Mental Health Nursing - Assessing Mental Health
A physical exam is often included in mental health tests to rule out any physical ailments. This may involve blood work or urine tests, as well as brain scans.
Psychologists also use a wide range of tools to evaluate mental health. They can use tests that are written on paper and pen to in-depth interviews or self-complete questionnaires sent to you by post.
Affect and mood
The doctor will first observe the patient's mood and affect. They describe the patient's general emotional tone, which can range from joy to sadness, or even irritability to anger. The effect can be analyzed through facial expressions, general attitude and response to external or internal stimuli. smiling at a joke or crying at the loss of a loved one).
Affect is an emotion that is temporary, while mood is a long-lasting emotion. It is generally described as euthymic, or dysphoric or normal (meaning depression). Psychiatric professionals should be careful to avoid confusion between the terms because they are interpreted differently and can be affected by many factors.
While the MSE is a useful tool for clinical use but it isn't always easy to interpret based on subjective patient report. Asking patients about their feelings in the last few weeks is more helpful than relying on only the observations of a doctor. A recent study found that a large proportion of symptoms, including those that fall 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 possible that the MSE is based on self-reporting, which may be prone to bias. For example, a patient who describes experiencing a headache and anxiety will likely report less than a patient who reports only the sensation of a headache. Additionally, there is a tendency for patients to minimize negative emotions and overestimate the severity of positive feelings.
Affect and mood directly affect thoughts, which can influence decision-making, interpersonal behaviour and physical functioning. They can be influenced by fatigue, stress and social interactions, as well as world events, hormones and even the weather. A positive mood can increase creativity and mental strength. A negative mood can cause confusion and decrease concentration. A thorough and thoughtful mental health evaluation must be able to consider the patient's mood and affect as well as the fundamental factors.
Thought content
One of the most crucial aspects of a mental health examination is assessing how the patient thinks. Particularly, evaluating thought processes and thought content. Thought process refers to the coherence, logic and organization of a patient's thought processes. Normal thought processes are rational and goal-oriented. Thought processing can be distorted when a person suffers from mental health issues. Examples include hallucinations, delusions, and loose associations.
A mental state examination also examines judgment and insight. Insight is the ability to spot the presence of a problem. Judgment is the ability of making a well-considered decision after receiving information. Both can be impaired in many mental health conditions such as schizophrenia and depression. If a patient has impaired insight and/or judgement, they are at a higher risk of harming themselves or others. If they are in danger, their sensible judgement would tell to leave the house immediately. However, a patient with impaired judgment might recommend staying in the house and trying to put out the fire.
Thought content refers to the topics, subjects and beliefs that a patient holds. Typically, examiners discuss the clarity, relevance and the content of a patient's thoughts. They will note tangential thoughts or circumstantial ones, and when a patient is digressing (digressions away from the subject of the conversation). They will also comment on a person's pace of thinking, such as if they seem to be faster or slower.
It is also important to determine whether the patient's mood matches their environment. A patient with depression might hear angry voices, whereas someone suffering from schizophrenia may experience an illusion that a calm voice is speaking. Patients should also be asked about any suicidal or homicidal thought. Although they are uncommon however, they can be life-threatening and must be taken into consideration in every mental health evaluation.
Watching
The ability of nurses to observe is vital in an assessment of mental health. They involve a thorough evaluation of behavior, appearance, any unusual beliefs or perceptions (such delusions or hallucinations) mood, cognition (including attention, memory, orientation). A mental state examination for nurses also incorporates observation of the ability to move, which includes physical movement such as eating or drinking, brushing your teeth or using the toilet, as well as wearing shoes.
The Observation portion of the mental health examination is vital in determining if the patient poses a risk to themselves or anyone else. This is done by assessing whether the patient appears be acting in a way that suggests they are trying to harming themselves or someone else.
In addition, a detailed thought content assessment is made by keeping track of the patient throughout the interview and determining their thoughts and concerns. It is essential to determine if a patient has any suicidal or homicidal ideas and to determine if they're having thoughts of delusion.
assessment in mental health of functioning (GAF) which 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 a crucial element of the mental state exam and assists in guiding the treatment decisions.
It is important to be aware of the fact that observing the behavior of a patient can cause distress and it is crucial to conduct the procedure in a way that does not cause anxiety for the patient and does not be uncomfortable for them. It is essential that the patient be fully informed of the purpose of the observations and the length of the procedure.
Nursing observation is an essential skill and it must be a key part of the nursing process. However, it should be noted that patients might be dissatisfied with the quality of observation and if they cannot reach an agreement with the staff, they should have access to an advocate service which can represent their interests and support patients in any discussions about their care. This should be part of local policy and practice, with the participation and support of groups of users.
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 assist the person to obtain an assessment. These assessments can be conducted on a variety of topics that include mood, appearance and the thought process. A mental health professional could also inquire about the person's personal life. They will ask what they've been feeling and what has happened recently.
The assessment also includes a cognitive test, which focuses on the ability of the person to think clearly and remember information. The test subject may ask to complete a few basic tasks, like focusing their attention on a list of objects or words and recollecting lists of basic information or solving math problems. The test can also be used to assess the person's judgment and ability to make sound decisions. The test measures a patient's awareness, which is the understanding of their condition and how it affects them.
Another important component of an assessment of mental health is the person's attitude toward the world, himself and his illness. The tone of voice, the facial expressions, and body language of a patient can signal depression, anger or a sense of helplessness. It is important to check whether the patient appears seek help or accepting their situation.
In more serious instances the assessment of mental health might include an examination the patient's thoughts, which may involve hallucinations or illusions. These conditions can be dangerous and even fatal.
In general an assessment of mental health should be holistic and consider 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 talk with the person about the challenges that have led them to seek help and assure them that there is nothing wrong with seeking out a mental health professional.