Mental Health Nursing - Assessing Mental Health
A physical examination is typically part of mental health tests to rule out physical conditions. This may involve blood work, urine tests or brain scans.
Psychologists also utilize a variety of tools to assess 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 among the most significant components of the mental health examination (MSE) and are the first things to be viewed by the doctor. They define the patient's general mood that can range from happiness to sadness, or even irritability to anger. The patient's mood can be measured through facial expressions, general behavior and reaction to external or internal stimuli. You can express your emotions by smiling at an absurd joke, or crying when you lose a beloved one.
Affect is a short-term emotion but mood is a more long-lasting emotional state. It is usually described as euthymic (normal) or dysphoric, meaning depressed. Professionals in psychiatry must be careful to not confuse the two terms, as they are interpreted differently and can be affected by many factors.
While the MSE is a helpful tool for clinical use, it can be difficult to interpret based on a subjective patient reports. Asking patients about their feelings over the past few weeks can be more beneficial than relying on only observations from a physician. Recent research revealed that assessment tools were different in their ability to capture a significant portion of symptoms. This included the symptoms that were classified under the same disorder. This can be because of the different emphasis placed on cognitive or emotional symptoms and also the differences between time periods and frequency in symptom reporting.
It is also possible that the MSE is based on self-reporting which could be susceptible to bias. For instance, a patient who complains of anxiety and a headache is likely to report a lower score than a person who describes only an occasional headache. Patients tend to minimize negative emotions while exaggerating positive ones.
Affect and mood can have a direct influence on the content of thought. This can impact decision-making, interpersonal behavior, and physical function. They are affected by fatigue, stress and social interactions. A positive mood can actually enhance creativity and mental power. Conversely, a negative mood can decrease concentration and cause confusion. A thorough and meticulous mental health assessment should take into account the patient's mood and affect, as well as underlying factors.
Thought content
Assessing how the patient thinks is one the most crucial aspects of a mental state examination. Particularly, evaluating thought processes and thoughts. The thought process is the coherence, logic and structure of the patient's thoughts. assessing mental health are focused and logic-based. Thought processing may be altered in several mental health conditions. Examples include hallucinations, delusions, and loose associations.
Insight and judgement are assessed in a mental status exam. Insight is the ability to identify the presence of an issue, and judgement is the ability to make an informed decision based on information. Both are impaired in many mental health conditions such as depression and schizophrenia. If a patient has impaired insight and/or judgement is at greater risk of causing harm to themselves or others. If they are in danger, their rational judgement would suggest leaving the house immediately. A patient with impaired judgement may suggest that they stay in the building to try and put out the fire.
Thought content is the topics, subject matter, and beliefs that a patient holds. Examiners generally comment on the clarity, relatedness and quality of a patient's thoughts. They will note tangential thoughts or circumstantial ones, as well as when a patient is digressing (digressions away from the subject of the conversation). They will also comment on the speed of a person's thoughts, such as whether they seem fast or slow.
It is also essential to determine if the patient's mood matches the environment in which they live. A patient with depression might hear voices of anger, while those suffering from schizophrenia may have the illusion that a peaceful voice is speaking. Ask the patient if they have any suicidal or homicidal ideas. These are uncommon, but could be life-threatening and should be taken into consideration in every mental health assessment.
Observation
The nurse's ability to watch is vital in the mental assessment. They include a careful examination of appearance, behavior and any unusual beliefs or perceptions (such hallucinations or delusions) mood, cognition (including memory, attention, orientation). A mental health assessment for nursing also includes observing the ability to move, which includes physical activity like eating, drinking, brushing teeth using the toilet and taking off shoes.
The Observation portion of the mental state exam is vital in determining if a patient poses a risk to themselves or others. This is done by assessing whether the patient is acting in a manner that suggests they are in danger of harming themselves or anyone else.
A thorough assessment of the content of thoughts is also done by monitoring the patient during the interview and determining preoccupations. It is essential to determine if the patient is having suicidal or violent thoughts and to determine if they're having delusions.
A global assessment of functioning (GAF) is an evaluation of the numerical value on a scale from zero to 100 that evaluates the ability of a person to function in everyday life along with their ability to cope with the stresses in their lives. The GAF is a crucial element of the mental state exam and assists in guiding treatment decisions.
It is important to be aware that observing a patient's behaviour can cause distress and it is crucial to conduct the procedure in a manner that does not provoke the patient and doesn't feel intrusive. It is also crucial that the patient is aware of the reason for the observation and the length of time it will last.
Nursing observation is an essential skill that must be at the heart of any nursing process. It is crucial to keep in mind that patients can disagree with staff about the level of observation. If they are unable to reach a consensus with staff, they must be able access an advocate service that can represent their interests and assist in any discussions about their treatment. This should be a fundamental part of the local policy and practice with the involvement of user groups, to ensure that patients are included in the development of written information as well as staff training on this aspect of clinical governance.
Questioning
Many people are reluctant to discuss their mental health issues, but family members are often able to detect if something is not right. They can also urge the person to seek an assessment. These assessments are broad and cover a wide range of subjects, such as mood, appearance as well as memory, thought process and much more. In addition to these tests, a mental health professional will also ask the person questions about their personal life, including what's been happening recently and what their emotions have been like.
The assessment also includes a cognitive assessment, which focuses on the ability of the person to think clearly and recall information. The test subject may require the person to complete basic tasks such as paying attention to a list of objects, remembering lists or solving math questions. The test can also be used to check the ability of the person's judgement and to make sound decisions. The test also evaluates the patient's understanding, which reflects their knowledge of their condition and its effects on them.
The attitude of the patient towards himself, others and the illness is also an important aspect of a mental evaluation. The tone of voice, the facial expression, and the body language of a patient can convey anger, depression or a sense of powerlessness. It is also important to note whether the patient appears to be seeking help or resigned to living with their condition.
In more serious cases, an assessment of mental health might include a thorough examination of the patient's mental state which could include illusions or hallucinations. It is crucial to recognize the presence of these disorders because they can be extremely dangerous and even life-threatening.
In general, a mental health assessment should take a holistic approach and look at the person's connection to their social environment. A health professional may use photographs, music, art, or any other electronic assessment tool to better understand the individual. They should also speak to the person about the issues that led them to seek help and reassure them that there is nothing wrong with seeking out a mental health professional.