Mental Health Nursing - Assessing Mental Health
Mental health assessments typically include a physical exam to rule out physical ailments. This could include urine tests, blood tests tests or even brain scans.
Psychologists utilize a variety instruments to evaluate mental health. These tools range from paper and pencil test forms to more in-depth interviews or self-completed postal questionnaires.
Mood and affect
Mood and affect are the most important components of the mental health exam (MSE) and are the first to be viewed by the medical professional. They are the general mood that can range from happiness to sadness, or anger to anger. Affect can be assessed by looking at facial expressions and demeanour as well as the response to external or internal stimuli (e.g. You can express your feelings by laughing at a joke, or crying when you lose a loved one.
Affect is an emotion that is only temporary, whereas mood is a state of constant emotion. It is typically described as euthymic, dysphoric or normal (meaning depression). Psychiatric professionals should be careful to avoid confusion between the terms, as they are different in their definition and are affected by a variety of factors.
While the MSE is a valuable diagnostic tool, it can be difficult to interpret based upon subjective patient report. It is therefore helpful to ask patients how they have been feeling over the last few weeks, rather than using only the observation of a physician. A recent study showed that a significant percentage of symptoms, including those that are grouped within the same disorder category, vary between assessment tools. This could be due the different emphasis placed on cognitive, emotional or physical symptoms as along with differences in the duration and frequency of reporting symptom reports.
private mental health assessment is possible that the MSE relies on self-reporting which could be biased. For instance, a person who reports a headache and anxiety will likely report an lower score than a person who describes only a headache. In addition there is a tendency for patients to minimize negative feelings and overestimate the severity of positive feelings.
Affect and mood can have a direct impact on the content of thought. This can impact decision-making, interpersonal behavior, and physical functioning. They are affected by stress, fatigue social interactions, global events, hormones and even the weather. A positive mood can actually boost creativity and mental energy. However, a mood that is negative can decrease concentration and cause confusion. A thorough and meticulous mental health assessment should consider both the patient's mood and affect and the underlying factors.
Thought content
One of the most important aspects of a mental health examination is to determine how the patient thinks. Evaluation of thoughts and their content. The term "thought process" refers to the coherence, logic and organization of a patient's thought processes. A normal thought processes is focused and rational. Thought processing can be altered in a variety of mental health conditions. Examples include hallucinations and delusions as well as loose associations.
A mental status examination also evaluates insight and judgement. Insight is the ability to recognize the presence of a problem. Judgement is the process to make a well-considered choice after receiving information. Both are affected by a variety of mental health issues such as depression and schizophrenia. Patients with impaired insight or judgment is more likely to hurt themselves or others. For example when they are in danger of destroying their home and they have a good sense of judgement, it would be wise for that they should leave the premises immediately. A patient with impaired judgement might suggest that they remain in the building to try and get rid of the fire.
The contents of a patient's mind encompasses their themes, subject matter, and beliefs. Typically, examiners discuss the clarity, relevance and the content of a patient's thoughts. They will also note any thoughts that are tangential or circumstantial or thoughts, and also if the patient is prone to having a flurry of thoughts (digressions from the conversation subject). They will also comment on the speed of a person's thoughts, for instance, whether they appear fast or slow.
Other important aspects to consider are whether the patient's thoughts are mood and in tune with their environment. A patient with depression might be able to hear angry voices, whereas someone suffering from schizophrenia may have an illusion that a calm voice is speaking. Ask the patient if they have any suicidal or homicidal thoughts. Although they are not common, they can be life-threatening and should be taken into account in every mental health assessment.
Watching
The ability of nurses to observe is crucial in the mental assessment. They are a thorough review of appearance, behaviour as well as any unusual beliefs or perceptions (such as hallucinations or delusions) mood, and aspects of cognition (including attention, orientation memory, and orientation). A nursing mental status examination also includes observing the ability to move, which includes physical activity like eating or drinking, brushing your teeth using the toilet and taking off shoes.
The Observation portion of the mental state exam is essential in determining whether a patient poses a risk to them or anyone else. This is accomplished by determining whether the patient appears to be moving in a deliberate way that suggests they are about harming themselves or someone else.
In addition, a detailed thought content assessment is made by observing the patient throughout the interview and identifying their preoccupations. It is important to check whether the patient is experiencing suicidal, homicidal or delusional thoughts.
Global assessment of functioning (GAF) which is which is a numerical score ranging between 0 and 100, combines the ability of a person to function in daily life with their ability of managing stressors. The GAF is a crucial element of the mental state assessment and aids in making the treatment decisions.
It is essential to be aware of the fact that observing an individual's behavior can cause anxiety and it is crucial to conduct the procedure in a manner that does not cause anxiety for the patient and does not feel intrusive. It is also vital that the patient is fully aware of the reason for the observation as well as the length of time it will last.
Nursing observation is a crucial skill that must be the core of any nursing process. However, it must be noted that patients might not agree with the degree of observation. If they are unable to come to an agreement with staff then they should be able to access an advocate service which can represent their interests and assist their discussions on their treatment. This should be an integral part of local observation policy and practice with the involvement of user groups to ensure that patients are included in the development of written documents and staff training on this aspect of clinical governance.
Questioning
Many people are hesitant to discuss their mental health issues, but family members are often able to detect if something is not right. They can also help the person obtain an assessment. These assessments can cover a wide range of subjects that include mood, appearance and thought process. In addition to these tests, a mental health professional will also ask the individual questions about their personal life, including what's happened lately and what their feelings have been like.
The test consists of an assessment of cognitive ability that focuses on a person's ability to think clearly and retain information. The person may be asked to complete a few basic tasks, such as focusing their attention on a list of words or objects, memorizing simple lists or solving math problems. The test will also test the ability of the individual to make sound decisions and use their judgment. The test also evaluates the patient's understanding, which reflects their level of understanding about their illness and its impact on them.
The attitude of the patient towards others, himself and the illness is an important part of a mental evaluation. The tone of voice, facial expression and body language may convey anger, hostility depression or a feeling of insecurity. It is important to check whether the patient appears to seek help or accepting their condition.
In more serious situations, an assessment of mental health may include a look at the patient's thinking which could include hallucinations or even illusions. These conditions can be extremely dangerous and even fatal.
A mental health assessment should be comprehensive and look at the person's relationship with their environment. A health professional can use photographs, music, art or any other assessment tool to gain a better understanding of the person. They should also talk about the challenges that led the person to seek help, and reassure that there is nothing wrong in seeing an expert in mental health.