Mental Health Nursing - Assessing Mental Health
Mental health assessments typically include a physical exam, to rule out physical conditions. This may include blood tests and urine tests as well as brain scans.
Psychologists also employ a array of tools to measure mental health. These tools vary from pencil and paper test forms, to in-depth interviews or self-completed postal questionnaires.
Mood and affect
Mood and affect are the most significant components of the mental status examination (MSE) and are the first to be observed by the medical professional. They describe the patient's general emotional tone that can range from happiness to sadness, or even irritability to anger. The effect can be analyzed through facial expressions, general attitude and reaction to internal or external stimuli. You can express your feelings by smirking at the joke or crying when you lose a beloved one.
Affect is a temporary emotion but mood is a more long-lasting emotional state. It is usually described as euthymic (normal) or dysphoric, which translates to depressed. Professionals in psychiatry must be careful to avoid confusion between the two terms, as they are different in their definition and are affected by many factors.
While the MSE is a helpful diagnostic tool however, it isn't always easy to interpret based on a subjective patient reports. The process of asking patients to share their experiences in the last few weeks is more helpful than relying on only the observations of a doctor. Recent research has revealed that assessment tools differed in their ability to identify a significant portion of symptoms. This included the symptoms that were classified under the same disorder. This could be due the different emphasis placed on cognitive, emotional or physical symptoms, as well as differences in time periods and frequency of symptom reporting.
It is possible that the MSE relies solely on self-reporting which could be biased. For example, a patient who describes experiencing a headache and anxiety will likely have an lower score than someone who has only a headache. Patients tend to minimize negative feelings while exaggerating positive feelings.
The mood and the affect of a person can have an impact on the content of thought. This can affect decision-making, interpersonal behavior, and physical performance. They can be affected by stress, fatigue and social interactions. A positive mood can boost creativity and mental energy. A negative mood can lead to confusion and decrease concentration. A thorough and careful mental health evaluation must consider the patient's mood as well as affect and the other 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 the logic, organization and coherence of a patient's thoughts. Normal thought processes are rational and focused on a goal. Thought processing may be altered when a person suffers from mental health issues. Examples include hallucinations, delusions and loose associations.
Insight and judgement are evaluated during a mental status exam. Insight is the ability to spot problems. Judgement is the process to make a well-considered choice after receiving information. Both can be impaired by a variety of mental health issues such as depression and schizophrenia. A person who isn't able to see or judgment is more likely to hurt themselves or others. For instance if they are in danger of burning their house down the sensible judgment would tell that they should leave the premises immediately. A patient with impaired judgment might suggest that they remain in the house to try to put out the flame.
The content of a patient's thoughts include their themes, subject matter and beliefs. Examiners generally comment on the clarity, relatedness and quality of a patient's thoughts. They will note tangential thoughts or those that are merely circumstantial, and in the event that the patient's thoughts diverge (digressions off from the main topic of the conversation). They will also make comments on the speed of someone's thoughts, for instance, whether they seem fast or slow.
It is also important to determine if the patient's mood is in line with the environment in which they live. A person suffering from depression could hear angry voices, whereas a person suffering from schizophrenia might experience an illusion that a calm voice is speaking. Patients should also be asked about any suicidal or homicidal thoughts. These are uncommon, but could be life-threatening and should be taken into consideration during every mental health assessment.
Observation
A nurse's observation skills are essential to an assessment of mental health. They are a thorough review of the appearance, behavior, any unusual beliefs and perceptions (such as hallucinations or delusions) mood, as well as aspects of cognition (including attention to orientation, attention memory, and orientation). The mental status exam for nurses also includes monitoring the movement. This includes any physical movement, such as eating, drinking or brushing your teeth.
The Observation component of the mental state examination is essential in determining whether a patient poses a risk to them or others. This is determined by assessing whether or not the patient is moving deliberately in a way that suggests that they are in danger of harming themself or someone else.
In addition, a comprehensive assessment of the content of thoughts is conducted by keeping track of the patient throughout the interview and determining their main concerns. It is important to check whether the patient is experiencing suicidal, homicidal, or delusional thoughts.
Global assessment of functioning (GAF) which is a numerical rating between 0 and 100, combines the ability of a person to function in daily life along with their capacity for coping with stressors. The GAF is an important component of the mental health exam and assists in guiding the treatment decisions.
It is important to understand that observing the behaviour of a patient could cause distress. It is crucial to conduct the procedure in a manner that does not provoke or make the patient feel uncomfortable. It is important that the patient is informed of the purpose of the observations and the length of the process.
Nursing observation is an essential skill and it must be a key element of the nursing process. However, it should be remembered that patients may be dissatisfied with the quality of observation. If they are unable to reach an agreement with staff then they should have access to an advocate service that will represent their needs and help their discussions on their care. This should be an integral part of local observation policy and practice, including the involvement of user groups, to ensure that patients are involved in the development of written information and staff training to support this aspect of clinical governance.
Questioning
Many people have a hard to discuss their mental health problems, but loved ones will often be able to recognize when something is wrong. They can also assist the person to take an assessment. These assessments be a variety of subjects such as mood, appearance and thought process. In addition to these tests, the mental health professional will also ask the individual questions about their life, such as what's been happening lately and what their feelings have been like.
assessment in mental health includes an assessment of cognitive ability that focuses on a person's ability to think clearly and remember information. The test taker may be asked to complete basic tasks, such as keeping their attention on an alphabet of objects or words as well as storing lists and lists for solving math problems. The test can also check the ability of the individual to make informed decisions and use their judgment. The test determines a person's awareness, which is the understanding of their illness and how it affects them.
The person's attitude towards others, himself and the illness is also an important element of a mental evaluation. The tone of voice, facial expression, and body expressions of a patient could convey anger, depression, or a feeling of utter powerlessness. It is also important to note whether the patient is seeking help or just living with their illness.
In more serious situations, a mental health assessment might include an examination of the patient's mental state, which could involve 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, a mental health assessment should be holistic and consider the person's interactions with their social life. Health professionals can employ art, music or photos, or any other assessment tool to gain a better understanding of the person. They should also talk to the person about the issues that caused them to seek assistance and assure them that there is nothing wrong with seeing a mental health professional.