Mental Health Nursing - Assessing Mental Health
A physical exam is usually included in mental health tests to rule out physical ailments. These can include urine tests, blood tests test or even brain scans.
Psychologists employ a variety of tools to assess mental health. These tools be anything from pencil and paper test forms, to in-depth interviews or self-completed questionnaires via mail.
Affect and mood
Mood and affect are the most crucial components of the mental status exam (MSE) and are the first things to be observed by a medical professional. They are the general mood that can range from joy to sadness, or even irritability to anger. Affect can be assessed by watching facial expressions and demeanour as well as the response to external or internal stimuli (e.g. smiling at the joke or crying over the loss of a loved one).
Affect is a temporary emotion while mood is a more long-lasting emotional state. It is usually described as either euthymic (normal) or dysphoric, meaning depressed. Psychiatric professionals should be careful to avoid confusion between the two terms because they are defined differently and are affected by various factors.
While the MSE is a useful clinical tool however, it isn't always easy to interpret based on subjective patient report. It is therefore important to ask patients how they've been feeling over the last few weeks, instead of relying solely on the observations of doctors. Recent research showed that the assessment instruments differed in their capacity to detect a substantial part of symptoms. This included those that were grouped under the same disorder. This could be due to the different emphasis placed on emotional or cognitive symptoms, as well as the different time periods and frequency in reporting symptoms.
It is also possible that the MSE relies on self-report which is susceptible to bias. A patient who reports both a headache and anxiety is likely to report a lower score compared to those who report only migraine. Patients tend to minimize negative emotions while exaggerating positive feelings.
The affect and mood of a person influence the content of thoughts and can affect decision-making, interpersonal behaviour, and physical functioning. They can be affected by stress, fatigue, social interactions, world events, hormones, and weather. In fact, a positive mood has been proven to boost creativity and thinking power. A negative mood can lead to confusion and lower concentration. Therefore, a thorough and thorough mental health assessment is required to consider the patient's mood and affect as in addition to the underlying causes.
Thought content
Assessing how the patient thinks is one of the most crucial aspects of a mental health exam. Specifically, evaluating thought process and thoughts. The term "thought process" refers to the logic, organization and coherence of a patient's thinking. Normal thought processes are rational and focused on a goal. In many mental health disorders however, thought processing is altered. Examples include hallucinations, delusions and loose associations.
A mental health assessment also assesses the quality of insight and judgement. Insight is being able to identify problems. Judgment is the ability of making a well-considered decision after receiving information. Both can be impaired by various mental health conditions like depression and schizophrenia. If a patient suffers from impaired insight and/or judgement is at greater risk of harming themselves or others. For example when they are at risk of burning their home down, sensible judgement would tell them to leave the building immediately. A patient with impaired judgement might suggest that they remain in the building to try to get rid of the fire.
The contents of a patient's mind include the subject matter, themes and beliefs. Generally, examiners comment on the clarity, relatedness and content of a patient's thinking. They will also note any thoughts that are tangential or circumstantial and also whether the patient is prone to having a flurry of thoughts (digressions from the topic of conversation). They will also comment on a person's pace of thinking, such as whether they seem fast or slower.
Other areas to be considered are whether the patient's thoughts are compatible or not in line with their surroundings. For example, a patient who is depressed might hear voices that sound angry and threatening, while those suffering from schizophrenia may experience a hallucination of a calm and soothing voice. Ask the patient if they have any suicidal or homicidal thoughts. These are uncommon, but could be life-threatening and should be taken into account during every mental health assessment.
Observation
The observation skills of nurses are crucial in an assessment of mental health. They involve a thorough evaluation of appearance, behavior and any peculiar beliefs or perceptions (such hallucinations or delusions) mood, cognition (including attention, memory, orientation). The mental status exam for nurses also involves the observation of motility. This includes any physical movement, like eating, drinking or brushing teeth.
The observation component of the mental health examination is vital in determining if the patient poses a risk to themselves or anyone else. This is determined by assessing if the patient appears to be acting in a way that suggests they're trying to harm themselves or another person.
A detailed evaluation of the thought content is also done by monitoring the patient during the interview and determining concerns. It is crucial to determine whether the patient is suffering from suicidal, homicidal or delusional thoughts.
Global assessment of functioning (GAF) is which is a numerical score ranging between 0 and 100, measures the capacity of a person to perform in everyday life and their capability of coping with stressors. The GAF is a crucial part of the mental status exam and assists in guiding treatment decisions.
It is crucial to realize that observing the behavior of a patient may cause anxiety. It is therefore important to conduct the procedure in a manner that doesn't cause or feel intrusive. It is also vital that the patient is aware of the reason for the observation and the length of time it will last.
Nursing observation is an important skill and it must be a central element of the nursing process. It is important to remember that patients might disagree on the level of observation. If they cannot reach a consensus with staff, they should be able to access an advocate service to represent their interests and aid them in any discussions regarding their care. mental health assessments for adults should be an integral element of the local observation 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 on this aspect of clinical governance.
Questioning
A lot of people are hesitant to discuss their mental health issues, but their family members are often able to tell when something is amiss. They can also help the person to get an assessment. These assessments can be very broad and cover a wide range of subjects such as mood, appearance as well as memory, thought process and much more. In addition to these tests, a mental health professional will also ask the individual questions about their life, such as what's happened recently and what their feelings have been like.
The test also includes a cognitive assessment that focuses on the person's ability to think clearly and retain information. The test subject may ask to complete basic tasks, such as keeping their attention on an alphabet of objects or words and recollecting lists of basic information or solving math problems. The test will also test the person's ability to make informed decisions and use their judgment. The test also evaluates the patient's knowledge and understanding of the illness and its effects on them.
Another vital aspect of an assessment of mental health is the person's attitude towards the world, himself and his illness. The patient's voice, facial expression and body language may convey hostility, anger or depression, or a feeling of helplessness. It is also important to determine whether the patient is seeking help or just living with their illness.
In more serious instances the evaluation of mental health may include a thorough examination of the patient's thoughts, which may involve illusions or hallucinations. These conditions can be harmful and even deadly.
In general, a mental health assessment should be holistic and examine the person's relationship to their social life. Health professionals can employ art, music or photos, or any other assessment tool to gain a better understanding of the individual. They should also speak to the person about the issues that have caused them to seek help and reassure them that there is nothing wrong with visiting a mental health professional.