Mental Health Nursing - Assessing Mental Health
Mental health assessments often include a physical exam to rule out physical problems. This can include blood tests, urine testing, or even brain scans.
Psychologists also utilize a array of tools to measure mental health. These tools can vary from pencil and paper test forms to in depth interviews or self-completed questionnaires via mail.
Mood and affect
The clinician will first notice the patient's mood and emotional state. They define the patient's general emotional tone that can range from happiness to sadness, or even irritability to anger. Affect can be assessed by watching facial expressions and 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 refers to an emotion that is temporary, whereas mood is a state of sustained emotion. It is generally described as euthymic, or dysphoric or normal (meaning depressed). Professionals in psychiatry must be careful to avoid confusion between the terms because they are interpreted differently and are affected by various factors.
While the MSE is a valuable tool for clinical use however, it isn't always easy to interpret based on a subjective patient reports. Inquiring about the feelings of patients in the last few weeks can be more beneficial than relying on just the observations of a doctor. Recent research revealed that assessment tools were different in their ability to detect a substantial portion of symptoms. This included those that were grouped under the same disorder. This could be due to the different emphasis placed on emotional, cognitive or physical symptoms, as well as differences in the duration and frequency of reporting symptom reports.
It is possible that the MSE relies solely on self-reporting, which could be biased. For instance, a person who reports anxiety and a headache is likely to report a lower score than a patient who reports only a headache. Patients tend to minimize negative feelings while exaggerating positive ones.
Mood and affect can have a direct influence on thought content. This could affect decision-making, interpersonal behavior, and physical performance. They can be influenced by fatigue, stress social interactions, global events, hormones and even the weather. In actual fact positive moods have been shown to enhance thinking and creativity. However, a mood that is negative can affect concentration and cause confusion. A thorough and thoughtful mental health evaluation must consider the patient's mood as well as affect and the other factors.
Thought content
Assessing how the patient thinks is among the most crucial aspects of a mental state exam. Particularly, it is assessing thought process and thoughts. Thought process refers the coherence, logic, and organization of a patient's thinking. Normal thought processes are logical and focused on goals. In a variety of mental health conditions however, the thought process can be altered. Examples include hallucinations, delusions, and loose associations.
A mental state examination also evaluates insight and judgement. Insight is the ability to recognize the presence of a problem, and judgement is the ability to make a considered decision based on information. Both can be impaired by various mental health conditions such as schizophrenia and depression. If a patient is impaired in judgment and/or insight is at a higher chance of harming themselves or others. For instance when they are in danger of burning their home down the sensible judgment would tell them to leave the house immediately. However, a person with impaired judgment might recommend staying in the house and trying to put out the fire.
The content of a patient's thoughts includes the subject matter, themes and beliefs. Examiners will assess the clarity, relevance and content of a patient's thoughts. They will note any thoughts that are circumstantial or tangential, and whether the patient is having flashes of ideas (digressions from the topic of conversation). private mental health assessment will also provide feedback on a person's pace of thinking, for example, if they seem to be faster or slower.
Other important areas to consider are whether the patient's thoughts are congruent or incongruent with their environment. A patient with depression might hear voices of anger, while someone suffering from schizophrenia might experience a hallucination that a soothing voice is speaking. Patients should also be asked about any suicidal or homicidal thought. Although they are not common however, they can be life threatening and should be taken into account during every mental health assessment.
Observation
The nurse's ability to observe is essential in the mental assessment. They include a careful examination of appearance, behavior and any peculiar beliefs or perceptions (such hallucinations or delusions), mood, and cognition (including attention, memory and orientation). The nursing mental status exam also involves the observation of the movement. This is any physical activity, like eating, drinking and brushing teeth.
The observation component of the mental state exam is essential in determining whether a patient poses a risk to themselves or others. This is determined by assessing whether or not the patient is moving in a way which suggests they are in danger of harming themself or someone else.
A detailed evaluation of the content of thoughts is also accomplished by observing the patient during the interview and determining the preoccupations. It is important to check whether the patient is experiencing suicidal, homicidal, or delusional thoughts.
Global assessment of functioning (GAF), a numerical rating between 0 and 100, measures the capacity of an individual to function in daily life along with their capacity for managing stressors. The GAF is a crucial part of the mental status examination and helps to guide treatment decisions.
It is crucial to be aware of the fact that observing an individual's behavior can cause anxiety and it is important that the process is conducted in a way that doesn't provoke the patient or make them feel intrusive. It is also crucial that the patient is aware of the reason for the observation and the amount of time it will take.
Nursing observation is a vital skill that must be the core of any nursing program. It is crucial to keep in mind that patients might disagree on the degree of observation. If they cannot reach an agreement with staff members, they must be able access an advocate service to represent their interests and aid them in any discussions regarding their care. This should be part of local policy and practice, with the participation and the support of groups of patients.
Questioning
Many people have a difficult time talking about their mental health problems However, loved ones are often able to tell the signs that something is not right. They can also assist the person take steps to obtain an assessment. These assessments cover a wide range of subjects that include mood, appearance and thought process. A mental health professional could also ask questions regarding the person's personal life. They'll ask them what they've been feeling and what's happened in the last few days.
The assessment also includes a cognitive test that focuses on the ability of the individual to think clearly and retain information. The test subject may require the person to complete basic tasks, such as focussing on a list or objects, memorizing lists or solving math questions. The test will also test the ability of the individual to make informed decisions and use their judgment. The assessment determines a patient's insight which is their understanding of their illness and how it affects them.
Another vital aspect of an assessment of mental health is the person's attitude toward other people, himself and the illness. The tone of voice, the facial expressions, and body language of a patient can indicate depression, anger, or a feeling of powerlessness. It is also important to note whether the patient appears to be seeking help or resigned to living with their illness.
In more serious cases, an assessment of mental health might include a look at the patient's thinking, which may involve hallucinations or illusions. It is important to note the presence of these disorders because they can be extremely risky and even life-threatening.
In general the mental health assessment should take a holistic approach and look at the person's relationship to their social life. A health professional could use art, music, photos or a range of electronic assessment tools to better understand the person and their unique view of the world around them. They should also discuss the issues that led to the person to seek help, and assure them that there is nothing wrong with seeking out a mental healthcare professional.