value on a scale ranging from 0 to 100 that combines a person's ability to function in daily life and their ability to deal with the stresses in their lives. The GAF is a crucial component of the mental health examination and helps guide treatment decisions.
It is crucial to realize that observing the behavior of a patient can cause anxiety. It is therefore important that the process be conducted in a manner that doesn't cause or make the patient feel uncomfortable. It is also vital that the patient is fully informed about the purpose of the observation and the amount of time it will last.
Nursing observation is a vital skill that must be the core of any nursing process. However, it should be remembered that patients may not agree with the degree of observation and if they are unable to come to an agreement with the staff, they should have access to an advocate service that can represent their interests and assist patients in any discussions about their treatment. This should be a fundamental part of local observation policy and practice, with the involvement of user groups, to ensure that patients are included in the creation of written information and staff training to support this aspect of governance in the clinic.
Questioning
Many people are hesitant to discuss their mental health issues, however family members can often tell when something is amiss. They can also assist the person get an assessment. These tests can be extremely broad and cover a variety of subjects, such as mood, appearance, memory, thinking process and more. A mental health professional may also inquire regarding the person's personal life. They will ask what they have been feeling and what's happened in the last few days.
The test consists of a cognitive evaluation that examines a person's ability think clearly and retain information. The test taker may be asked to complete simple tasks, such as keeping their attention on a list of objects or words as well as storing lists and lists for solving math problems. The test may also test 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 attitude of the patient toward others, himself and the illness is an important part of a mental assessment. The patient's tone of voice, facial expression and body language can convey hostility, anger depression or a feeling of insecurity. It is crucial to determine whether the patient seems to be asking for assistance or is accepting their situation.
In more serious cases, a mental health assessment might include an assessment of the patient's thinking, which could involve hallucinations (false perceptions of sensory stimuli that are not real stimuli) or illusions (misperceptions of real stimuli). It is vital to be aware of the presence of these disorders because they can be extremely risky 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 world. A health professional could use images, music, art or a variety of assessment tools using electronic technology 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 assistance and assure them that there is nothing wrong with seeking out an expert in mental health.