Mental Health Nursing - Assessing Mental Health
A physical examination is typically part of mental health assessments to rule out physical conditions. This may involve blood work or urine tests, as well as brain scans.
Psychologists also utilize a array of tools to measure mental health. These tools be anything from pencil and paper test forms to in depth interviews or self-completed questionnaires via mail.
Affect and mood
The clinician will first notice the patient's mood and affect. They describe a patient's general emotional tone. This can vary from joy to sadness or anger and irritability. get a mental health assessment can be measured through facial expressions, overall demeanor and the response to external or internal stimuli. You can express your emotions by smiling at the joke or crying when you lose a loved one.
Affect is a temporary emotion but mood is a more sustained emotional state. It is generally described as euthymic, normal, or dysphoric (meaning depressed). Psychologists should be cautious to not confuse the two terms because they are defined differently and can be affected by a variety of factors.
While the MSE is a useful clinical tool however, it isn't always easy to interpret based on subjective patient report. It is therefore beneficial to inquire about how patients have been feeling in the last few weeks, as opposed to relying on physician observation only. A recent study revealed that a significant proportion of symptoms, which includes those grouped together within the same disorder category, differ between assessment tools. This could be due to the different emphasis placed on cognitive or emotional symptoms as well as differences between the time intervals and frequency of symptom reporting.
It is possible that the MSE relies solely on self-reporting, which could be biased. For instance, a person who reports a headache and anxiety is likely to report an lower score than a person who describes only the sensation of a headache. Patients tend to minimize negative emotions while exaggerating positive feelings.
The affect and mood of a person have a direct impact on the content of thoughts which influences the way we make decisions, our interpersonal behavior and physical performance. They are affected by fatigue, stress and social interactions. In reality, a positive mood has been proven to boost creativity and thinking power. A negative mood can reduce concentration and lead to confusion. Therefore, a careful and thorough mental health assessment needs to take into account the patient's current mood and affect as well as their underlying factors.
Thought content
Assessing how the patient thinks is one of the most crucial aspects of a mental health examination. Specifically, evaluating thought process and thought content. Thought process refers the logic, organization and coherence of a patient's thought processes. A normal thought processes is goal directed and logical. In a variety of mental health conditions however, the thought process is altered. Examples include hallucinations, delusions and loose associations.
Insight and judgement are assessed during a mental state exam. Insight is the ability to identify that there is an issue, and judgement is the ability to make a rational decision when presented with information. Both are affected by several mental health conditions, such as depression and schizophrenia. Patients with impaired insight or judgement is more likely to hurt themselves or others. If they are in danger, their sensible judgement would tell to leave the home immediately. A patient with impaired judgement might suggest they stay in the house to try to get rid of the fire.
The content of a patient's thoughts include their subject matter, themes, and beliefs. Typically, examiners discuss the clarity, connection and content of a patient's thinking. They will note any tangential or circumstantial thoughts or thoughts, and also if the patient has flights of ideas (digressions from the topic of conversation). They will also provide feedback on a person's pace of thinking, for example, if they seem to be faster or slower.
It is also important to determine whether the patient's mood is in line with their environment. For instance, a patient who is depressed might hear voices that sound aggressive and threatening, whereas a person with schizophrenia might be able to imagine an ethereal and calm voice. Ask the patient if they are experiencing any thoughts of suicide or homicide. Although they are not common but they could be life-threatening and must be taken into consideration in every mental health evaluation.
Watching
The ability of nurses to observe is crucial in the mental assessment. They include a careful examination of behavior, appearance, any peculiar beliefs or perceptions (such delusions or hallucinations) and mood cognition (including memory, attention and orientation). A mental state examination for nurses also includes observing the ability to move, which includes physical movement such as eating or drinking, brushing your teeth, using the toilet and putting on shoes.
The Observation portion of the mental state exam is vital in determining if a patient poses a risk to them or others. This is determined by assessing whether or not the patient appears to be acting in a manner that suggests they may be threatening to harm themselves or someone else.
Additionally, a thorough thought content assessment is made by monitoring the patient throughout the interview and identifying their preoccupations. It is important to check whether the patient is experiencing suicidal, homicidal, or delusional thoughts.
Global assessment of functioning (GAF), a numerical rating between 0 and 100, combines the ability of an individual to function in daily life and their capability of coping with stressors. The GAF is an essential part of the mental state exam and aids in making treatment decisions.
It is essential to be aware of the fact that observing a patient's behaviour can cause anxiety and it is important to conduct the procedure in a manner that does not provoke the patient and doesn't feel intrusive. It is also crucial that the patient is fully aware of the reason for the observation as well as the length of time it will take.
Nursing observation is an essential skill that should be a key element of the nursing process. However, it should be kept in mind that patients could not agree with the degree of observation. If they cannot reach an agreement with staff, then they should have access to an advocate service that will represent their needs and help their discussions on their treatment. This should be an integral part of the local policy and practice with the involvement of user groups to ensure that patients are involved in the development of written information as well as staff training on this aspect of clinical governance.
Questioning
A lot of people are hesitant to discuss their mental health issues, but family members are often able to discern when something isn't right. They can also encourage the person to take a look at an assessment. These assessments be a variety of subjects, including mood, appearance and the thought process. A mental health professional can also inquire about the person's private life. They will ask them what they have been feeling and what has happened recently.
The assessment also includes a cognitive assessment that is focused on the person's ability to think clearly and retain information. The test taker may be asked to complete a few basic tasks, like focusing their attention on the 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 determines a person's insight which is their understanding of their condition and how it affects them.
The person's attitude towards himself, others and the illness is an important aspect of a mental evaluation. The tone of voice, facial expression, and body language of a patient may signal depression, anger, or a feeling of powerlessness. It is also important to note whether the patient appears to be seeking help or resigned to living with their condition.
In more serious instances the mental health assessment could include a thorough examination of the patient's thoughts that may include hallucinations (false sensory perceptions that do not correspond to real stimuli) or illusions (misperceptions of real stimuli). These conditions can be extremely dangerous and even fatal.
In general, a mental health assessment should be holistic and look at the person's connection to their social life. A health professional may use art, music or photos, or any other electronic assessment tool to better understand the individual. They should also discuss the difficulties that prompted the person to seek help, and assure them that there is nothing wrong with seeking out an expert in mental health.