Mental Health Nursing - Assessing Mental Health
Mental health assessments usually include a physical exam to rule out physical ailments. This could include blood tests, urine tests or even brain scans.
Psychologists also utilize a array of tools to measure mental health. These range from 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 crucial elements of the mental state exam (MSE) and are the first thing to be observed by the medical professional. They describe the patient's general emotional state, which can range from happiness to sadness or irritability to anger. The patient's mood can be measured by facial expressions, overall attitude and reaction to external or internal stimuli. You can express your feelings by smirking at the joke or crying when you lose a loved one.
Affect refers to an emotion that is temporary, whereas mood is a state of sustained emotion. It is often described as euthymic (normal) or dysphoric, which means depressed. However, psychiatric specialists should be cautious not to mix the two because they have different definitions and are affected by a variety of factors.
While the MSE is a helpful diagnostic tool however, it can be difficult to interpret based on subjective patient reports. Asking patients about their feelings during the past few weeks is more helpful than relying on only the observations of a doctor. A recent study showed that a significant proportion of symptoms, including those that are grouped within the same disorder category, differ between assessment tools. This could be due the different emphasis on cognitive, emotional or physical symptoms, as well as differences in duration and frequency of reporting symptoms.
It is possible that the MSE is based on self-reporting which could be susceptible to bias. A patient who has anxiety and a headache is likely to have lower scores than one who reports only a migraine. Patients tend to minimize negative emotions while exaggerating positive feelings.
Mood and affect can have a direct influence on the content of thought. This could affect decision-making, interpersonal behavior, and physical performance. They are affected by fatigue, stress and social interactions. A positive mood can actually enhance creativity and mental power. Conversely, a negative mood can reduce concentration and lead to confusion. A thorough and thoughtful mental health evaluation must consider both the patient's mood and affect as well as the other factors.
Thought content
The ability to determine how a patient thinks is among the most important aspects of a mental state exam. Particularly, evaluating thought processes and thought content. The thought process is the coherence, logic and structure of a patient's thoughts. Normal thought processes are rational and focused on goals. In many mental health disorders however, thought processing can be altered. Examples include hallucinations and delusions as well as loose associations.
A mental state examination also examines judgment and insight. Insight is being able to spot problems. Judgment is the ability of making a well-considered decision after receiving information. Both can be impaired in several mental health conditions, such as schizophrenia and depression. If a patient has impaired judgment and/or insight in any way, they are at a higher risk of causing harm to themselves or others. For example if they are at risk of burning their home down and they have a good sense of judgement, it would be wise for them to leave the house immediately. mental health assessment test with impaired judgment might suggest they stay in the house to try to get rid of the fire.
Thought content refers to the subject matter, themes and beliefs that a patient holds. Examiners will comment on the clarity, relatedness and the content of the patient's thoughts. They will also note any thoughts that are circumstantial or tangential and also whether the patient has flights of thoughts (digressions from the conversation subject). They will also provide feedback on a person's pace of thinking, for example, if they seem to be more or less fast.
Other important areas to consider are whether the patient's thoughts are mood compatible or not in line with their surroundings. For example, a patient who is depressed might hear voices that are angry and threatening, while those suffering from schizophrenia may experience a hallucination of the sound of a calm and soothing voice. The patient should be asked about any suicidal or homicidal thoughts. Although they are not common but they could be life threatening and should be taken into account during every mental health assessment.
Watching
The nurse's ability to watch is crucial in a mental assessment. They will conduct a thorough examination of the appearance, behavior as well as any unusual beliefs or perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention to orientation, attention memory, and orientation). A mental state examination for nurses also includes observing motility, including any physical movement, such as eating, drinking, brushing teeth, using the toilet and putting on shoes.
The Observation component of the mental health examination is vital in determining if the patient poses a risk to them or others. This is accomplished by determining whether the patient appears be acting in a way that suggests they are trying to harming themselves or someone else.
A thorough assessment of the content of thoughts is also made by monitoring the patient during the interview and determining thoughts and concerns. It is particularly important to determine if the patient is having suicidal or homicidal ideas and to determine if they're having delusions.
Global assessment of functioning (GAF) is an assessment of functioning in numerical form, ranging from 0 to 100, combines the ability of the person to function in daily life and their capability of managing stressors. The GAF is a crucial component of the mental health examination and aids in making treatment decisions.
It is crucial to realize that observing the behaviour of a patient could cause distress. Therefore, it is essential that the process be conducted in a way that does not cause discomfort or feel intrusive. It is also vital that the patient is fully aware of the reason for the observation and the length of time it will last.
Nursing observation is a crucial skill and it must be a key part of the nursing process. However, it must be remembered that patients may disagree with the level of observation. If they are unable to reach an agreement with the staff, they should be able to access an advocate service that can represent their interests and support patients in any discussions about their care. This should be part of local policy and practice, with the participation and support of groups of patients.
Questioning
Many people are hesitant to talk about their mental health issues, but their family members can usually tell when something is amiss. They can also urge the person to get an assessment. These assessments can be very broad and cover a wide range of topics including mood, appearance, thought process, memory and many more. In addition to these tests, a mental health professional will also ask the individual questions about their life, such as what's been happening recently and what their feelings have been like.
The test includes a cognitive evaluation which focuses on an individual's ability to think clearly and retain information. The test subject may require the person to complete simple tasks such as focussing on a list or objects, remembering lists or completing math problems. The test may also test the person's ability to make good decisions and use judgment. The test determines a person's awareness, which is the understanding of their illness and how it affects them.
The attitude of the patient towards himself, others and the illness is an important aspect of a mental assessment. The patient's tone of voice, facial expressions and body language can convey anger, hostility, depression or a sense of helplessness. It is crucial to determine whether the patient seems to seek help or accepting their condition.
In more serious cases the evaluation of mental health could 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 take a holistic approach and consider the person's interactions with their social life. Health professionals can employ photographs, music, art, or any other assessment tool to better understand the individual. They should also talk about the challenges that led the person to seek help, and assure that there is nothing wrong with seeing a mental health professional.