Mental Health Nursing - Assessing Mental Health
A physical exam is usually part of mental health tests to rule out any physical ailments. This may include blood tests or urine tests, as well as brain scans.
Psychologists utilize a variety instruments to evaluate mental health. These tools can vary from pencil and paper test forms to in depth interviews or self-completed questionnaires for postal mail.
Mood and affect
Mood and affect are among the most significant components of the mental health exam (MSE) and are the first thing to be observed by a clinician. They define the patient's general emotional state, which can range from happiness to sadness, or even irritability to anger. Affect can be measured by observing facial expressions and overall demeanour as well as the reactivity to internal or external stimuli (e.g. smiling at a joke or crying at the loss of a loved one).
Affect is a short-term emotion but mood is a more sustained emotional state. It is usually described as euthymic (normal) or dysphoric, which translates to depressed. However, psychiatrists must be careful not to misunderstand the terms because they have different definitions and are affected by a range of factors.
While the MSE is a useful diagnostic tool however, it can be difficult to interpret based upon subjective patient report. It is therefore beneficial to inquire about how patients have been feeling in the last few weeks, rather than relying on physician observation only. Recent research has revealed that assessment instruments differed in their capacity to identify a significant portion of symptoms. This included those that were classified under the same disorder. This can be because of the different emphasis placed on cognitive or emotional symptoms as well as the different time periods and frequency of symptom reporting.
It is possible that the MSE relies solely on self-reporting which could be biased. For example, a patient who describes experiencing anxiety and headaches will likely report an lower score than someone who has only the sensation of a headache. Additionally there is an inclination for patients to minimize negative feelings and overestimate the severity of positive feelings.
Affect and mood can have an impact on thought content. This can affect the way people make decisions, their interpersonal behavior and physical functioning. They are affected by stress, fatigue and social interactions. In actual fact positive moods have been proven to boost creativity and thinking power. A negative mood can lead to confusion and lower concentration. A thorough and meticulous mental health assessment should consider both the patient's mood and affect, as well as other factors.
Thought content
One of the most important aspects of a mental health examination is to determine how the patient thinks. Particularly, it is assessing thought process and thoughts. Thought process refers the logic, organization and coherence of a patient's thinking. Normal thought processes are rational and focused on a goal. Thought processing can be distorted when a person suffers from mental health issues. Examples include hallucinations, delusions and loose associations.
Insight and judgement are assessed in a mental status exam. Insight is the ability to see the presence of a problem, while judgement is the ability to make a considered decision when presented with information. Both can be impaired by several mental health conditions such as depression and schizophrenia. If a patient suffers from impaired judgment and/or insight, they are at greater chance of harming themselves or others. For instance if they are in danger of burning their home down, sensible judgement would tell that they should leave the premises immediately. However, a patient with impaired judgment might recommend staying in the house and attempting to put out the fire.
The contents of a patient's mind includes the subject matter, themes and beliefs. Typically, examiners discuss the clarity, relatedness and the content of a patient's thought. They will take note of any tangential or circumstantial thoughts or thoughts, and also if the patient is having flashes of thoughts (digressions from the topic of conversation). They will also discuss the speed of someone's thoughts, such as whether they appear fast or slow.
It is also crucial to determine whether the patient's mood is in line with the environment in which they live. For instance, a patient who is depressed could hear voices that are aggressive and threatening, whereas those suffering from schizophrenia may have a hallucination of an ethereal and calm voice. Ask the patient if they are experiencing any thoughts of suicide or homicide. Although they are uncommon, they can be life-threatening and must be considered in every mental health evaluation.
Watching
The ability of nurses to observe is vital in the mental assessment. They include a careful review of appearance, behaviour and any strange 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 involves monitoring the movement. This is any physical activity, such as eating, drinking and brushing your teeth.
The observation component of the mental state examination is essential in determining whether a patient poses a risk to them or anyone else. This is accomplished by determining whether the patient appears to be acting in a way that suggests they're trying to harming themselves or someone else.
Additionally, a thorough assessment of the content of thoughts is conducted by monitoring the patient throughout the interview and determining their main concerns. It is important to check whether the patient has suicidal, homicidal or delusional thoughts.
Global assessment of functioning (GAF) is a numerical rating between 0 and 100, combines the ability of the person to function in daily life with their ability of managing stressors. The GAF is an important component of the mental health exam and assists in guiding treatment decisions.
It is important to recognize that observing the behavior of a patient could cause anxiety. Therefore, it is essential to conduct the procedure in a way that doesn't cause or cause discomfort. It is essential that the patient is aware of the goal of the observations and the duration of the process.
Nursing observation is an essential skill and it must be a central part of the nursing process. Full Write-up is important to remember that patients can disagree with staff about the extent of observation. If they are unable to reach an agreement with staff, they should be able to use an advocate service to represent their interests and assist in any discussions regarding their care. This should be a part of the local policy and practice, with the participation and support of user groups.
Questioning
Many people are hesitant to talk about their mental health issues, but family members can often detect if something is not right. They can also encourage the person to get an assessment. These tests can be extremely broad and cover a variety of subjects, including appearance, mood, memory, thought process and many more. In addition to these tests, the mental health professional will also ask the person questions regarding their personal life, such as what's been happening recently and what their emotions have been like.
The test consists of an evaluation of the cognitive capacity which focuses on an individual's ability think clearly and retain information. The person could be asked to complete basic tasks such as paying attention to a list of objects, remembering lists, or solving math questions. The test may also test the person's ability to make informed decisions and use judgment. The assessment determines a patient's insight which is their understanding of their condition and how it affects them.
The person's attitude towards others, himself and the illness is also an important aspect of a mental assessment. The patient's tone of voice, facial expressions and body language can convey anger, hostility or depression, or a feeling of powerlessness. It is also important to determine whether the patient appears to be seeking help or is content living with their illness.
In more serious situations the assessment of mental health may include a look at the patient's thoughts that may include hallucinations or illusions. These conditions can be harmful and even deadly.
In general, a mental health assessment should be holistic and examine the person's connection to their social life. A health professional may use images, music, or art, or any other electronic assessment tool to gain a better understanding of the person. They should also talk with the person about the challenges that have caused them to seek assistance and assure them that there is nothing wrong with seeing a mental health professional.