Mental Health Nursing - Assessing Mental Health
A physical examination is typically part of mental health assessments to rule out physical ailments. This can include urine tests, blood test or even brain scans.
Psychologists utilize a variety tools for assessing mental health. These range from pen and paper test forms to in-depth interviews or self-complete questionnaires sent to you by post.
Mood and affect
Mood and affect are the most significant elements of the mental state exam (MSE) and are the first things to be observed by a clinician. They define the patient's general emotional tone, which can range from happiness to sadness, or even irritability to anger. Affect can be assessed by observing facial expressions and overall manner of speaking as well as the reaction to external or internal stimuli (e.g. You can express your emotions by smirking at an absurd joke, or crying when you lose a loved one.
Affect is a temporary emotion, whereas mood is a more long-lasting emotional state. It is typically described as euthymic, or dysphoric, or normal (meaning depressed). Professionals in psychiatry must be careful to avoid confusion between the terms, as they are different in their definition and can be affected by various factors.
The MSE is a helpful instrument for diagnosing clinical conditions however, it can be difficult to interpret from an individual patient's report. The process of asking patients to share their experiences during the past few weeks is more helpful than relying solely on observations from a physician. A recent study showed that a significant proportion of symptoms, which includes those that are grouped within the same disorder category, differ between assessment tools. This could be due to the different emphasis on cognitive, emotional or physical symptoms, as along with differences in time periods and frequency of reporting symptom reports.
It is also possible that the MSE relies on self-report which could be susceptible to bias. For instance, a person who describes experiencing a headache and anxiety will likely have a lower score than a person who describes only the sensation of a headache. Patients tend to minimize negative emotions while exaggerating positive ones.
Affect and mood can have an impact on thought content. This can affect decision-making, interpersonal behavior, and physical performance. They are affected by stress, fatigue and social interactions. A positive mood can enhance creativity and mental power. A mood that is negative can cause confusion and reduce concentration. A thorough and meticulous mental health assessment must take into account the patient's mood and affect and the underlying factors.
Thought content
One of the most important elements of a mental status examination is to determine how the patient thinks. Particularly, it is assessing thought process and thought content. The term "thought process" refers to the coherence, logic, and organization of a patient's thinking. Normal thought processes are goal directed and rational. Thought processing can be altered when a person suffers from mental health issues. Examples include hallucinations, delusions, and loose associations.
A mental status examination also evaluates insight and judgement. Insight is the ability to spot problems. Judgment is the capability to make a well-considered choice after receiving information. Both can be impaired by various mental health conditions such as schizophrenia and depression. If a patient is impaired in judgment or insight in any way, they are at greater risk of harming themselves or others. For instance, if they are at risk of burning their house down the sensible judgment would tell them to leave the house immediately. However, a person with impaired judgment may recommend staying in the house and attempting to put out the fire.
The content of a patient's thoughts encompasses their subject matter, themes, and beliefs. Examiners will assess the clarity, relatedness, and content of thoughts of the patient. They will take note of any thoughts that are circumstantial or tangential and also whether the patient is prone to having a flurry of ideas (digressions from the conversation subject). They will also discuss the speed of a person's thoughts, including whether they seem fast or slow.
Other important aspects to consider are whether the patient's thoughts are mood compatible or not in line with their surroundings. For instance, a patient who is depressed may hear voices that sound aggressive and threatening, whereas those suffering from schizophrenia may be able to imagine the sound of a calm and soothing voice. Ask the patient if they've had any thoughts of suicide or homicide. These are rare but can be life-threatening and should be taken into consideration in every mental health evaluation.
Watching
Nurses' observation skills play an important role in the mental health assessment. They are a thorough review of appearance, behaviour and any strange beliefs or perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention, orientation memory). The mental status exam for nurses also involves observing motility. This includes any physical movement, like eating, drinking, or brushing teeth.
The Observation component of the mental state examination is a crucial aspect of determining whether or not a patient may pose the risk to themselves or others. This is done by assessing if the patient appears to be moving in a deliberate way that suggests they are trying to harming themselves or someone else.
In addition, a detailed thought content assessment is made by monitoring the patient throughout the interview and determining their thoughts and concerns. It is crucial to determine whether the patient has suicidal, homicidal, or delusional thoughts.
Global assessment of functioning (GAF), an assessment of functioning in numerical form, ranging from 0 to 100, combines the ability of an individual to function in daily life and their capability of managing stressors. The GAF is a crucial component of the mental health examination and aids in making the treatment decisions.
It is essential to be aware that watching the behavior of a patient can cause distress and it is essential to conduct the procedure in a manner that doesn't provoke the patient and does not make them feel uncomfortable. It is also crucial that the patient is aware of the reason for the observation as well as the length of time it will take.
Nursing observation is an important skill and it must be a key element of the nursing process. It is crucial to keep in mind that patients can disagree with staff about the degree of observation. If they cannot reach a consensus with the staff, they should be able to use an advocate service to represent their interests and assist them in any discussions regarding their treatment. This should be part of the local policy and practice, with the involvement and the support of user groups.
Questioning
Many people are reluctant to talk about their mental health issues, but family members can usually discern when something isn't right. They can also encourage the person to get an assessment. These tests can be extremely broad and cover a wide range of subjects including appearance, mood and memory, thought process and many more. In addition to these tests, a mental health professional will also ask the individual questions about their personal life, including what's been happening lately and what their feelings have been like.
The test includes an evaluation of the cognitive capacity that focuses on a person's ability think clearly and retain information. The test subject may require the person to complete basic tasks such as focusing on a list or objects, remembering lists, or solving math questions. The test can also check the person's ability to make informed decisions and make good judgments. The assessment determines a patient's awareness, which is the understanding of their condition and how it affects them.
Another vital aspect of an assessment of mental health is the patient's attitude towards the world, himself and his illness. The patient's tone of expression, facial expression and body language may convey hostility, anger, depression or a sense of powerlessness. It is also important to determine whether the patient appears to be seeking help or is content living with their health condition.
In more serious situations, a mental health assessment might include an examination of the patient's mental state that may include hallucinations (false sensory perceptions without real stimuli) or illusions (misperceptions of real stimuli). mental illness assessment can be harmful and even fatal.
A mental health assessment should be holistic and focus on the person's relationship to their world. A health professional may use art, music or photos, or any other electronic assessment tool to gain a better understanding of the person. They should also talk with the person about the challenges that have led them to seek help and reassure them that there is nothing wrong with visiting a mental health professional.