Mental Health Nursing - Assessing Mental Health
Mental health assessments often involve a physical examination, to rule out physical conditions. This could include urine tests, blood test or even brain scans.
Psychologists use a variety of tools for assessing mental health. These range from tests that are written on paper and pen to in-depth interviews, or self-complete postal questionnaires.
Affect and mood
Mood and affect are among the most crucial components of the mental status examination (MSE) and are the first thing to be observed by a clinician. They define a patient's general emotional state. It can range from happiness to sorrow or anger and irritability. The patient's mood can be measured through facial expressions, overall attitude and reaction to external or internal stimuli. smiling at an absurd joke or crying over the loss of a loved one).
Affect is a temporary emotion while mood is a more long-lasting emotional state. It is often described as euthymic (normal) or dysphoric, which means depressed. Psychiatric professionals should be careful to not confuse the two terms, as they are interpreted differently and can be affected by many factors.
The MSE is a helpful tool for diagnosing clinical problems however, it can be difficult to interpret from a subjective patient report. Asking patients about their feelings during the past few weeks is more helpful than relying solely on the observations of a doctor. A recent study revealed that a significant proportion of symptoms, which includes those grouped together under the same disorder category, vary between assessment tools. This can be because of the different emphasis on cognitive or emotional symptoms as well as the different the time intervals and frequency of the reporting of symptoms.
It is possible that the MSE relies on self-reporting which could be biased. A patient who has anxiety and headache is likely to get lower scores than those who report only a migraine. Furthermore there is the tendency for patients to downplay negative feelings and overestimate the severity of positive feelings.
Affect and mood can have a direct influence on thought content. This can impact decision-making, interpersonal behavior, and physical function. They are affected by fatigue, stress and social interactions. In reality positive moods have been proven to increase thinking and creativity. mental health assessments that is negative can cause confusion and decrease concentration. A thorough and meticulous 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 essential aspects of a mental health examination is to determine how the patient thinks. Evaluation of thought process and content. The thought process is the coherence, logic and structure of a patient's thoughts. Normal thought processes are objective-oriented and logical. In several mental health conditions however, the thought process is altered. Examples include hallucinations, delusions, and loose associations.
Insight and judgement are also evaluated during a mental status test. Insight is the ability to see that there is an issue, and judgement is the ability to make an informed decision based on information. Both are impaired in several mental health conditions, such as depression and schizophrenia. 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 destroying their home the sensible judgment would tell them to leave the building immediately. However, a person with impaired judgment might suggest staying in the building and trying to put out the fire.
The thoughts of a patient includes the subject matter, themes and beliefs. Examiners will comment on the clarity, relevance and content of a patient's thoughts. They will take note of any tangential or circumstantial thoughts or thoughts, and also if the patient has flights of ideas (digressions from the topic of conversation). They will also provide feedback on the speed at which someone is thinking, such as whether they seem to be more or less fast.
It is also crucial to determine whether the patient's mood is similar to the environment in which they live. For instance, a patient who is depressed could hear voices that sound hostile and frightening, whereas someone suffering from schizophrenia could be able to imagine a calm and soothing voice. The patient should be asked about any suicidal or homicidal ideation. They are not common, but they can be life-threatening and should be taken into account in every mental health evaluation.
Watching
A nurse's observation skills play an important role in a mental health assessment. They include a careful examination of behavior, appearance and any peculiar beliefs or perceptions (such hallucinations or delusions) and mood cognition (including attention, memory, orientation). The nursing mental state exam also includes observing motility. This includes any physical movement, like eating, drinking, or brushing teeth.
The observation component of the mental state exam is essential in determining whether a patient poses a risk to themselves or others. This is done by assessing whether or not the patient is moving in a way that suggests that they are in danger of harming themselves or anyone else.
A thorough assessment of the thought-based content is also accomplished by observing the patient during the interview and determining the concerns. It is crucial to check if the patient has any suicidal or homicidal ideas and to determine if they're having thoughts of suicide or delusions.
A global assessment of functioning (GAF) is a numerical rating on a scale from 0 to 100 that combines the ability of a person to function in everyday life with their ability to deal with the stressors in their life. The GAF is an important part of the mental status examination and helps to guide the treatment decisions.
It is important to be aware that observing a patient's behaviour could cause anxiety, and it is essential that the process is conducted in a way that does not provoke the patient and doesn't be uncomfortable for them. It is crucial that the patient is fully aware of the goal of the observations and the duration of the process.
Nursing observation is an important ability and should be a central element of the nursing process. However, it must be kept in mind that patients could be dissatisfied with the quality of observation. If they cannot reach an agreement with staff then they should have access to an advocate service that can represent their needs and help their discussions on their care. This should be an integral part of local observation policy and practice with the involvement of user groups to ensure that patients are involved in the creation 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 tell when something is amiss. They can also help the person to take a look at an assessment. These assessments can be very broad and cover a wide range of subjects, including mood, appearance, memory, thinking process and many more. A mental health professional could also ask questions about the person's personal life. They'll ask them what they feel and what's happened in the last few days.
The test also includes a cognitive evaluation that focuses on the ability of the person to think clearly and retain information. The test subject may require the person to complete basic tasks such as focusing on a list or objects, memorizing lists, or solving math questions. The test can be used to test the person's judgment and ability to make informed choices. The test determines a person's awareness, which is the understanding of their condition and how it affects them.
The person's attitude towards himself, others and the illness is also an important element of a mental evaluation. The tone of voice, the facial expressions, and body expressions of a patient could signal depression, anger or a sense of helplessness. It is also important to determine whether the patient is seeking help or is content living with their illness.
In more serious cases, a mental health assessment might include an examination of the patient's thoughts that could include hallucinations (false sensory perceptions that do not correspond to real stimuli) or illusions (misperceptions of real stimuli). These conditions can be dangerous and even fatal.
In general the mental health assessment must be holistic and examine the person's relationship to their social life. A health professional can use art, music or photos or any other assessment tool to better understand the individual. They should also talk to the person about the issues that have caused them to seek help and assure them that there is nothing wrong with visiting an expert in mental health.