Mental Health Nursing - Assessing Mental Health
Mental health assessments typically include a physical exam, to rule out physical conditions. This may include blood tests and urine tests as well as brain scans.
Psychologists use a variety of instruments to evaluate mental health. These range from pen and paper test forms to in-depth interviews, or self-complete postal questionnaires.
Mood and affect
Mood and affect are the most significant components of the mental health exam (MSE) and are the first to be observed by a medical professional. They describe the patient's general emotional state that can range from happiness to sadness or irritability to anger. Affect can be measured by looking at facial expressions and manner of speaking 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 is a feeling that lasts only a few minutes, whereas mood is a longer-lasting emotional state. It is generally described as euthymic, dysphoric, or normal (meaning depression). However, psychiatric professionals must be careful not to misunderstand the terms because they have different definitions and are affected by a variety of factors.
The MSE can be a valuable tool for clinical diagnosis however, it can be difficult to interpret based on a subjective patient report. It is therefore beneficial to inquire about how patients have felt over the past few weeks, as opposed to using only the observation of a physician. A recent study found that a significant proportion of symptoms, even those that fall under the same disorder category, vary between assessment tools. This can be because of the different emphasis on emotional or cognitive symptoms, as well as the different time periods and frequency of the reporting of symptoms.
It is possible that the MSE is based on self-reporting which is susceptible to bias. For instance, a patient who describes experiencing anxiety and headaches will likely have less than a person who describes only a headache. Additionally, there is an inclination for patients to minimize negative emotions and underestimate the severity of positive emotions.
Affect and mood can have an impact on the content of thought. This can affect the way we make decisions, our interpersonal behavior, and physical functioning. They are affected by stress, fatigue and social interactions. In reality positive moods have been proven to increase the ability to think and be creative. Conversely, a negative mood can reduce concentration and lead to confusion. A thorough and meticulous mental health assessment must be able to consider the patient's mood and affect as well as the other factors.
Thought content
One of the most essential aspects of a mental state exam is assessing how a patient thinks. Particularly, evaluating thought processes and thoughts. The thought process is the logic, coherence and organization of a patient's thoughts. The normal process of thinking is objective-oriented and rational. Thought processing can be distorted when a person suffers from mental health issues. Examples include hallucinations, delusions and loose associations.
Insight and judgment are assessed in a mental status test. Insight is being able to recognize problems. Judgment is the capability of making a well-considered decision after receiving information. Both are affected by various mental health conditions, such as schizophrenia and depression. A person who isn't able to see or judgement is more likely to harm themselves or others. For instance if they are in danger of burning their house down the sensible judgment would tell them to leave the building immediately. mental health assessment service iampsychiatry.uk with impaired judgment might suggest that they remain in the building to try to get rid of the fire.
Thought content refers to the subject matter, themes and beliefs that a patient has. Examiners will comment on the clarity, connection, and content of patient's thoughts. They will also note tangential thoughts or circumstantial ones, as well as if the patient has digressions (digressions off from the main topic of the conversation). They will also make comments on the pace at which a person is thinking, such as whether they seem fast or slower.
Other important areas to consider are whether the patient's thoughts are mood and in tune with their surroundings. For example, a patient who is depressed might hear voices that are angry and threatening, while someone suffering from schizophrenia could have a hallucination of an ethereal and calm voice. Ask the patient if they've had any thoughts of suicide or homicide. Although these are rare, they can be life threatening and should be taken into consideration in every mental health assessment.
Watching
Nurses' observation skills play an important role in a mental health assessment. They involve a thorough evaluation of appearance, behavior as well as any unusual beliefs or perceptions (such delusions or hallucinations) mood, cognition (including memory, attention, orientation). The nursing mental status exam is also a way of the observation of the movement. This includes any physical movement, like eating, drinking, or brushing your teeth.
The observation component of the mental status exam is an essential element of determining whether the patient could pose an imminent risk to themselves or others. This is accomplished by determining whether the patient appears be acting in a deliberate manner that suggests they are planning to harm themselves or another person.
In addition, a comprehensive assessment of thought content is done by keeping track of the patient throughout the interview and determining their main concerns. It is important to check whether the patient is suffering from suicidal, homicidal or delusional thoughts.
A global assessment of functioning (GAF) is an assessment of a numerical score on a scale ranging from 0 to 100 that combines the ability of a person to function in daily life and their capacity to handle the stresses that come with life. The GAF is a vital part of the mental status assessment and aids in making the treatment decisions.
It is important to recognize that observing the behavior of a patient may cause distress. It is therefore important that the procedure is conducted in a manner that does not provoke or feel intrusive. It is also vital that the patient is fully informed about the purpose of the observation as well as the length of time it will take.
Nursing observation is a crucial skill that should be a central part of the nursing process. However, it must be noted that patients might disagree with the level of observation. If they are unable to reach an agreement with the staff, they should have access to an advocate service that can represent their needs and help their discussions on their care. This should be a component of the local policy and practice, with the involvement and support of user groups.
Questioning
Many people are reluctant to talk about their mental health issues, however family members are often able to detect if something is not right. They can also help the person take steps to take an assessment. These tests can be a variety of subjects, including mood, appearance and thought process. In addition to these tests, the mental health professional will also ask the person questions regarding their personal life, including what has been going on lately and what their feelings have been like.
The test also includes a cognitive assessment that focuses on the ability of the individual to think clearly and remember information. The person could be asked to complete basic tasks such as paying attention to a list of objects, recollecting lists, or solving math questions. The test may also test the ability of the individual to make informed decisions and use their judgment. The test determines a person's perception, which is their knowledge of their condition and how it affects them.
The patient's attitude towards himself, others and the illness is also an important part of a mental evaluation. The patient's voice, facial expressions and body language can convey hostility, anger, depression or a sense of powerlessness. It is also important to know whether the patient appears to be seeking help or resigned to living with their condition.
In more serious situations, an assessment of mental health may include an examination the patient's thinking which could include illusions or hallucinations. These conditions can be dangerous and even deadly.
In general the mental health assessment must be holistic and consider the person's interactions with their social world. Health professionals can employ photographs, music, art, or any other assessment tool to better understand the individual. They should also talk to the person about the challenges that have led them to seek help and assure them that there is nothing wrong with seeing an expert in mental health.