Mental Health Nursing - Assessing Mental Health
A physical exam is often part of mental health tests to rule out any physical ailments. These can include urine tests, blood testing, or even brain scans.
Psychologists also use a wide array of tools to measure mental health. These tools vary from pencil and paper test forms to in depth interviews or self-completed postal questionnaires.
Affect and mood
The clinician will first notice the patient's mood as well as their affect. They are the general mood, which can range from happiness to sadness, or even irritability to anger. The affect can be assessed through facial expressions, general attitude and response to external or internal stimuli. smiling at a joke or crying at the loss of a loved one).
Affect is a temporary emotion while mood is a longer-lasting emotional state. It is usually described as euthymic or dysphoric, or normal (meaning depression). However, psychiatrists must be careful not to misunderstand the terms as they have varying definitions and are influenced by a variety of factors.
The MSE is a helpful instrument for diagnosing clinical conditions however, it can be difficult to interpret based on the subjective report of a patient. It is therefore helpful to ask patients how they have been feeling over the last few weeks, rather than relying solely on the observations of doctors. A recent study found that a large proportion of symptoms, which includes those that fall within the same disorder category, vary between assessment tools. This could be due the differing emphasis on cognitive, emotional or physical symptoms, as well as differences in duration and frequency of reporting symptoms.
It is possible that the MSE relies on self-reports which could be susceptible to bias. A patient who has anxiety and a headache is likely to get a lower score compared to one who reports only migraine. In addition there is a tendency for patients to minimize negative feelings and overestimate the severity of positive emotions.
The affect and mood of a person directly affect thought content, which can influence the way we make decisions, our interpersonal behavior and physical functioning. They are affected by fatigue, stress and social interactions. In reality, a positive mood has been proven to boost creativity and thinking power. However, a mood that is negative can decrease concentration and cause confusion. A thorough and thoughtful mental health assessment should be able to consider both the patient's mood and affect and the other factors.
Thought content
One of the most essential aspects of a mental state examination is to determine how the patient thinks. Evaluation of the thought process and its content. The thought process is the coherence, logic and structure of a patient's thoughts. Normal thought processes are objective-oriented and logic-based. Thought processing may be altered when a person suffers from mental health issues. Examples include hallucinations, delusions and loose associations.
A mental health assessment also examines judgment and insight. Insight is the ability to recognize the presence of an issue, and judgement is the ability to make a considered decision when presented with information. Both are affected by many mental health conditions such as schizophrenia and depression. If a patient is impaired in judgment and/or insight in any way, they are at a higher risk of causing harm to themselves or others. For instance, if they are in danger of destroying their home and they have a good sense of judgement, it would be wise for that they should leave the premises immediately. A person with impaired judgment might suggest they stay in the building to try and get rid of the flame.
Thought content includes the topics, subjects and beliefs that a patient has. Generally, examiners comment on the clarity, relatedness and content of a patient's thoughts. They will take note of any thoughts that are circumstantial or tangential, and whether the patient is prone to having a flurry of thoughts (digressions from the subject of conversation). They will also make comments on the speed of a person's thoughts, for instance, whether they seem fast or slow.
Other important areas to consider are whether the patient's thoughts are and in tune with their environment. Patients suffering from depression may hear voices of anger, while someone suffering from schizophrenia may have a hallucination that a soothing voice is speaking. The patient should also be asked about any homicidal or suicidal thoughts. Although they are not common, they can be life threatening and should be taken into account in every mental health assessment .
Watching
The nurse's ability to watch is essential in an assessment of mental health. They are a thorough review of the appearance, behavior and any strange beliefs or perceptions (such as hallucinations or delusions) mood, and aspects of cognition (including attention to orientation, attention memory). A mental health assessment for nursing also includes observing mobility, which includes any physical activity like eating, drinking, brushing teeth, using the toilet and taking off shoes.
The Observation component of the mental status exam is an essential element of determining if the patient is posing the risk to themselves or others. This is accomplished by determining whether the patient appears be acting in a way that suggests they're about harm themselves or another person.
In addition, a detailed thought content assessment is made by keeping track of the patient throughout the interview and determining their main concerns. It is essential to determine whether the patient is suffering from suicidal, homicidal or delusional thoughts.
Global assessment of functioning (GAF) is a numerical rating from 0 to 100, combines the ability of the person to perform in everyday life and their capability of dealing with stressors. The GAF is a vital component of the mental health exam and assists in guiding treatment decisions.
It is essential to be aware that watching a patient's behaviour could cause anxiety, and it is crucial that the process is conducted in a manner that does not provoke the patient and does not feel intrusive. It is crucial that the patient is aware of the reason for the observations and the duration of the process.
Nursing observation is an essential skill that must be at the heart of any nursing process. However, it must be noted that patients might not agree with the degree of observation and if they cannot reach an agreement with staff then they should have access to an advocate service which can represent their interests and support them in any discussions regarding their care. This should be an integral part of the local policy and practice, including the participation of user groups to ensure that patients are involved in the development of written information as well as staff training for this aspect of clinical governance.
Questioning
A lot of people are hesitant to discuss their mental health issues, however family members can usually tell when something is amiss. They can also encourage the person to take a look at an assessment. These tests can be extremely broad and cover a variety of topics including mood, appearance and thought process, memory and many more. A mental health professional could also ask questions about the person's private life. They will ask what they feel and what has happened recently.
The test also includes a cognitive evaluation that is focused on the ability of the individual to think clearly and remember information. The test taker may be asked to complete basic tasks, such as focusing their attention on an alphabet of objects or words, memorizing simple lists or solving math problems. The test can also be used to check the individual's judgment and ability to make good choices. The test also assesses the patient's insight and level of understanding about their condition and its effects on them.
The patient's attitude toward others, himself and the illness is also an important element of a mental evaluation. The tone of voice, facial expression, and the body language of a patient may indicate depression, anger or a sense of powerlessness. It is crucial to determine whether the patient seems to be asking for help or accepting their condition.
In more serious situations the mental health assessment might include an assessment of the patient's thinking, which could involve hallucinations (false sensory perceptions that do not correspond to real stimuli) or illusions (misperceptions of real stimuli). It is crucial to recognize the presence of these conditions because they can be extremely dangerous and even life-threatening.
In general, a mental health assessment should take a holistic approach and consider the person's relationship to their social environment. Health professionals can employ images, music, or art, or any other electronic assessment tool to better understand the individual. They should also speak to the person about the difficulties that caused them to seek help and assure them that there is nothing wrong with visiting an expert in mental health.