Mental Health Nursing - Assessing Mental Health
A physical exam is usually part of mental health tests to rule out physical conditions. This could include urine tests, blood test or even brain scans.
Psychologists also utilize a variety of tools to assess mental health. They can use pen and paper test forms to deep interviews or self-fill questionnaires sent to you by post.
Mood and affect
Mood and affect are the most crucial elements of the mental state exam (MSE) and are the first thing to be viewed by the doctor. They are the most accurate indicators of a patient's emotional state. This could be anything from sadness to happiness or irritability and anger. The effect can be analyzed through facial expressions, overall behavior and reaction to external or internal stimuli. You can express your emotions by laughing at a joke, or crying when you lose a beloved one.
Affect is an emotion that is only temporary, whereas mood is a state of constant emotion. It is usually described as being either euthymic (normal) or dysphoric, which translates to depressed. Professionals in psychiatry must be careful to avoid confusion between the terms, as they are different in their definition and are affected by various factors.
The MSE can be a useful instrument for diagnosing clinical conditions however, it can be difficult to interpret from a subjective patient report. The process of asking patients to share their experiences in the last few weeks is more effective than relying on just observations from a physician. A recent study found that a significant proportion of symptoms, even those grouped together under the same disorder category, differ between assessment tools. This can be due to the differing emphasis on emotional, cognitive or physical symptoms as along with differences in duration and frequency of symptom reporting.
It is possible that the MSE is based on self-reporting which could be susceptible to bias. For example, a patient who describes experiencing anxiety and headaches will likely report an lower score than someone who has only an occasional headache. Patients tend to minimize negative feelings while exaggerating positive ones.
The mood and the affect of a person can have a direct impact on thought content. This could affect the way we make decisions, our interpersonal behavior, and physical performance. They are affected by fatigue, stress and social interactions. In actual fact positive moods have been proven to increase the ability to think and be creative. A negative mood can cause confusion and decrease concentration. Therefore, a careful and thorough mental health assessment is required to consider the patient's current mood and affect as in addition to the underlying causes.
Thought content
One of the most crucial aspects of a mental health exam is assessing how a patient thinks. Particularly, evaluating thought processes and thoughts. The thought process is the coherence, logic and structure of a patient's thoughts. The normal process of thinking is focused and logic-based. Thought processing can be distorted when a person suffers from mental health issues. Examples include delusions, hallucinations and loose associations.
Insight and judgment are assessed during a mental state exam. Insight is the ability to spot the presence of a problem. Judgment is the ability to make a rational decision after receiving information. Both are impaired in various mental health conditions, like schizophrenia and depression. A patient with impaired insight or judgement is more likely to hurt themselves or others. If they are in danger, their rational judgment would advise them to leave the home immediately. However, a person with impaired judgment may recommend staying in the house and attempting to put the fire out.
Thought content is the topics, subjects and beliefs that a patient has. Examiners will comment on the clarity, connection and the content of the thoughts of the patient. They will note any tangential or circumstantial thoughts, and whether the patient is prone to having a flurry of thoughts (digressions from the conversation subject). They will also comment on a person's pace of thinking, for example, if they seem to be more or less fast.
Other areas to be considered are whether the patient's thoughts are mood and in tune with their surroundings. For instance, a person who is depressed may hear voices that sound aggressive and threatening, whereas those suffering from schizophrenia may experience a hallucination of the sound of a calm and soothing voice. Ask the patient if they've had any suicidal or homicidal thoughts. Although they are uncommon, they can be life-threatening and must be taken into account in every mental health assessment.
Observation
The ability of nurses to observe is vital in an assessment of mental health. They include a careful examination of behavior, appearance, any unusual beliefs or perceptions (such delusions or hallucinations) mood, cognition (including memory, attention and orientation). The nursing mental state exam also involves the observation of the movement. This includes any physical movement, such as eating, drinking and brushing teeth.
The observation component of the mental state examination is vital in determining if the patient poses a risk to themselves or others. This is done by assessing whether the patient is moving in a way that suggests that they are in danger of harming themself or someone else.
In addition, a detailed assessment of the content of thoughts is conducted by observing the patient throughout the interview and determining their preoccupations. It is essential to determine whether the patient is experiencing 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 the capacity of a person to function in daily life with their capacity to handle the stressors in their life. The GAF is an important part of the mental status examination and helps to guide treatment decisions.
It is important to recognize that observing the behaviour of a patient could cause anxiety. Therefore, it is essential that the procedure is conducted in a way 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 a key element of the nursing process. It is important to remember that patients may disagree about the extent of observation. If they cannot come to an agreement with the staff, they must be able access an advocate service to represent their interests and assist in any discussions regarding their treatment. This should be a fundamental element of the local observation policy and practice, with the involvement of user groups to ensure that patients are a part in the creation of written information and staff training on this aspect of governance in the clinic.
Questioning
Many people have a difficult to discuss their mental health issues, but loved ones will often be able to recognize the signs of something being wrong. They can also help the person take steps to take an assessment. These tests can be extremely broad and cover a wide range of topics including mood, appearance, thought process, memory and more. A mental health professional may also inquire about the person's personal life. They will ask them what they have been feeling and what's happened recently.
The assessment also includes a cognitive evaluation that focuses on the person's ability to think clearly and recall information. The person may be required to complete basic tasks such as focussing on a list or objects, remembering lists or completing math problems. The test can also be used to assess the person's judgment and ability to make good choices. assessing mental health determines a person's perception, which is their knowledge of their condition and how it affects them.
Another vital aspect of a mental health assessment is the person's attitude toward others, himself and his illness. The patient's tone of voice, facial expressions and body language can indicate anger, hostility or depression, or a feeling of insecurity. It is also important to note whether the patient is seeking help or resigned to living with their health condition.
In more serious cases, a mental health assessment might include an examination of the patient's thoughts that could include hallucinations (false perceptions of sensory stimuli that are not real stimuli) or illusions (misperceptions of real stimuli). These conditions can be dangerous and even deadly.
In general an assessment of mental health should be holistic and consider the person's interactions with their social world. A health professional may employ art, music, photos or a variety of electronic assessment tools to help understand the person and their unique view of the world around them. They should also talk with the person about the challenges that have caused them to seek help and assure them that there is nothing wrong with seeing an expert in mental health.