Mental Health Nursing - Assessing Mental Health
Mental health assessments usually include a physical exam to rule out physical conditions. This can include blood tests, urine test or even brain scans.
Psychologists also utilize a range of tools to evaluate mental health. These range from tests that are written on paper and pen to in-depth interviews, or self-complete questionnaires sent to you by post.
Mood and affect
The affect and mood are the most crucial components of the mental status examination (MSE) and are the first thing to be observed by a medical professional. They are the most accurate indicators of a patient's emotional state. This could be anything from sadness to happiness or irritability and anger. Affect can be assessed by looking at facial expressions and 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 refers to an emotion that is temporary, whereas mood is a long-lasting emotion. It is usually described as euthymic (normal) or dysphoric, which means depressed. However, psychiatrists must be careful not to mix the two because they have different definitions and are influenced by a variety of factors.
The MSE can be a valuable instrument for diagnosing clinical conditions, but it is difficult to interpret from a subjective patient report. Asking patients about their feelings during the past few weeks is more helpful than relying solely on observations from a physician. A recent study showed that a significant percentage of symptoms, even those grouped together within the same disorder category, vary between assessment tools. This could be due to the different emphasis on cognitive or emotional symptoms as well as differences between time periods and frequency of symptom reporting.
It is possible that the MSE relies solely on self-reporting, which can be biased. For example, a patient who describes experiencing anxiety and headaches will likely have less than a patient who reports only an occasional headache. Furthermore, there is the tendency for patients to minimize negative feelings and overestimate the severity of positive ones.
Mood and affect have a direct impact on the content of thoughts and can affect the way we make decisions, our interpersonal behavior, and physical functioning. They are affected by fatigue, stress and social interactions. Positive moods can boost creativity and mental energy. A negative mood can cause confusion and lower concentration. A thorough and meticulous mental health assessment must take into account both the patient's mood and affect and the fundamental factors.
Thought content
One of the most crucial aspects of a mental health examination is assessing how the patient thinks. Specifically, evaluating thought process and thoughts. Thought process refers the logic, organization and coherence of a patient's thinking. Normal thought processes are rational and goal-oriented. In many mental health disorders however, thought processing can be altered. Examples include hallucinations, delusions and loose associations.
A mental status examination also examines judgment and insight. Insight is the ability to spot problems. Judgment is the capability to make a well-considered choice after receiving information. Both are impaired in several mental health conditions, like schizophrenia and depression. If a patient is impaired in insight and/or judgement is at greater chance of harming themselves or others. For instance, if they are in danger of burning their home down, sensible judgement would tell them to leave the building immediately. However, a person with impaired judgment might recommend staying in the house and attempting to put out the fire.
The content of a patient's thoughts includes their themes, subject matter and beliefs. Examiners will comment on the clarity, connection, and content of thoughts of the patient. They will note any thoughts that are tangential or circumstantial or thoughts, and also if the patient is having flashes of ideas (digressions from the subject of conversation). They will also provide feedback on the pace at which a person is thinking, for example, if they seem to be faster or slower.
Other important aspects to consider are whether the patient's thoughts are congruent or incongruent with their surroundings. A person suffering from depression could hear voices of anger, while someone suffering from schizophrenia might experience an illusion that a calm voice is speaking. Ask the patient if they are experiencing any thoughts of suicide or homicide. Although they are uncommon however, they can be life-threatening and must be considered in every mental health evaluation.
Watching
The observation skills of nurses are essential to an assessment of mental health. They involve a thorough evaluation of appearance, behavior, any peculiar beliefs or perceptions (such hallucinations or delusions) and mood cognition (including memory, attention, orientation). A mental state examination for nurses also incorporates observation of mobility, which includes any physical activity like eating drinking, eating, brushing teeth using the toilet and putting on shoes.
The Observation component of the mental state examination is essential in determining whether the patient poses a risk to themselves or others. This is determined by assessing whether or not the patient is acting in a manner which suggests they are about to harm themselves or anyone else.
Additionally, a thorough assessment of the content of thoughts is conducted by observing the patient throughout the interview and determining their main concerns. It is crucial to determine whether the patient has suicidal, homicidal, or delusional thoughts.
A global assessment of functioning (GAF) is a numerical rating on a scale ranging from 100 to 0 that measures the ability of a person to function in everyday life with their ability to deal with the stresses in their lives. The GAF is an essential part of the mental state exam and helps guide treatment decisions.
It is crucial to realize that observing the behavior of a patient could cause distress. It is therefore important that the process be conducted in a way that does not provoke or cause discomfort. It is also vital that the patient is fully informed about the purpose of the observation and the length of time it will last.
Nursing observation is a crucial skill that should be the core of any nursing program. However, it must be noted that patients might not agree with the degree of observation. If they are unable to reach an agreement with staff then they should have access to an advocate service which can represent their needs and help patients in any discussions about their treatment. This should be a fundamental element of the local observation policy and practice, with the participation of user groups to ensure that patients are included in the development of written information as well as staff training for this aspect of governance in the clinic.
Questioning
Many people have a hard to discuss their mental health issues, but loved ones can often notice when something is wrong. They can also urge the person to get an assessment. These assessments be conducted on a variety of subjects such as mood, appearance and thought process. 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 assessment also includes a cognitive test that is focused on the ability of the individual to think clearly and recall information. The person may be asked to complete simple tasks, such as keeping their attention on a list of objects or words, memorizing simple lists or solving math problems. The test can also be used to check the person's judgment and ability to make good choices. The test measures a patient's perception, which is their knowledge of their condition 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 indicate hostility, anger depression or a feeling of helplessness. It is important to check whether the patient seems to be seeking help or accepting their situation.
In more serious instances the assessment of mental health could include a look at the patient's mental state which could include illusions or hallucinations. assessment for mental health can be dangerous and even fatal.
In general an assessment of mental health should be holistic and look at the person's relationship to their social environment. Health professionals can employ art, music or photos or any other assessment tool to gain a better understanding of the individual. They should also speak to the person about the challenges that caused them to seek help and reassure them that there is nothing wrong with seeking out a mental health professional.