Mental Health Nursing - Assessing Mental Health
Mental health assessments usually include a physical exam, to rule out physical ailments. This may include blood tests, urine tests or brain scans.
Psychologists also employ a array of tools to measure mental health. They can use tests that are written on paper and pen to in-depth interviews, or self-complete postal questionnaires.
Mood and affect
The affect and mood are the most crucial components of the mental status exam (MSE) and are the first things to be observed by a medical professional. They define a patient's general emotional tone. It can be anything from sadness to happiness or anger and irritability. The patient's mood can be measured through facial expressions, general behavior and response to external or internal stimuli. You can express your emotions by laughing at the joke or crying when you lose a beloved one.
Affect is a short-term emotion, whereas mood is a more sustained emotional state. It is usually described as either euthymic (normal) or dysphoric, meaning depressed. However, psychiatrists should be cautious not to misunderstand the terms as they have varying definitions and are affected by a range of factors.
While the MSE is a useful tool for clinical use however, it can be difficult to interpret based upon subjective patient reports. Inquiring about the feelings of patients during the past few weeks is more effective than relying on only physician observations. A recent study found that a significant percentage of symptoms, which includes those that fall under the same disorder category, vary between assessment tools. This can be because of the different emphasis placed on emotional or cognitive symptoms, as well as the different the time intervals and frequency of reporting symptoms.
It is possible that the MSE relies on self-reporting which could be biased. A patient who has anxiety and headache is likely to get lower scores than those who report only a migraine. Patients tend to minimize negative feelings while exaggerating positive feelings.
Mood and affect have a direct impact on thought content and can affect decision-making, interpersonal behaviour, and physical functioning. They are affected by stress, fatigue and social interactions. In fact, a positive mood has been proven to increase thinking and creativity. assessment mental health can lead to confusion and reduce concentration. A thorough and meticulous mental health evaluation must take into account the patient's mood and affect and the fundamental factors.
Thought content
One of the most essential aspects of a mental state examination is to determine how the patient thinks. Specifically, evaluating thought process and thought content. The thought process is the coherence, logic and structure of a patient’s thoughts. A normal thought processes is focused and logic-based. Thought processing may be altered when a person suffers from mental health issues. Examples include hallucinations and delusions as well as loose associations.
A mental state examination also assesses the quality of insight and judgement. Insight is the ability to recognize 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 like depression and schizophrenia. If a patient has impaired insight and/or judgement is at a higher risk of causing harm to themselves or others. If they are in danger, their rational judgement would suggest leaving the home immediately. A patient with impaired judgement might suggest that they remain in the building to try to get rid of the fire.
Thought content refers to the topics, subjects and beliefs that a patient has. Examiners will evaluate the clarity, connection and the content of the thoughts of the patient. They will also 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 comment on the speed of someone's thoughts, including whether they appear fast or slow.
It is also crucial to determine whether the patient's mood matches their surroundings. A patient with depression might hear angry voices, whereas those suffering from schizophrenia might experience a hallucination that a soothing voice is speaking. A patient should also be asked about any homicidal or suicidal thought. Although they are not common but they could be life threatening and should be considered in every mental health assessment.
Observation
The nurse's ability to observe is vital in an assessment of mental health. They will conduct a thorough examination 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 the environment, orientation, memory). A mental health assessment for nursing also incorporates observation of the ability to move, which includes physical activity like eating or drinking, brushing your teeth using the toilet and putting on shoes.
The Observation component of the mental state examination is crucial in determining if the patient poses a risk to themselves or anyone else. This is accomplished by determining whether the patient appears to be acting in a deliberate way that suggests they are about harming themselves or someone else.
In addition, a detailed assessment of thought content is done by monitoring the patient throughout the interview and determining their main concerns. It is crucial to determine whether the patient has suicidal, homicidal or delusional thoughts.
Global assessment of functioning (GAF), an assessment of functioning in numerical form, ranging between 0 and 100, evaluates the ability of a person to function in daily life with their ability of dealing with stressors. The GAF is an important component of the mental health examination and helps to guide the treatment decisions.
It is essential to be aware of the fact that observing the behavior of a patient can cause distress and it is important that the procedure is carried out in a manner that doesn't provoke the patient or make them be uncomfortable for them. It is important that the patient is fully aware of the reason for the observations and the duration of the procedure.
Nursing observation is an important ability and should be a key part of the nursing process. It is crucial to keep in mind that patients may disagree about the degree of observation. If they cannot reach a consensus with staff, they should be able to access an advocate service to represent their interests and aid them in any discussions about their treatment. This should be part of the local policy and practice, with the involvement and support of user groups.
Questioning
A lot of people are hesitant to talk about their mental health issues, but their family members are often able to discern when something isn't right. They can also assist the person take steps to get an assessment. These assessments cover a wide range of topics, including mood, appearance and the thought process. A mental health professional can also ask questions about the person's personal life. They will ask what they've been feeling and what's happened in the last few days.
The assessment includes an evaluation of the cognitive capacity which focuses on an individual's ability to think clearly and remember information. The test taker may be asked to complete simple tasks, like focusing their attention on the list of words or objects, memorizing simple lists or solving math problems. The test can also be used to check the person's judgment and ability to make sound decisions. The test measures a patient's perception, which is their knowledge of their illness and how it affects them.
The person's attitude towards himself, others and the illness is also an important element of a mental evaluation. The tone of voice, the facial expression, and the body expressions of a patient could convey anger, depression, or a feeling of helplessness. It is important to observe whether the patient seems to be seeking help or accepting their situation.
In more serious situations the mental health assessment could include a thorough examination of the patient's mental state that may include hallucinations (false sensory perceptions without real stimuli) or illusions (misperceptions of real stimuli). These conditions can be extremely dangerous and even deadly.
In general, a mental health assessment must be holistic and look at the person's interactions with their social environment. A health professional could use images, music, art or a variety of assessment tools that are electronic to help the person understand themselves and their unique view of the world around them. They should also speak to the person about the challenges that caused them to seek assistance and assure them that there is nothing wrong with visiting a mental health professional.