Mental Health Nursing - Assessing Mental Health
A physical exam is usually included in mental health tests to rule out physical issues. This may involve blood work, urine tests or brain scans.
Psychologists also employ a array of tools to measure mental health. These range from pen and paper test forms to in-depth interviews or self-complete postal questionnaires.
Mood and affect
Mood and affect are among the most crucial components of the mental status exam (MSE) and are the first thing to be viewed by the medical professional. They describe the patient's general mood that can range from joy to sadness or irritability to anger. The effect can be analyzed through facial expressions, overall attitude and reaction to internal or external stimuli. smiling at a joke or crying at the loss of a loved one).
Affect is a short-term emotion while mood is a more sustained emotional state. It is often described as either euthymic (normal) or dysphoric, meaning depressed. Psychologists should be cautious 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 useful tool for clinical use however, it isn't always easy to interpret based on subjective patient report. It is therefore beneficial to ask patients how they have been feeling in the last few weeks, as opposed to relying solely on the observations of doctors. Recent research showed that the assessment instruments differed in their capacity to capture a significant portion of symptoms. This included the symptoms that were classified under the same disorder. This can be due to the different emphasis placed on cognitive, emotional or physical symptoms, as along with differences in duration and frequency of reporting symptom reports.
It is possible that the MSE is based solely on self-reporting, which could be biased. For example, a patient who reports a headache and anxiety will likely have an lower score than a patient who reports only a headache. Additionally there is an inclination for patients to downplay negative feelings and overestimate the severity of positive feelings.
Affect and mood have a direct impact on the content of thoughts and can affect the way we make decisions, our interpersonal behavior, and physical functioning. They are influenced by fatigue, stress social interactions, world events, hormones, and even the weather. In fact, a positive mood has been proven to increase creativity and thinking power. Conversely, a negative mood can decrease concentration and cause confusion. A thorough and careful mental health assessment should take into account the patient's mood and affect as well as the fundamental factors.
Thought content
One of the most crucial aspects of a mental health examination is to determine how the patient thinks. Particularly, evaluating private mental health assessment and thought content. Thought process refers to the coherence, logic, and organization of a patient's thinking. The normal process of thinking is focused and rational. In several mental health conditions however, thought processing can be altered. Examples include hallucinations and delusions as well as loose associations.
Insight and judgment are assessed in a mental status exam. Insight is the ability to recognize a problem. Judgment is the capability to make a well-considered choice after receiving information. Both are impaired in many mental health conditions such as depression and schizophrenia. Patients with impaired insight or judgment is more likely to hurt themselves or others. If they are in danger, their sensible judgement would suggest leaving the premises immediately. However, a person with impaired judgment might decide to stay in the building and trying to put the fire out.
Thought content refers to the topics, subject matter, and beliefs that a patient has. Generally, examiners comment on the clarity, relevance and the content of a patient's thinking. They will also note any thoughts that are circumstantial or tangential, and whether the patient is having flashes of ideas (digressions from the topic of conversation). They will also make comments on a person's pace of thinking, for example, if they seem fast or slower.
Other areas to be considered are whether the patient's thoughts are and in tune with their surroundings. For example, a patient who is depressed could hear voices that sound angry and threatening, while a person with schizophrenia might have a hallucination of the sound of a calm and soothing voice. Ask the patient if they've had any suicidal or homicidal ideas. Although they are uncommon but they could be life-threatening and should be taken into account in every mental health assessment.
Watching
The nurse's ability to observe is vital in an assessment of mental health. They will conduct a thorough examination of appearance, behaviour as well as any unusual beliefs or perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention to the environment, orientation, memory). The nursing mental state exam also involves observing the movement. This includes any physical movement, such as eating, drinking or brushing your teeth.
The Observation element of the mental health exam is an essential element of determining whether the patient is posing the risk to themselves or others. This is accomplished by determining if the patient appears to be acting in a deliberate manner that suggests they are planning to harm themselves or another person.
A detailed assessment of the thought content is also done by monitoring the patient during the interview and determining the preoccupations. It is essential to determine whether the patient has suicidal, homicidal, or delusional thoughts.
A global assessment of functioning (GAF) is an assessment of a numerical score on a scale ranging from zero to 100 that evaluates the capacity of a person to perform in daily life with their ability to cope with the stressors in their life. The GAF is a vital element of the mental state examination and helps to guide treatment decisions.
It is important to understand that observing the behavior of a patient can cause anxiety. It is therefore important to conduct the procedure in a manner that doesn't cause or make the patient feel uncomfortable. It is also vital that the patient is informed about the purpose of the observation and the length of time it will take.
Nursing observation is an essential ability and should be a central part of the nursing process. However, it should be noted that patients might be dissatisfied with the quality of observation and if they cannot reach an agreement with the staff, they should have access to an advocate service which can represent their interests and assist their discussions on their treatment. This should be a fundamental part of the local policy and practice with the involvement of user groups to ensure that patients are involved in the development of written documents and staff training to support this aspect of governance in the clinic.
Questioning
Many people are hesitant to discuss their mental health issues, but family members can usually discern when something isn't right. They can also encourage the person to get an assessment. These assessments be a variety of subjects that include mood, appearance and thought process. A mental health professional can also inquire about the person's private life. They'll ask them what they have been feeling and what's happened in the last few days.
The test also includes a cognitive evaluation that is focused on the person's ability to think clearly and recall information. The person could be asked to complete simple tasks such as focusing on a list or objects, recollecting lists or solving math questions. The test can also check the person's ability to make good decisions and use judgment. The test measures a patient's awareness, which is the understanding of their illness and how it affects them.
The person's attitude toward others, himself and the illness is an important aspect of a mental assessment. The tone of voice, facial expressions, and body expressions of a patient could convey anger, depression or a sense of powerlessness. It is important to check whether the patient appears to seek assistance or is accepting their situation.
In more serious situations the mental health assessment might include an examination of the patient's thoughts that may include hallucinations (false sensory perceptions without real stimuli) or illusions (misperceptions of real stimuli). It is important to note the presence of these disorders because they can be extremely risky and even life-threatening.
A mental health assessment should be holistic and focus on the person's interactions with their social world. A health professional may use images, music, or art, or any other electronic assessment tool to better understand the individual. They should also talk to the person about the challenges that caused them to seek assistance and reassure them that there is nothing wrong with visiting a mental health professional.