Mental Health Nursing - Assessing Mental Health
Mental health assessments often include a physical exam to rule out physical problems. These can include blood tests, urine tests or even brain scans.
Psychologists also use a wide array of tools to measure mental health. These tools be anything from pencil and paper test forms to in depth interviews or self-completed postal questionnaires.
Mood and affect
The doctor will first observe the patient's mood as well as their affect. They define a patient's general emotional tone. It can vary from joy to sadness or anger and irritability. The patient's mood can be measured through facial expressions, overall behavior and reaction to external or internal stimuli. You can express your feelings by smiling at an absurd joke, or crying when you lose a beloved one.
Affect is a feeling that is temporary, while mood is a state of constant emotion. It is usually described as euthymic, or dysphoric, or normal (meaning depressed). Professionals in psychiatry must be careful to avoid confusion between the terms, as they are defined differently and can be affected by various factors.
The MSE can be a useful tool for diagnosing clinical problems, but it is difficult to interpret based on an individual patient's report. The process of asking patients to share their experiences in the last few weeks is more effective than relying on only observations from a physician. A recent study found that a significant proportion of symptoms, including those grouped together under the same disorder category, vary between assessment tools. This could be due to the different emphasis placed on cognitive, emotional or physical symptoms as along with differences in time periods and frequency of reporting symptoms.
It is possible that the MSE relies on self-reports which could be susceptible to bias. For instance, a person who describes experiencing anxiety and a headache will likely report a lower score than a patient who reports only the sensation of a headache. Patients tend to minimize negative feelings while exaggerating positive ones.
Mood and affect can have a direct impact on thought content. This can impact the way people make decisions, their interpersonal behavior and physical function. They can be affected by stress, fatigue, social interactions, world events, hormones, and weather. A positive mood can boost creativity and mental energy. A negative mood can cause confusion and lower concentration. A thorough and meticulous mental health evaluation must take into account the patient's mood and affect, as well as underlying factors.
Thought content
Assessing how the patient thinks is one the most important aspects of a mental state examination. Particularly, evaluating thought processes and thought content. The thought process is the coherence, logic, and organization of a patient's thoughts. Normal thought processes are rational and focused on goals. Thought processing may be altered in a variety of mental health conditions. Examples include delusions, hallucinations and loose associations.
Insight and judgement are assessed in a mental status test. Insight is the ability to see the presence of a problem, and judgement is the ability to make an informed decision when presented with information. Both can be impaired by various mental health conditions like depression and schizophrenia. A person who isn't able to see or judgement is more likely to harm themselves or others. If they are in danger, their sensible judgment would advise them to leave the house immediately. A patient with impaired judgement 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 holds. Examiners generally comment on the clarity, connection and the content of a patient's thinking. They will be able to identify tangential ideas 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 make comments on the pace at which a person is thinking, such as whether they seem to be faster or slower.
Other important areas to consider are whether the patient's thoughts are mood compatible or not in line with their environment. For example, a patient who is depressed may hear voices that sound angry and threatening, while those suffering from schizophrenia may have a hallucination of an ethereal and calm voice. Ask the patient if they've had any suicidal or homicidal ideas. Although these are rare but they could be life threatening and should be taken into consideration during every mental health assessment.
Observation
The nurse's ability to watch is crucial in a mental assessment. They are a thorough review of behavior, appearance and any strange beliefs or perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention to orientation, attention memory). The nursing mental state exam also includes monitoring the movement. This includes any physical movement, such as eating, drinking and brushing teeth.
The Observation element of the mental status examination is a key component of determining if the patient could pose a risk to themselves or others. This is determined by assessing whether the patient appears be acting in a deliberate way that suggests they're trying to harming themselves or someone else.
In mental illness assessment , a detailed thought content assessment is made by keeping track of the patient throughout the interview and determining their preoccupations. It is important to check whether the patient is suffering from suicidal, homicidal or delusional thoughts.
A global assessment of functioning (GAF) is an assessment of a numerical score on a scale ranging from 100 to 0 that measures a person's ability to perform in daily life with their ability to deal with the stresses that come with life. The GAF is a key part of the mental state exam and helps guide the treatment decisions.
It is crucial to realize that observing the behaviour of a patient may cause anxiety. It is crucial that the procedure is conducted in a way that doesn't cause or make the patient feel uncomfortable. It is essential that the patient be fully aware of the goal of the observations and the length of the process.
Nursing observation is a vital skill that should be a central part of any nursing procedure. However, it should be noted that patients might be dissatisfied with the quality of observation and if they cannot reach an agreement with staff then they should be able to access an advocate service which can represent their interests and support their discussions on their care. This should be a component of the local policy and practice, with the involvement and participation of user groups.
Questioning
Many people are reluctant to talk about their mental health issues, however family members can usually detect if something is not right. They can also assist the person take an assessment. These assessments be a variety of topics, including mood, appearance and the thought process. In addition to these tests, the mental health professional will also ask the individual questions regarding their personal life, including what has been going on lately and what their feelings have been like.
The test also includes a cognitive evaluation that is focused on the person's ability to think clearly and retain information. The test subject may require the person to complete basic tasks such as focussing on a list or objects, remembering lists, or solving math questions. The test can be used to test the ability of the person's judgement and to make informed choices. The test also assesses the patient's understanding and knowledge of their illness and its impact on them.
Another vital aspect of an assessment of mental health is the patient's attitude towards the world, himself and his illness. The tone of voice, the facial expression, and the body language of a patient can signal depression, anger, or a feeling of utter powerlessness. It is crucial to determine whether the patient appears be seeking help or accepting their condition.
In more serious situations, an assessment of mental health could include an examination the patient's mental state, which may involve hallucinations or even illusions. It is vital to be aware of the presence of these conditions because they can be extremely dangerous and even life-threatening.
In general an assessment of mental health should be holistic and examine the person's connection to their social life. A health professional could use images, music, art or a variety of assessment tools that are electronic to better understand the person and their unique view of the world around them. They should also talk about the difficulties that prompted the person to seek help, and assure them that there is nothing wrong with seeking out a mental health professional.