Mental Health Nursing - Assessing Mental Health
Mental health assessments often include a physical exam to rule out physical ailments. This could include urine tests, blood tests testing, or even brain scans.
Psychologists also employ a variety of tools to assess mental health. These tools range from paper and pencil test forms to more in-depth interviews or self-completed questionnaires via mail.
Affect and mood
Mood and affect are among the most significant elements of the mental state exam (MSE) and are the first things to be observed by a medical professional. They are the most accurate indicators of a patient's emotional state. This can vary from joy to sadness or irritability and anger. Affect can be measured by observing facial expressions and overall attitude as well as reactivity to internal or external stimuli (e.g. smiling at the joke or crying over the loss of a loved one).
Affect is a feeling that lasts only a few minutes but mood is a more long-lasting emotional state. It is generally described as euthymic, or dysphoric, or normal (meaning depressed). Psychiatric professionals should be careful to avoid confusion between the terms, as they are defined differently and can be affected by a variety of factors.
While the MSE is a useful clinical tool but it can be difficult to interpret based upon subjective patient report. It is therefore important to ask patients how they've been feeling over the last few weeks, as opposed to using only the observation of a physician. A recent study showed that a large proportion of symptoms, even those grouped together under the same disorder category, differ between assessment tools. This could be due the different emphasis placed on cognitive, emotional or physical symptoms, as along with differences in the duration and frequency of reporting symptoms.
It is also possible that the MSE relies on self-report, which may be prone to bias. For instance, a person who describes experiencing anxiety and a headache is likely to report a lower score than someone who has only the sensation of a headache. Patients tend to minimize negative emotions while exaggerating positive feelings.
The affect and mood of a person influence the content of thoughts which influences the way people make decisions, their interpersonal behavior and physical performance. They are influenced by fatigue, stress social interactions, world events, hormones, and weather. In actual fact, a positive mood has been proven to increase creativity and thinking power. However, a mood that is negative can decrease concentration and cause confusion. Therefore, a careful and thorough mental health evaluation needs to consider the patient's mood and state of mind as well as their underlying factors.
Thought content
One of the most crucial aspects of a mental health examination is assessing how the patient thinks. Particularly, evaluating thought processes and thoughts. The thought process is the logic, coherence and organization of a patient's thoughts. Normal thought processes are logical and goal-oriented. Thought processing may be altered when a person suffers from mental health issues. Examples include hallucinations, delusions and loose associations.
A mental status examination also assesses the quality of insight and judgement. Insight is being able to identify a problem. mental health assessment uk is the capability of making a well-considered decision after receiving information. Both can be impaired by several mental health conditions like depression and schizophrenia. Patients with impaired insight or judgment is more likely to harm themselves or others. For instance when they are in danger of burning their house down and they have a good sense of judgement, it would be wise for them to leave the building immediately. However, a person with impaired judgment might suggest staying in the building and attempting to put the fire out.
Thought content includes the topics, subjects and beliefs that a patient has. Examiners will evaluate the clarity, relevance and the content of the thoughts of the patient. They will also note tangential thoughts or circumstantial ones, and in the event that the patient's thoughts diverge (digressions away from the subject of the conversation). They will also comment on the speed of someone's thoughts, including whether they seem fast or slow.
Other important aspects to consider are whether the patient's thoughts are congruent or incongruent with their environment. A person suffering from depression could hear voices of anger, while someone suffering from schizophrenia may experience an illusion that a calm voice is speaking. Ask the patient if they have any suicidal or homicidal thoughts. Although they are uncommon, they can be life threatening and should be taken into account in every mental health assessment.
Watching
A nurse's observation skills play an important role in a mental health assessment. They are a thorough review 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). A mental state examination for nurses also incorporates observation of mobility, which includes any physical movement, such as eating, drinking, brushing teeth, using the toilet and taking off shoes.
The observation component of the mental health exam is an essential element of determining whether or not the patient could pose an imminent risk to themselves or others. This is done by assessing whether the patient appears to be moving in a way that suggests that they may be threatening to harm themselves or someone else.
A thorough assessment of the thought content is also done by monitoring the patient during the interview and determining their preoccupations. It is crucial to check if the patient has any suicidal or homicidal ideas and to determine if they are having thoughts of delusion.
A global assessment of functioning (GAF) is an evaluation of the numerical value on a scale ranging from 100 to 0 that measures the ability of a person to function in everyday life and their ability to cope with the stressors in their life. The GAF is a crucial component of the mental state exam and assists in making treatment decisions.
It is crucial to be aware that observing an individual's behavior could cause anxiety, and it is important to conduct the procedure in a way that does not provoke the patient and does not make them feel uncomfortable. It is also vital that the patient is fully aware of the reason for the observation and the amount of time it will last.
Nursing observation is a crucial skill that should be at the heart of any nursing procedure. However, it should be noted that patients might not agree with the degree of observation and if they are unable to come to an agreement with staff then they should be able to access an advocate service which can represent their needs and help patients in any discussions about their care. This should be a component of the local policy and practice, with the participation and support of groups of users.
Questioning
Many people are reluctant to talk about their mental health issues, but family members can often tell when something is amiss. They can also help the person take steps to get an assessment. These tests can be extremely broad and cover a wide range of subjects, including appearance, mood, memory, thought process and many more. In addition to these tests, mental health professionals will also ask the individual questions about their personal life, including 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 remember information. The test taker may be asked to complete a few basic tasks, such as keeping their attention on an alphabet of words or objects and recollecting lists of basic information or solving math problems. The test may also test the ability of the individual to make sound decisions and use their judgment. The test measures a patient's perception, which is their knowledge of their illness and how it affects them.
The patient's attitude towards others, himself and the illness is an important part of a mental assessment. The patient's tone of voice, facial expression and body language can convey anger, hostility or depression, or a feeling of helplessness. It is important to observe whether the patient appears be seeking help or accepting their condition.
In more serious situations the assessment of mental health may include a thorough examination of the patient's thoughts that may include illusions or hallucinations. It is vital to be aware of the presence of these conditions because they can be extremely risky and even life-threatening.
In general, a mental health assessment must be holistic and look at the person's relationship to their social life. A health professional might use art, music, photos or a range of assessment tools that are electronic to better understand the person and their unique view of the world around them. They should also talk to the person about the issues that caused them to seek help and reassure them that there is nothing wrong with seeing an expert in mental health.
