Mental Health Nursing - Assessing Mental Health
Mental health assessments typically include a physical exam to rule out physical problems. This could involve blood tests, urine tests or brain scans.
Psychologists utilize a variety instruments to evaluate mental health. They can use tests that are written on paper and pen to in-depth interviews or self-complete questionnaires for postal delivery.
Mood and affect
The affect and mood are the most significant elements of the mental state exam (MSE) and are the first thing to be observed by a doctor. They describe a patient's general emotional tone. This can vary from joy to sadness or irritability and anger. Affect can be measured by observing facial expressions and overall manner of speaking as well as the reaction to external or internal stimuli (e.g. You can express your feelings by laughing at a joke, or crying when you lose a loved one.
Affect is a temporary emotion, whereas mood is a more sustained emotional state. It is typically described as euthymic, normal, or dysphoric (meaning depression). Professionals in psychiatry must be careful to avoid confusion between the two terms because they are defined differently and are affected by a variety of factors.
The MSE can be a useful tool for clinical diagnosis however, it can be difficult to interpret from an individual patient's report. Inquiring about the feelings of patients in the last few weeks is more helpful than relying on only physician observations. A recent study showed that a significant percentage of symptoms, even those grouped together within the same disorder category, differ between assessment tools. This can be because of the different emphasis placed on cognitive or emotional symptoms as well as the different the time intervals and frequency of the reporting of symptoms.
It is also possible that the MSE relies on self-report which could be susceptible to bias. A patient who reports both anxiety and headache is likely to report a lower score compared to those who report only migraine. Patients tend to minimize negative feelings while exaggerating positive feelings.
Mood and affect can have an impact on the content of thought. This could affect the way we make decisions, our interpersonal behavior, and physical function. They are affected by stress, fatigue and social interactions. In actual fact, a positive mood has been proven to increase thinking and creativity. However, a mood that is negative can decrease concentration and cause confusion. A thorough and thoughtful mental health assessment should consider the patient's mood and affect as well as the fundamental factors.
Thought content
One of the most crucial aspects of a mental state examination is assessing how the patient thinks. Assessment of thought process and content. Thought process refers to the coherence, logic and organization of a patient's thinking. Normal thought processes are logical and goal-oriented. In several mental health conditions however, thought processing is altered. Examples include hallucinations, delusions, and loose associations.
A mental status examination also evaluates insight and judgement. Insight is the ability to recognize the presence of an issue, and judgement is the ability to make an informed decision when presented with information. Both can be impaired by several mental health conditions such as depression and schizophrenia. If a patient is impaired in judgment and/or insight is at a higher chance of harming themselves or others. For example if they are in danger of burning their home down the sensible judgment would tell them to leave the building immediately. A patient with impaired judgment may suggest that they stay in the building to try and put out the fire.
Thought content is the subject matter, themes and beliefs that a patient holds. Examiners will assess the clarity, connection and content of a thoughts of the patient. They will take note of any tangential or circumstantial thoughts or thoughts, and also if the patient is having flashes of ideas (digressions from the topic of conversation). They will also comment on the speed at which someone is thinking, for example, if they seem to be faster or slower.
Other important areas to consider are whether the patient's thoughts are mood and in tune with their surroundings. A patient with depression might hear voices of anger, while a person suffering from schizophrenia might experience the illusion that a peaceful voice is speaking. Ask the patient if they've had any thoughts of suicide or homicide. Although they are uncommon, they can be life-threatening and must be taken into consideration during every mental health assessment.
Observation
A nurse's observation skills play an important role in an assessment of mental health. They include a careful review of behavior, appearance and any strange beliefs or perceptions (such as hallucinations or delusions) mood, as well as aspects of cognition (including attention, orientation memory, and orientation). A mental state examination for nurses also involves observing mobility, which includes any physical activity like eating drinking, eating, brushing teeth or using the toilet, as well as putting on shoes.
The observation component of the mental status examination is a key component of determining whether or not a patient may pose the risk to themselves or others. This is determined by assessing whether the patient appears to be acting in a way that suggests they're about harm themselves or another person.
A detailed assessment of the content of thoughts is also accomplished by observing the patient during the interview and determining concerns. It is important to check whether the patient is experiencing suicidal, homicidal or delusional thoughts.
Global assessment of functioning (GAF) which is an assessment of functioning in numerical form, ranging from 0 to 100, measures the capacity of an individual to perform in everyday life with their ability of dealing with stressors. The GAF is a vital element of the mental state examination and helps to guide treatment decisions.
It is important to be aware that observing the behavior of a patient can cause anxiety and it is crucial to conduct the procedure in a way that does not cause anxiety for the patient or make them be uncomfortable for them. how to get a mental health assessment is important that the patient be fully aware of the goal of the observations and the length of the procedure.
Nursing observation is a crucial skill that should be a central part of any nursing program. However, it must be noted that patients might not agree with the degree of observation. If they are unable to come to an agreement with the staff, they should have access to an advocate service which can represent their needs and help them in any discussions regarding their care. This should be an integral part of local observation policy and practice, with the involvement of user groups, to ensure that patients are a part in the development of written documents and staff training for this aspect of clinical governance.
Questioning
Many people have a difficult to discuss their mental health problems However, loved ones are often able to tell when something is wrong. They can also help the person take an assessment. These tests can be a variety of topics, including mood, appearance and thought process. In addition to these tests, a mental health professional will also ask the individual questions about their personal life, including what's been happening recently and what their emotions have been like.
The assessment also includes a cognitive assessment that focuses on the ability of the individual to think clearly and retain information. The person could be asked to complete simple tasks such as focussing on a list or objects, remembering lists, or solving math questions. The test can also be used to check the individual's judgment and ability to make sound decisions. The test also evaluates the patient's knowledge that reflects their level of understanding about their illness and its impact on them.
The patient's attitude towards himself, others and the illness is an important aspect of a mental evaluation. The tone of voice, facial expression and body language may convey anger, hostility, depression or a sense 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, an assessment of mental health might include a thorough examination of the patient's thinking that may include hallucinations or illusions. These conditions can be dangerous and even deadly.
In general an assessment of mental health should be holistic and consider the person's relationship to their social world. A health professional may employ images, music, art or a range of assessment tools using electronic technology to help the person understand themselves and their unique perspective on the world around them. They should also talk about the challenges that led the person to seek help, and assure them there is nothing wrong in seeing an expert in mental health.