Mental Health Nursing - Assessing Mental Health
Mental health assessments often include a physical exam, to rule out physical ailments. This could involve blood tests, urine tests or brain scans.
Psychologists use a variety of tools to assess mental health. These tools can vary from pencil and paper test forms to in depth interviews or self-completed questionnaires for postal mail.
Mood and affect
Mood and affect are the most important elements of the mental state examination (MSE) and are the first to be observed by a clinician. They describe the patient's general emotional state, which can range from joy to sadness, or even irritability to anger. Affect can be measured by looking at facial expressions and demeanour as well as the response to external or internal stimuli (e.g. smiling at the joke or crying over the loss of a loved one).
Affect is a feeling that is temporary, while mood is a long-lasting emotion. It is often described as either euthymic (normal) or dysphoric, which means depressed. However, assessment mental health must be careful not to mix the two as they have varying definitions and are affected by a range of factors.
While the MSE is a useful clinical tool, it isn't always easy to interpret based on subjective patient report. It is therefore helpful to inquire about how patients have been feeling in the last few weeks, instead of relying solely on the observations of doctors. Recent research showed that the assessment instruments differed in their capacity to detect a substantial portion of symptoms. This included those that were grouped under the same disorder. This could be due to the different emphasis placed on emotional, cognitive or physical symptoms as along with differences in the duration and frequency of reporting symptoms.
It is possible that the MSE relies solely on self-reporting which could be biased. For instance, a person who complains of anxiety and headaches will likely have less than a patient who reports only a headache. In addition, there is a tendency for patients to downplay negative feelings and overestimate the severity of positive feelings.
The affect and mood of a person directly affect thoughts and can affect the way people make decisions, their interpersonal behavior and physical performance. They can be affected by fatigue, stress and social interactions. In reality positive moods have been shown to enhance thinking and creativity. A negative mood can cause confusion and reduce concentration. Therefore, a thorough and thorough mental health assessment needs to consider the patient's mood and emotional state as in addition to the underlying causes.
Thought content
Examining the way a patient thinks is one the most crucial aspects of a mental state examination. Particularly, it is assessing thought process and thoughts. Thought process refers the logic, organization and coherence of a patient's thinking. Normal thought processes are logical and goal-oriented. Thought processing can be altered in several mental health conditions. Examples include hallucinations, delusions and loose associations.
A mental health assessment also examines judgment and insight. Insight is the ability to see the presence of an issue, and judgement is the ability to make an informed decision based on information. Both are affected by several mental health conditions such as depression and schizophrenia. A patient with impaired insight or judgement 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 person with impaired judgment might suggest they stay in the house to try to get rid of the flame.
Thought content refers to the subject matter, themes and beliefs that a patient has. Typically, examiners discuss the clarity, connection and quality of a patient's thinking. They will be able to identify tangential ideas 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 speed of someone's thoughts, including whether they seem to be fast or slow.
It is also essential to determine if the patient's mood matches the environment in which they live. For instance, a patient who is depressed might hear voices that sound aggressive and threatening, whereas those suffering from schizophrenia may be able to imagine the sound of a calm and soothing voice. Ask the patient if they have any suicidal or homicidal thoughts. These are uncommon, but could be life-threatening and should be taken into consideration in every mental health assessment.
Observation
Nurses' observation skills play an important role in the mental health assessment. They are a thorough review of behavior, appearance as well as any unusual beliefs or perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention, orientation, memory). A mental state examination for nurses also incorporates observation of mobility, which includes any physical activity like eating or drinking, brushing your teeth or using the toilet, as well as wearing shoes.
The observation component of the mental state exam is essential in determining whether the patient poses a risk to them or others. This is accomplished by determining whether the patient appears to be moving in a deliberate manner that suggests they are trying to harming themselves or someone else.
A thorough assessment of the thought content is also done by monitoring the patient during the interview and determining the concerns. It is essential to check if the patient is suffering from 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 of zero to 100 that evaluates the capacity of a person to function in everyday life along with their capacity to handle the stresses in their lives. The GAF is an essential part of the mental health examination and helps guide treatment decisions.
It is crucial to be aware that watching a patient's behaviour could cause anxiety, and it is crucial to conduct the procedure in a manner that does not cause anxiety for the patient or make them be uncomfortable for them. It is also essential that the patient is informed about the purpose of the observation and the length of time it will take.
Nursing observation is a vital skill that must be at the heart of any nursing procedure. It is important to remember that patients might disagree on the degree of observation. If they cannot reach an agreement with the staff, they should be able to access an advocate service that can represent their interests and aid them in any discussions regarding 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 development of written information as well as staff training for this aspect of governance in the clinic.
Questioning
Many people have a difficult time talking about their mental health problems however, family members are often able to tell the signs of something being wrong. They can also urge the person to get an assessment. These tests can be a variety of subjects that include mood, appearance and thought process. A mental health professional may also ask questions about the person's private life. They will ask them what they feel and what's happened recently.
The test also includes a cognitive test, which focuses on the ability of the person to think clearly and remember information. The person could be asked to complete basic tasks such as focusing on a list or objects, memorizing lists or completing math problems. The test may also test the ability of the individual to make good decisions and make good judgments. The assessment also determines the patient's insight and level of understanding about their condition and its effects on them.
Another crucial aspect of the mental health assessment is the patient's attitude towards others, himself and his illness. The patient's voice, facial expressions and body language can convey hostility, anger depression or a feeling of helplessness. It is also important to know whether the patient is seeking help or is content living with their illness.
In more serious situations the mental health assessment might include an examination of the patient's mental state that may include hallucinations (false sensory perceptions without 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 consider the person's connection to their social world. A health professional might use images, music, art or a variety of electronic assessment tools to better understand the person and their unique view of the world around them. They should also talk about the issues that led to the person to seek help, and assure that there is nothing wrong in seeing an expert in mental health.