Mental Health Nursing - Assessing Mental Health
A physical exam is often included in mental health assessments to rule out physical conditions. These can include urine tests, blood tests or even brain scans.
Psychologists also employ a variety of tools to assess mental health. These range from tests that are written on paper and pen to deep interviews or self-fill postal questionnaires.
Affect and mood
The affect and mood are the most crucial components of the mental status exam (MSE) and are the first to be observed by a doctor. They describe a patient's general emotional state. This can vary from joy to sadness or irritability and anger. The patient's mood can be measured by facial expressions, overall behavior and response to external or internal stimuli. You can express your emotions by smirking at a joke, or crying when you lose a beloved one.
Affect is a short-term emotion but mood is a more long-lasting emotional state. It is typically described as euthymic, or dysphoric, or normal (meaning depression). However, psychiatric professionals should be cautious not to misunderstand the terms as they have varying definitions and are influenced by a variety of factors.
While the MSE is a valuable clinical tool but it isn't always easy to interpret based on a subjective patient reports. It is therefore beneficial to ask patients how they've felt over the past few weeks, as opposed to relying solely on the observations of doctors. A recent study found that a large proportion of symptoms, even those grouped together under the same disorder category, differ between assessment tools. This can be because of the different emphasis on cognitive or emotional symptoms as well as the different time periods and frequency of reporting symptoms.
It is possible that the MSE relies on self-reporting, which can be biased. For instance, a person who describes experiencing a headache and anxiety will likely have an lower score than a patient who reports only a headache. Patients tend to minimize negative emotions while exaggerating positive feelings.
Mood and affect influence the content of thoughts which influences the way we make decisions, our interpersonal behavior and physical performance. They are influenced by fatigue, stress social interactions, global events, hormones and weather. Positive moods can boost creativity and mental energy. A mood that is negative can cause confusion and lower concentration. A thorough and careful mental health evaluation must take into account the patient's mood as well as affect and the underlying factors.
Thought content
One of the most important aspects of a mental state examination is to determine how the patient thinks. Evaluation of the thought process and its content. The thought process is the coherence, logic, and organization of a patient’s thoughts. Normal thought processes are rational and goal-oriented. Thought processing may be altered in several mental health conditions. Examples include hallucinations, delusions and loose associations.
Insight and judgement are also assessed in a mental status test. Insight is the ability to see the presence of a problem, while judgement is the ability to make an informed decision based on information. Both can be impaired by a variety of mental health issues such as schizophrenia and depression. If a patient suffers from impaired judgment or insight in any way, they are at a higher risk of harming themselves or others. For instance, if they are in danger of destroying their home the sensible judgment would tell them to leave the house immediately. However, a patient with impaired judgment might suggest staying in the building and attempting to put the fire out.
The contents of a patient's mind includes the subject matter, themes, and beliefs. Typically, examiners discuss the clarity, relatedness and quality of a patient's thinking. They will note tangential thoughts or circumstantial ones, as well as when a patient is digressing (digressions away from the subject of the conversation). They will also make comments on the speed at which someone is thinking, such as if they seem to be faster or slower.
It is also important to determine whether the patient's mood is similar to the environment in which they live. For example, a patient who is depressed could hear voices that sound aggressive and threatening, whereas those suffering from schizophrenia may be able to imagine an ethereal and calm voice. Patients should be asked about any homicidal or suicidal thought. They are not common, but they can be life-threatening and should be taken into account in every mental health assessment.
Observation
A nurse's observation skills are crucial in a mental health assessment. They are a thorough examination of appearance, behavior, any peculiar beliefs or perceptions (such hallucinations or delusions) and mood cognition (including memory, attention and orientation). The mental status exam for nurses also includes the observation of the movement. This is any physical activity, such as eating, drinking and brushing your teeth.
The Observation element of the mental health examination is a crucial aspect of determining whether the patient could pose a risk to themselves or others. This is accomplished by determining whether the patient is moving in a way that suggests that they may be threatening to harm themselves or someone else.
A thorough assessment of the content of thoughts is also made by monitoring the patient during the interview and determining preoccupations. It is essential to check if the patient is having suicidal or violent thoughts and to determine if they are having thoughts of delusion.
A global assessment of functioning (GAF) is an assessment of a numerical score on a scale from 0 to 100 that combines the ability of a person to perform in daily life with their ability to cope with the stresses that come with life. The GAF is a key part of the mental state exam and aids in making treatment decisions.
It is important to understand that observing the behaviour of a patient can cause distress. It is therefore important to conduct the procedure in a way that does not cause discomfort or make the patient feel uncomfortable. It is important 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 part of the nursing process. It is crucial to keep in mind that patients can disagree with staff about the extent of observation. If they are unable to reach an agreement with staff, they must be able access an advocate service to represent their interests and assist them in any discussions regarding their care. This should be a component of the local policy and practice, with the participation and support of user groups.
Questioning
Many people have a difficult time talking about their mental health problems, but loved ones can often notice when something is wrong. They can also help the person take steps to get an assessment. gp mental health assessment can be very broad and cover a variety of subjects including mood, appearance and thought process, memory and much more. In addition to these tests, the mental health professional will also ask the individual questions about their personal life, including what has been going on recently and what their emotions have been like.
The test consists of an evaluation of the cognitive capacity which focuses on an individual's ability to think clearly and retain information. The person may be required to complete basic tasks, such as focussing on a list or objects, memorizing lists or solving math questions. The test may also test the ability of the individual to make informed decisions and use judgment. The test measures a patient's perception, which is their knowledge of their condition and how it affects them.
Another crucial aspect of an assessment of mental health is the person's attitude towards the world, himself and his illness. The tone of voice, facial expressions, and body language of a patient can convey anger, depression, or a feeling of powerlessness. It is also important to know whether the patient appears to be seeking help or just living with their condition.
In more serious cases the mental health assessment may include an assessment of the patient's thinking that could include hallucinations (false sensory perceptions without real stimuli) or illusions (misperceptions of real stimuli). These conditions can be dangerous and even deadly.
A mental health assessment should be holistic and focus on the person's interaction to their world. A health professional might use art, music, photos or a variety of assessment tools that are electronic to help the person understand themselves and their unique view of the world around them. They should also discuss the challenges that led the person to seek help, and reassure them that there is nothing wrong with seeing a mental healthcare professional.