Mental Health Nursing - Assessing Mental Health
A physical exam is usually part of mental health assessments to rule out any physical issues. This may involve blood work and urine tests as well as brain scans.
Psychologists also utilize a range of tools to evaluate mental health. These tools can vary from pencil and paper test forms, to in-depth interviews or self-completed questionnaires via mail.
Affect and mood
The affect and mood are the most important components of the mental status exam (MSE) and are the first to be observed by a medical professional. They define a patient's general emotional state. It can range from happiness to sorrow or irritability and anger. Affect can be measured by observing facial expressions and overall manner of speaking as well as the response to external or internal stimuli (e.g. You can express your feelings by smiling at a joke, or crying when you lose a loved one.
Affect is a feeling that is temporary, while mood is a state of sustained emotion. It is usually described as either euthymic (normal) or dysphoric, meaning depressed. Professionals in psychiatry must be careful to not confuse the two terms because they are different in their definition and are affected by many factors.
While the MSE is a helpful diagnostic tool however, it can be difficult to interpret based upon subjective patient report. Asking patients about their feelings over the past few weeks is more effective than relying on just the observations of a doctor. Recent research showed that the assessment tools were different in their ability to capture a significant part of symptoms. This included the symptoms that were classified under the same disorder. This could be due to the different emphasis on emotional, cognitive or physical symptoms, as and also the different time periods and frequency of symptom reporting.
It is possible that the MSE relies on self-report which could be susceptible to bias. A patient who has anxiety and headache is likely to get a lower score compared to a patient reporting only headache. Additionally there is an inclination for patients to downplay negative emotions and underestimate the severity of positive ones.
The affect and mood of a person directly affect thought content which influences the way people make decisions, their interpersonal behavior and physical functioning. They can be affected by stress, fatigue and social interactions. A positive mood can increase creativity and mental strength. A negative mood can reduce concentration and lead to confusion. Therefore, a careful and thorough mental health evaluation needs to consider the patient's current mood and emotional state as well as their underlying factors.
Thought content
The ability to determine how a patient thinks is one of the most important aspects of a mental state examination. Specifically, evaluating thought process and thought content. Thought process refers the coherence, logic, and organization of a patient's thought processes. assessment mental health are logical and focused on a goal. Thought processing can be distorted when a person suffers from mental health issues. Examples include hallucinations, delusions and loose associations.
A mental state examination also assesses the quality of insight and judgement. Insight is the ability to recognize the presence of a problem. Judgment is the capability to make a rational decision after receiving information. Both are impaired in several mental health conditions, such as depression and schizophrenia. If a patient is impaired in insight and/or judgement is at a higher chance of harming themselves or others. If they are in danger, their rational judgment would advise them to leave the house immediately. A patient with impaired judgment may suggest that they stay in the building to try and get rid of the flame.
The thoughts of a patient include the subject matter, themes and beliefs. Examiners will assess the clarity, connection and content of a patient's thoughts. They will be able to identify tangential ideas or circumstantial ones, as well as in the event that the patient's thoughts diverge (digressions away from the subject of the conversation). They will also discuss the speed of someone's thoughts, such as whether they seem fast or slow.
Other important aspects to consider are whether the patient's thoughts are mood congruent or incongruent with their environment. For instance, a patient who is depressed could hear voices that are angry and threatening, while a person with schizophrenia might have a hallucination of the sound of a calm and soothing voice. A patient should be asked about any suicidal or homicidal ideation. These are rare but can be life-threatening and should be taken into account in every mental health evaluation.
Watching
The ability of nurses to observe is crucial in the mental assessment. They involve a thorough evaluation of behavior, appearance, any unusual beliefs or perceptions (such hallucinations or delusions) and mood cognition (including memory, attention, orientation). The nursing mental status exam is also a way of monitoring motility. This includes any physical movement such as eating, drinking or brushing your teeth.
The observation component of the mental status exam is an essential element of determining whether the patient could pose an imminent risk to themselves or others. This is accomplished by determining whether the patient appears to be moving deliberately in a way that suggests that they may be threatening to harm themselves or someone else.
A thorough assessment of the thought content is also accomplished by observing the patient during the interview and determining their preoccupations. It is essential to determine whether the patient is suffering from suicidal, homicidal or delusional thoughts.
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 perform in daily life and their ability to cope with the stresses in their lives. The GAF is a vital component of the mental health examination and helps to guide treatment decisions.
It is crucial to realize that observing the behaviour of a patient may cause distress. Therefore, it is essential to conduct the procedure in a manner that does not provoke or make the patient feel uncomfortable. It is essential that the patient is aware of the goal of the observations and the length of the procedure.
Nursing observation is a crucial ability and should be a key element of the nursing process. However, it must be remembered that patients may disagree with the level of observation. If they cannot reach an agreement with the staff, they should have access to an advocate service that will represent their interests and support patients in any discussions about their care. This should be a fundamental part of the local policy and practice, with the participation of user groups to ensure that patients are a part in the creation of written documents and staff training on this aspect of clinical governance.
Questioning
Many people have a difficult time talking about their mental health issues However, loved ones will often be able to recognize when something is wrong. They can also encourage the person to get an assessment. These assessments can be very broad and cover a variety of subjects including mood, appearance and thought process, memory and much more. A mental health professional can also inquire about the person's private life. They'll ask them what they feel and what's happened in the last few days.
The assessment also includes a cognitive test that focuses on the ability of the individual to think clearly and retain information. The person may be asked to complete a few basic tasks, like focusing their attention on an alphabet of objects or words as well as storing lists and lists for solving math problems. The test can also be used to check the person's judgment and ability to make informed choices. The test also evaluates the patient's insight, which reflects their understanding of their condition and its effects on them.
Another crucial aspect of an assessment of mental health is the patient's attitude towards others, himself and his illness. The patient's tone of voice, facial expressions and body language can convey anger, hostility depression or a feeling of helplessness. It is also important to note whether the patient is seeking help or just living with their condition.
In more serious cases the evaluation of mental health could include an examination the patient's thinking that may include hallucinations or even illusions. It is important to note the presence of these conditions as they can be extremely hazardous and even life-threatening.
In general, a mental health assessment should be holistic and examine the person's interactions with their social life. A health professional could use photographs, music, art or a range of electronic assessment tools to better understand the person and their unique view of the world around them. They should also speak to the person about the challenges that have caused them to seek help and reassure them that there is nothing wrong with seeking out a mental health professional.