Mental Health Nursing - Assessing Mental Health
A physical exam is usually part of mental health tests to rule out any physical issues. This may involve blood work and urine tests as well as brain scans.
Psychologists utilize a variety tools to assess mental health. These tools vary from pencil and paper test forms to in depth interviews or self-completed postal questionnaires.
Mood and affect
The doctor will first be aware of the patient's mood and affect. They describe a patient's general emotional tone. This could vary from joy to sadness or anger and irritability. Affect can be assessed by observing facial expressions and overall manner of speaking as well as the response to external or internal stimuli (e.g. smiling at the joke or crying over the loss of a loved one).
Affect is a feeling that is temporary, whereas mood is a state of sustained emotion. It is often described as being either euthymic (normal) or dysphoric, meaning depressed. However, psychiatrists must be careful not to confuse the terms because they have different definitions and are affected by a range of factors.
While the MSE is a valuable clinical tool however, it isn't always easy to interpret based upon subjective patient reports. It is therefore beneficial to inquire about how patients have been feeling in the last few weeks, instead of relying on physician observation only. Recent research showed that the assessment instruments differed in their capacity to detect a substantial part of symptoms. This included those that were grouped under the same disorder. 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.
mental health online assessment is possible that the MSE relies on self-reports, which may be prone to bias. A patient who has anxiety and headache is likely to report a lower score compared to one who reports only migraine. Patients tend to minimize negative emotions while exaggerating positive ones.
Affect and mood can have an impact on the content of thought. This could affect the way we make decisions, our interpersonal behavior, and physical functioning. They are influenced by fatigue, stress and social interactions, as well as world events, hormones, and weather. In actual fact positive moods have been proven to boost creativity and thinking power. However, a mood that is negative can reduce concentration and lead to confusion. A thorough and thoughtful mental health evaluation must be able to consider the patient's mood and affect, as well as underlying factors.
Thought content
Examining the way a patient thinks is among the most crucial aspects of a mental state examination. Assessment of thought process and content. The thought process is the coherence, logic, and organization of a patient's thoughts. Normal thought processes are rational and focused on goals. In several mental health conditions however, thought processing is distorted. Examples include delusions, hallucinations and loose associations.
A mental status examination also examines judgment and insight. Insight is the ability to identify the presence of a problem, and judgement is the ability to make a rational decision when presented with information. Both are affected by several mental health conditions, such as schizophrenia and depression. A patient with impaired insight or judgement is more likely to harm themselves or others. For instance if they are in danger of destroying their home the sensible judgment would tell that they should leave the premises immediately. A patient with impaired judgement may suggest that they stay in the house to try to put out the fire.
The contents of a patient's mind include the subject matter, themes and beliefs. Generally, examiners comment on the clarity, relatedness and quality of a patient's thought. They will also note tangential thoughts or those that are merely circumstantial, 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, for instance, whether they appear fast or slow.
Other important areas to consider are whether the patient's thoughts are congruent or incongruent with their surroundings. A person suffering from depression could hear angry voices, whereas those suffering from schizophrenia may experience a hallucination that a soothing voice is speaking. Ask the patient if they have any suicidal or homicidal ideas. They are not common, but they can be life-threatening and should be taken into account in every mental health assessment.
Watching
The observation skills of nurses play an important role in the mental health assessment. They include a careful review of the appearance, behavior as well as any unusual beliefs or perceptions (such as hallucinations or delusions) mood, as well as aspects of cognition (including attention to the environment, orientation, memory). The mental status exam for nurses also includes observing motility. This is any physical activity, like eating, drinking or brushing your teeth.
The observation component of the mental status examination is a crucial aspect of determining if the patient could pose an imminent risk to themselves or others. This is done by assessing whether the patient appears be acting in a deliberate manner that suggests they are planning to harm themselves or another person.
A detailed assessment of the thought-based content is also done by monitoring the patient during the interview and determining the concerns. It is crucial to determine if the patient is having suicidal or homicidal thoughts and to determine if they're having thoughts of delusion.
Global assessment of functioning (GAF) is a numerical rating from 0 to 100, measures the capacity of the person to perform in everyday life with their ability of managing stressors. The GAF is an important component of the mental health assessment and aids in making the treatment decisions.
It is important to recognize that observing the behavior of a patient can cause distress. It is crucial that the procedure is conducted in a manner that doesn't cause or feel intrusive. It is also vital that the patient is informed about the purpose of the observation and the length of time it will last.
Nursing observation is an important skill that should be an integral element of the nursing process. However, it should be remembered that patients may disagree with the level of observation and if they are unable to come to an agreement with staff, then they should be able to access an advocate service that will represent their interests and support their discussions on their treatment. This should be an integral part of local observation policy and practice, with the participation of user groups to ensure that patients are involved in the creation of written documents and staff training on this aspect of clinical governance.
Questioning
A lot of people are hesitant to discuss their mental health issues, however family members can often detect if something is not right. They can also help the person to obtain an assessment. These tests can be extremely broad and cover a variety of subjects including appearance, mood and memory, thinking process and much more. In addition to these tests, a mental health professional will also ask the individual questions about their personal life, such as what has been going on recently and what their feelings have been like.
The test consists of a cognitive evaluation that focuses on a person's ability to think clearly and remember information. The person may be asked to complete a few basic tasks, such as keeping their attention on the list of objects or words and recollecting lists of basic information or solving math problems. The test can also be used to check the individual's judgment and ability to make informed choices. The test also evaluates the patient's insight and level of understanding about their illness and its impact on them.
The patient's attitude towards others, himself and the illness is an important element of a mental evaluation. The tone of voice, the facial expression, and the body language of a patient may convey anger, depression or a sense of powerlessness. It is also important to determine whether the patient is seeking help or just living with their condition.
In more serious situations, a mental health assessment could include a thorough 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 disorders because they can be extremely hazardous and even life-threatening.
A mental health assessment should be holistic and focus on the person's interactions with their social world. A health professional may use art, music or photos or any other assessment tool to gain a better understanding of the person. They should also talk about the difficulties that prompted the person to seek help, and assure that there is nothing wrong with seeing a mental health professional.