Mental Health Nursing - Assessing Mental Health
A physical exam is usually included in mental health tests to rule out physical ailments. This may include blood tests and urine tests as well as brain scans.
Psychologists also use a wide 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 questionnaires sent to you by post.
Affect and mood
Mood and affect are among the most crucial components of the mental status exam (MSE) and are the first to be viewed by the clinician. They are the general mood that can range from joy to sadness, or anger to anger. The degree of affect can be determined by watching facial expressions and manner of speaking as well as the response to external or internal stimuli (e.g. You can express your emotions by smiling at the joke or crying when you lose a loved one.
Affect is a short-term emotion but mood is a longer-lasting emotional state. It is usually described as euthymic, or normal, or dysphoric (meaning depressed). However, psychiatrists must be careful not to mix the two since they have different definitions and are influenced by a variety of factors.
The MSE is a helpful tool for clinical diagnosis, but it is difficult to interpret from an individual patient's report. It is therefore beneficial to inquire about how patients have felt over the past few weeks, as opposed to using only the observation of a physician. A recent study found that a significant percentage of symptoms, even those that fall under the same disorder category, vary between assessment tools. This can be due to the different emphasis placed on emotional, cognitive or physical symptoms, as and also the different the duration and frequency of symptom reporting.
It is possible that the MSE relies on self-reporting which could be biased. Iam Psychiatry who has anxiety and headache is likely to have an lower score than a patient reporting only migraine. Patients tend to minimize negative feelings while exaggerating positive feelings.
The mood and the affect of a person can have a direct influence on thought content. This can impact the way we make decisions, our interpersonal behavior, and physical function. They are affected by stress, fatigue and social interactions. In fact positive moods have been shown to enhance creativity and thinking power. A negative mood can lead to confusion and decrease concentration. Therefore, a careful and thorough mental health evaluation needs to consider the patient's current mood and affect as well as their underlying factors.
Thought content
The ability to determine how a patient thinks is among the most crucial aspects of a mental health examination. Evaluation of the thought process and its content. The thought process is the coherence, logic, and organization of a patient’s thoughts. Normal thought processes are logical and focused on goals. In many mental health disorders however, thought processing is distorted. Examples include hallucinations, delusions, and loose associations.
A mental state examination also examines judgment and insight. Insight is the ability to recognize that there is a problem, while judgement is the ability to make a considered decision when presented with information. Both can be impaired by several mental health conditions like depression and schizophrenia. If a patient has impaired judgment and/or insight in any way, they are at greater risk of harming themselves or others. If they are in danger, their sensible judgement would suggest leaving the home immediately. A patient with impaired judgement may suggest that they stay in the building to try and get rid of the flame.
The contents of a patient's mind include their subject matter, themes and beliefs. Examiners generally comment on the clarity, connection and content of a patient's thoughts. They will take note of any tangential or circumstantial thoughts or thoughts, and also if the patient is prone to having a flurry of thoughts (digressions from the topic of conversation). They will also make comments on the speed of someone's thoughts, for instance, whether they appear fast or slow.
Other areas to be considered are whether the patient's thoughts are congruent or incongruent with their surroundings. For example, a patient who is depressed might hear voices that are hostile and frightening, whereas someone suffering from schizophrenia could be able to imagine a calm and soothing voice. Ask the patient if they are experiencing any suicidal or homicidal ideas. These are uncommon, but could be life-threatening and should be taken into consideration in every mental health assessment.
Watching
Nurses' observation skills are crucial in the mental health assessment. They include a careful examination of behavior, appearance and any peculiar beliefs or perceptions (such delusions or hallucinations) mood, cognition (including memory, attention and orientation). The nursing mental state exam also includes the observation of the movement. This is any physical activity, such as eating, drinking or brushing your teeth.
The Observation component of the mental state examination is vital in determining if the patient poses a risk to them or anyone else. This is done by assessing whether the patient appears to be moving in a deliberate way that suggests they're about harm themselves or another person.
A detailed assessment of the content of thoughts is also done by monitoring the patient during the interview and determining the thoughts and concerns. It is particularly important to determine if a patient is suffering from suicidal or homicidal ideas and to determine if they are having delusions.
Global assessment of functioning (GAF), an assessment of functioning in numerical form, ranging from 0 to 100, evaluates the ability of a person to function in daily life and their capability of managing stressors. The GAF is a crucial component of the mental health assessment and aids in making treatment decisions.
It is essential to be aware that watching the behavior of a patient can cause distress and it is important to conduct the procedure in a way that doesn't provoke the patient or make them be uncomfortable for them. It is also essential that the patient is fully informed about the purpose of the observation and the amount of time it will last.
Nursing observation is an important skill and it must be a key part of the nursing process. It is important to remember that patients can disagree with staff about the level of observation. If they are unable to reach a consensus with the staff, they should be able to use an advocate service to represent their interests and aid them in any discussions regarding their care. This should be part of local policy and practice, with the involvement and support of groups of patients.
Questioning
Many people are hesitant to discuss their mental health issues, but family members can usually tell when something is amiss. They can also help the person to obtain an assessment. These assessments can be a variety of subjects that include mood, appearance and the thought process. In addition to these tests, mental health professionals will also ask the person questions about their personal life, such as what's happened recently and what their feelings have been like.
The test consists of a cognitive evaluation that focuses on a person's ability to think clearly and retain information. The person may be asked to complete basic tasks, such as focusing their attention on the list of words or objects, memorizing simple lists or solving math problems. The test can be used to test the individual's judgment and ability to make informed choices. The test also assesses the patient's knowledge that reflects their knowledge of their condition and its effects on them.
Another vital aspect of the mental health assessment is the person's attitude toward the world, himself and his illness. The tone of voice, facial expression, and the body language of a patient can convey anger, depression, or a feeling of powerlessness. It is crucial to determine whether the patient appears to be asking for help or accepting their condition.
In more serious instances the evaluation of mental health may include an examination the patient's thinking which could include illusions or hallucinations. It is vital to be aware of the presence of these conditions as they can be extremely dangerous and even life-threatening.
A mental health assessment should be holistic and focus on the person's relationship with their social world. A health professional can use images, music, or art, or any other assessment tool to better understand the person. They should also talk with the person about the challenges that led them to seek help and reassure them that there is nothing wrong with seeing an expert in mental health.