Mental Health Nursing - Assessing Mental Health
A physical examination is typically part of mental health tests to rule out any physical ailments. These can include blood tests, urine testing, or even brain scans.
Psychologists use a variety of instruments to evaluate mental health. These range from pen and paper test forms to deep interviews or self-fill postal questionnaires.
Affect and mood
Mood and affect are the most significant components of the mental status examination (MSE) and are the first to be observed by a medical professional. mental health assessment uk describe the patient's general emotional tone, which can range from joy to sadness or irritability to anger. The degree of affect can be determined by watching facial expressions and demeanour as well as the reactivity to internal or external stimuli (e.g. smiling at the joke or crying over the loss of a loved one).
Affect is an emotion that is temporary, whereas mood is a long-lasting emotion. It is often described as either euthymic (normal) or dysphoric, which translates to depressed. However, psychiatrists should be cautious not to confuse the terms as they have varying definitions and are affected by a variety of factors.
The MSE can be a useful tool for diagnosing clinical problems, but it is difficult to interpret from the subjective report of a patient. It is therefore important to inquire about how patients have been feeling over the last few weeks, rather than relying on physician observation only. A recent study found that a significant proportion of symptoms, even those that fall under the same disorder category, vary between assessment tools. This could be due the differing emphasis on cognitive, emotional or physical symptoms, as and also the different the duration and frequency of reporting symptoms.
It is also possible that the MSE is based on self-reporting which is susceptible to bias. For instance, a patient who describes experiencing a headache and anxiety will likely have an lower score than a patient who reports only an occasional headache. Patients tend to minimize negative emotions while exaggerating positive feelings.
Mood and affect directly affect thoughts, which can influence the way we make decisions, our interpersonal behavior and physical performance. They can be affected by stress, fatigue, social interactions, global events, hormones and the weather. A positive mood can boost creativity and mental energy. A negative mood can affect concentration and cause confusion. A thorough and thoughtful mental health evaluation must take into account the patient's mood and affect as well as the fundamental factors.
Thought content
Examining the way a patient thinks is among the most important aspects of a mental state exam. Evaluation of thought process and content. The thought process is the logic, coherence and organization of the patient's thoughts. Normal thought processes are focused and logical. In a variety of mental health conditions however, thought processing can be altered. Examples include hallucinations and delusions as well as loose associations.
A mental health assessment also examines judgment and insight. Insight is the ability to identify the presence of a problem. Judgment is the capability to make a well-considered choice after receiving information. Both can be impaired by a variety of mental health issues like depression and schizophrenia. Patients with impaired insight or judgement is more likely to harm themselves or others. For example when they are in danger of destroying their home and they have a good sense of judgement, it would be wise for them to leave the building immediately. However, a person with impaired judgment may suggest staying in the building and trying to put the fire out.
The content of a patient's thoughts include their subject matter, themes and beliefs. Examiners generally comment on the clarity, relatedness and the content of a patient's thoughts. They will also note tangential thoughts or circumstantial ones, and if the patient has digressions (digressions away from the subject of the conversation). They will also make comments on a person's pace of thinking, for example, if they seem to be more or less fast.
Other important areas to consider are whether the patient's thoughts are mood congruent or incongruent with their surroundings. For example, a patient who is depressed could hear voices that are hostile and frightening, whereas a person with schizophrenia might be able to imagine an ethereal and calm voice. Patients should be asked about any suicidal or homicidal thought. These are rare but can be life-threatening and should be considered in every mental health evaluation.
Watching
The nurse's ability to observe is crucial in a mental assessment. They will conduct a thorough examination of the appearance, behavior and any strange beliefs or perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention to orientation, attention memory, and orientation). A mental state examination for nurses also involves observing mobility, which includes any physical movement such as eating, drinking, brushing teeth, using the toilet and taking off shoes.
The Observation component of the mental health exam is an essential element of determining whether the patient is posing an imminent risk to themselves or others. This is done by assessing whether the patient is moving deliberately in a way that suggests they are in danger of harming themself or someone else.
A detailed assessment of the thought content is also made by monitoring the patient during the interview and determining the concerns. It is crucial to determine whether the patient is suffering from suicidal, homicidal, or delusional thoughts.
A global assessment of functioning (GAF) is an evaluation of the numerical value on a scale from 100 to 0 that measures a person's ability to perform in daily life with their ability to deal with the stressors in their life. The GAF is a vital component of the mental health assessment and aids in making treatment decisions.
It is crucial to be aware that watching an individual's behavior could cause anxiety, and it is important that the process is conducted in a way that does not cause anxiety for the patient and does not make them feel uncomfortable. It is important that the patient be fully aware of the goal of the observations and the length of the procedure.
Nursing observation is a crucial skill that should be an integral element of the nursing process. It is crucial to keep in mind that patients might disagree on the extent of observation. If they are unable to reach an agreement with staff members, they must be able access an advocate service to represent their interests and assist them in any discussions about 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 talk about their mental health issues, but family members are often able to discern when something isn't right. They can also urge the person to seek an assessment. These assessments are broad and cover a variety of subjects, such as mood, appearance, memory, thinking process and more. In addition to these tests, the mental health professional will also ask the person questions about their life, including what has been going on lately and what their feelings have been like.
The test also includes a cognitive test that is focused on the ability of the person to think clearly and recall information. The person may be required to complete basic tasks such as paying attention to a list of objects, remembering lists or completing math problems. The test can be used to test the person's judgment and ability to make sound decisions. The test also evaluates the patient's insight that reflects their understanding of their illness and its impact on them.
The attitude of the patient towards others, himself and the illness is also an important aspect of a mental assessment. The patient's tone of expression, facial expression and body language can indicate hostility, anger or depression, or a feeling of insecurity. It is also important to note whether the patient is seeking help or is content living with their health condition.
In more serious situations the assessment of mental health might include a thorough examination of the patient's thoughts which could include hallucinations or even illusions. It is vital to be aware of the presence of these conditions as they can be extremely hazardous and even life-threatening.
In general the mental health assessment must be holistic and consider the person's relationship to their social environment. A health professional may use images, music, or art, or any other assessment tool to better understand the individual. They should also talk with the person about the difficulties that have led them to seek help and assure them that there is nothing wrong with seeing a mental health professional.