Mental Health Nursing - Assessing Mental Health
Mental health assessments typically include a physical exam, to rule out physical ailments. This could involve blood tests or urine tests, as well as brain scans.
Psychologists employ a variety of tools for assessing mental health. These tools vary from pencil and paper test forms, to in-depth interviews or self-completed questionnaires for postal mail.
Mood and affect
The doctor will first observe the patient's mood and affect. They are the most accurate indicators of a patient's emotional tone. This can range from happiness to sorrow or irritability and anger. Affect can be assessed by looking at facial expressions and manner of speaking as well as the reaction to external or internal stimuli (e.g. smiling at an absurd joke or crying over the loss of a loved one).
Affect is a feeling that lasts only a few minutes, whereas mood is a more sustained emotional state. It is usually described as euthymic (normal) or dysphoric, which means depressed. However, psychiatric professionals should be cautious not to misunderstand the terms because they have different definitions and are influenced by a variety of factors.
While the MSE is a useful clinical tool however, it isn't always easy to interpret based on a subjective patient report. Inquiring about the feelings of patients during the past few weeks can be more beneficial than relying on just physician observations. A recent study showed that a significant proportion of symptoms, which includes those that are grouped within the same disorder category, differ between assessment tools. This could be due the different emphasis placed on cognitive, emotional or physical symptoms as well as differences in the duration and frequency of reporting symptoms.
It is possible that the MSE is based solely on self-reporting, which could be biased. A patient who has anxiety and a headache is likely to have an lower score than a patient reporting only a migraine. Additionally, there is a tendency for patients to downplay negative emotions and overestimate the severity of positive feelings.
The mood and the affect of a person can have an impact on the thought content. This can affect the way we make decisions, our interpersonal behavior, and physical function. They can be affected by stress, fatigue and social interactions, as well as world events, hormones, and weather. Positive moods can increase creativity and mental strength. A negative mood can cause confusion and lower concentration. A thorough and meticulous mental health assessment must consider the patient's mood and affect and the underlying factors.
Thought content
Examining the way a patient thinks is one of the most crucial aspects of a mental health exam. Specifically, evaluating thought process and thought 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 can be altered in a variety of mental health conditions. Examples include hallucinations, delusions and loose associations.
Insight and judgment are evaluated during a mental status test. Insight is the ability to spot a problem. Judgement is the process to make a well-considered choice after receiving information. Both are affected by several mental health conditions, like schizophrenia and depression. If a patient is impaired in judgment or insight in any way, they are at greater chance of harming themselves or others. For example when they are in danger of burning their home down and they have a good sense of judgement, it would be wise for them to leave the house immediately. A patient with impaired judgement might suggest that they remain in the house to try to get rid of the flame.
The content of a patient's thoughts include their subject matter, themes, and beliefs. Examiners will evaluate the clarity, relatedness, and content of thoughts of the patient. They will note any thoughts that are tangential or circumstantial, and whether the patient has flights of ideas (digressions from the conversation subject). They will also comment on the pace at which a person is thinking, such as if they seem to be more or less fast.
Other areas to be considered are whether the patient's thoughts are mood congruent or incongruent with their environment. Patients suffering from depression may hear angry voices, whereas a person suffering from schizophrenia might experience an illusion that a calm voice is speaking. Ask the patient if they are experiencing any suicidal or homicidal thoughts. These are uncommon, but could be life-threatening and should be taken into consideration during every mental health assessment .
Watching
The nurse's ability to watch is vital in an assessment of mental health. They include a careful examination of behavior, appearance, any unusual beliefs or perceptions (such delusions or hallucinations), mood, and cognition (including attention, memory, orientation). The nursing mental status exam also includes observing motility. This is any physical activity, like eating, drinking or brushing your teeth.
The Observation element of the mental state exam is an essential element of determining whether or not a patient may pose an imminent risk to themselves or others. This is determined by assessing whether the patient appears to be moving in a way which suggests they may be threatening to harm themselves or someone else.
A thorough assessment of the thought-based content is also done by monitoring the patient during the interview and determining the preoccupations. It is essential to determine if the patient is suffering from suicidal or homicidal ideas and to determine if they're having thoughts of suicide or delusions.
A global assessment of functioning (GAF) is an evaluation of the numerical value on a scale of 0 to 100 that combines the capacity of a person to perform in daily life along with their ability to deal with the stressors in their life. The GAF is a vital part of the mental status exam and assists in guiding treatment decisions.
It is important to be aware of the fact that observing the behavior of a patient could cause anxiety, and it is essential to conduct the procedure in a manner that does not cause anxiety for the patient and does not feel intrusive. It is also crucial that the patient is aware of the reason for the observation as well as the length of time it will take.
Nursing observation is a crucial skill that should be a central part of any nursing procedure. However, it must be kept in mind that patients could be dissatisfied with the quality of observation and if they are unable to reach an agreement with staff, then they should be able to access an advocate service which can represent their needs and help patients in any discussions about their care. This should be part of the local policy and practice, with the participation and support of groups of users.
Questioning
Many people are reluctant to discuss their mental health issues, however family members can usually discern when something isn't right. They can also encourage the person to seek an assessment. These assessments can be very broad and cover a range of subjects, such as mood, appearance and memory, thought process and much more. A mental health professional may also inquire about the person's personal life. They will ask them what they have been feeling and what has happened recently.
The assessment includes an assessment of cognitive ability which focuses on an individual's ability to think clearly and retain information. The test subject may ask to complete a few basic tasks, such as keeping their attention on an alphabet of objects or words, memorizing simple lists or solving math problems. The test may also test the ability of the individual to make informed decisions and use judgment. The test determines a person's awareness, which is the understanding of their illness and how it affects them.
The patient's attitude towards others, himself and the illness is an important aspect of a mental evaluation. The patient's expression, facial expression and body language may convey anger, hostility depression or a feeling of powerlessness. It is also important to know whether the patient is seeking help or just living with their condition.
In more serious cases the evaluation of mental health might include an examination the patient's thinking that may include hallucinations or even illusions. These conditions can be extremely dangerous and even fatal.
In general an assessment of mental health should take a holistic approach and examine the person's connection to their social environment. Health professionals can employ images, music, or art or any other assessment tool to gain a better understanding of the individual. They should also talk to the person about the difficulties that led them to seek help and reassure them that there is nothing wrong with visiting a mental health professional.