Mental Health Nursing - Assessing Mental Health
Mental health assessments typically involve a physical examination, to rule out physical problems. This can include blood tests, urine test or even brain scans.
Psychologists also employ a variety of tools to assess mental health. These range from pen and paper test forms to in-depth interviews or self-complete questionnaires sent to you by post.
Affect and mood
The affect and mood are the most important components of the mental status exam (MSE) and are the first things to be observed by the clinician. They describe the patient's general emotional state that can range from joy to sadness, or anger to anger. The degree of affect can be determined by watching facial expressions and attitude as well as reactivity to internal or external stimuli (e.g. smiling at the joke or crying over the loss of a loved one).
Affect refers to an emotion that is temporary, while mood is a state of sustained emotion. It is usually described as euthymic, dysphoric or normal (meaning depressed). Professionals in psychiatry must be careful to avoid confusion between the terms because they are different in their definition and are affected by various factors.
While the MSE is a useful diagnostic tool, it can be difficult to interpret based on subjective patient report. It is therefore beneficial to inquire about how patients have been feeling in the last few weeks, as opposed to relying solely on the observations of doctors. A recent study showed that a significant percentage of symptoms, including those that fall under the same disorder category, differ between assessment tools. This could be due the differing emphasis on cognitive, emotional or physical symptoms, as along with differences in time periods and frequency of symptom reporting.
It is possible that the MSE relies on self-reports which is susceptible to bias. For example, a patient who reports anxiety and a headache is likely to report less than someone who has only a headache. Furthermore, there is the tendency for patients to downplay negative feelings and overestimate the severity of positive emotions.
The mood and the affect of a person can have a direct influence on the thought content. This can impact the way we make decisions, our interpersonal behavior, and physical function. They can be affected by stress, fatigue and social interactions, as well as global events, hormones and weather. A positive mood can actually increase creativity and mental strength. However, a mood that is negative can reduce concentration and lead to confusion. A thorough and meticulous mental health evaluation must take into account the patient's mood as well as affect as well as the fundamental factors.
Thought content
One of the most essential aspects of a mental state examination is assessing how the patient thinks. Assessment of the thought process and its content. The thought process is the coherence, logic and structure of the patient's thoughts. A normal thought processes is focused and logic-based. Thought processing can be distorted in a variety of mental health conditions. Examples include hallucinations, delusions and loose associations.
Insight and judgement are evaluated during a mental status exam. Insight is the ability to recognize the presence of a problem, while judgement is the ability to make a considered decision based on information. Both are impaired in many mental health conditions like schizophrenia and depression. If a patient suffers from impaired insight and/or judgement is at greater chance of harming themselves or others. For instance when they are at risk of destroying their home the sensible judgment would tell them to leave the building immediately. However, someone with impaired judgment might recommend staying in the house and attempting to put out the fire.
Thought content refers to the subject matter, themes and beliefs that a patient has. Examiners will assess the clarity, relatedness and the content of the thoughts of the patient. They will also note tangential thoughts or circumstantial ones, 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 a person's pace of thinking, such as whether they seem to be more or less fast.
It is also essential to determine whether the patient's mood is similar to their surroundings. A person suffering from depression could hear angry voices, whereas a person suffering from schizophrenia may have the illusion that a peaceful voice is speaking. Ask the patient if they've had any thoughts of suicide or homicide. These are uncommon, but could be life-threatening and should be taken into consideration 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 the appearance, behavior as well as any unusual beliefs or perceptions (such as hallucinations or delusions) mood, as well as aspects of cognition (including attention, orientation, memory). The nursing mental status exam also includes monitoring motility. This is any physical activity, such as eating, drinking, or brushing your teeth.
The observation component of the mental state examination is essential in determining whether the patient poses a risk to themselves or others. This is accomplished by determining whether the patient is acting in a manner that suggests that they are about to harm themselves or someone else.
A detailed assessment of the content of thoughts is also made by monitoring the patient during the interview and determining the preoccupations. It is important to check whether the patient is suffering from suicidal, homicidal, or delusional thoughts.
Global assessment of functioning (GAF) is a numerical rating between 0 and 100, evaluates the ability of the person to function in daily life with their ability of dealing with stressors. The GAF is an important element of the mental state examination and helps to guide treatment decisions.
It is important to be aware that observing an individual's behavior can cause anxiety and it is crucial that the procedure is carried out in a manner that doesn't provoke the patient or make them feel intrusive. It is also vital that the patient is informed about the purpose of the observation as well as the length of time it will last.
Nursing observation is an important ability and should be an integral element of the nursing process. It is crucial to keep in mind that patients might disagree on the level of observation. If they cannot come to an agreement with the staff, they should be able to use an advocate service that can represent their interests and assist them in any discussions about their treatment. This should be an integral part of the local policy and practice, including 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 hard to talk about their mental health problems however, family members will often be able to recognize the signs of something being wrong. They can also assist the person take an assessment. These assessments cover a wide range of subjects that include mood, appearance and thought process. A mental health professional could also inquire regarding the person's personal life. They will ask what they have been feeling and what has happened recently.
The test consists of a cognitive evaluation which focuses on an individual's ability think clearly and retain information. The test subject may require the person to complete basic tasks such as focusing on a list or objects, memorizing lists or solving math questions. The test can also check the person's ability to make informed decisions and make good judgments. private psychiatry assessment and level of understanding about their condition and its effects on them.
Another vital aspect of an assessment of mental health is the person's attitude toward the world, himself and his illness. The tone of voice, facial expression and body language can indicate anger, hostility, depression or a sense of insecurity. It is also important to know whether the patient appears to be seeking help or is content living with their illness.
In more serious instances the evaluation of mental health may include a thorough examination of the patient's mental state that may include illusions or hallucinations. It is vital to be aware of the presence of these conditions as they can be extremely hazardous and even life-threatening.
In general an assessment of mental health must be holistic and look at the person's relationship to their social world. Health professionals can employ art, music or photos or any other assessment tool to better understand the person. They should also talk with the person about the issues that have caused them to seek help and assure them that there is nothing wrong with seeking out an expert in mental health.