Mental Health Nursing - Assessing Mental Health
Mental health assessments usually include a physical exam, to rule out physical ailments. This may involve blood work, urine tests or brain scans.
Psychologists utilize a variety instruments to evaluate mental health. These tools vary from pencil and paper test forms to in depth interviews or self-completed postal questionnaires.
Affect and mood
The doctor will first be aware of the patient's mood and emotional state. They define the patient's general mood that can range from happiness to sadness or irritability to anger. The affect can be assessed by facial expressions, overall attitude and reaction to external or internal stimuli. smiling at a joke or crying at the loss of a loved one).
Affect refers to an emotion that is temporary, while mood is a state of constant emotion. It is typically described as euthymic or dysphoric, or normal (meaning depressed). However, psychiatric specialists must be careful not to confuse the terms because they have different definitions and are influenced by a variety of factors.
The MSE is a helpful instrument for diagnosing clinical conditions, but it is difficult to interpret based on a subjective patient report. The process of asking patients to share their experiences during the past few weeks is more helpful than relying on just the observations of a doctor. A recent study showed that a significant percentage of symptoms, including those that are grouped under the same disorder category, differ between assessment tools. This can be because of the different emphasis on cognitive or emotional symptoms as well as the different time periods and frequency of symptom reporting.
It is possible that the MSE is based on self-reporting, which may be prone to bias. For instance, a patient who describes experiencing a headache and anxiety is likely to report less than someone who has only an occasional headache. In addition there is the tendency for patients to minimize negative emotions and underestimate the severity of positive emotions.
Affect and mood have a direct impact on thoughts, which can influence decision-making, interpersonal behaviour and physical functioning. They are affected by stress, fatigue social interactions, world events, hormones, and even the weather. In actual fact, a positive mood has been proven to boost creativity and thinking power. A negative mood can affect concentration and cause confusion. A thorough and meticulous mental health evaluation must consider both the patient's mood and affect and the underlying factors.
Thought content
Assessing how the patient thinks is among the most crucial aspects of a mental health examination. Specifically, evaluating thought process and thought content. Thought process refers to the logic, organization and coherence of a patient's thoughts. Normal thought processes are goal directed and logical. Thought processing can be altered in a variety of mental health conditions. mental health assessments include hallucinations, delusions and loose associations.
A mental state examination also assesses the quality of insight and judgement. Insight is being able to recognize a problem. Judgment is the ability to make a rational decision after receiving information. Both can be impaired in many mental health conditions such as depression and schizophrenia. A patient with impaired insight or judgment is more prone to harm themselves or others. If they are in danger, their rational judgement would suggest leaving the house immediately. A patient with impaired judgment may suggest that they stay in the building to try and get rid of the flame.
The contents of a patient's mind include the subject matter, themes and beliefs. Generally, examiners comment on the clarity, relatedness and quality of a patient's thinking. They will also note any tangential or circumstantial thoughts, and whether the patient has flights of ideas (digressions from the conversation subject). They will also discuss the speed of a person's thoughts, such as whether they appear fast or slow.
It is also essential to determine if the patient's mood is in line with the environment in which they live. For instance, a patient who is depressed could hear voices that sound hostile and frightening, whereas those suffering from schizophrenia may be able to imagine an ethereal and calm voice. Ask the patient if they are experiencing any thoughts of suicide or homicide. These are rare but can be life-threatening and should be taken into consideration during every mental health assessment.
Watching
The nurse's ability to watch is vital in an assessment of mental health. They include a careful examination of appearance, behavior as well as any peculiar beliefs or perceptions (such delusions or hallucinations) mood, cognition (including attention, memory, orientation). A nursing mental status examination also involves observing motility, including any physical activity like eating or drinking, brushing your teeth or using the toilet, as well as taking off shoes.
The Observation component of the mental status examination is a crucial aspect of determining whether or not a patient may pose a risk to themselves or others. This is determined by assessing whether the patient appears to be moving deliberately in a way which suggests they are in danger of harming themself or someone else.
In addition, a detailed assessment of the content of thoughts is conducted by monitoring the patient throughout the interview and determining their preoccupations. It is important to check whether the patient is experiencing suicidal, homicidal, or delusional thoughts.
A global assessment of functioning (GAF) is a numerical rating on a scale from 0 to 100 that combines a person's ability to perform in daily life and their ability to cope with the stresses in their lives. The GAF is an essential part of the mental state exam and assists in making treatment decisions.
It is important to be aware of the fact that observing an individual's behavior can cause distress and it is crucial that the process is conducted in a manner that does not provoke the patient and doesn't feel intrusive. It is also essential that the patient is aware of the reason for the observation and the length of time it will last.
Nursing observation is a crucial skill that should be the core of any nursing program. However, it should be kept in mind that patients could not agree with the degree of observation. If they are unable to reach an agreement with staff, then they should be able to access an advocate service that will represent their needs and help patients in any discussions about their care. This should be a fundamental element of the local observation policy and practice, including the participation of user groups to ensure that patients are included in the development of written documents and staff training on this aspect of clinical governance.
Questioning
Many people are reluctant to talk about their mental health issues, however family members can often detect if something is not right. They can also help the person to get an assessment. These assessments can be very broad and cover a range of topics including mood, appearance and memory, thought process and many more. A mental health professional may also inquire about the person's private life. They will ask them what they have been feeling and what's happened in the last few days.
The test also includes a cognitive test, which focuses on the ability of the individual to think clearly and recall information. The test subject may require the person to complete simple tasks such as focusing on a list or objects, memorizing lists or solving math questions. The test may also test the ability of the individual to make informed decisions and make good judgments. The test also assesses the patient's knowledge that reflects their level of understanding about their illness and its impact on them.
Another vital aspect of the mental health assessment is the person's attitude toward other people, himself and the illness. The tone of voice, the facial expression, and body language of a patient can convey anger, depression, or a feeling of powerlessness. It is important to check whether the patient seems to be asking for assistance or is accepting their situation.
In more serious instances, a mental health assessment may include an examination of the patient's thoughts that could include hallucinations (false sensory perceptions without real stimuli) or illusions (misperceptions of real stimuli). It is important to note the presence of these disorders because they can be extremely hazardous and even life-threatening.
A mental health assessment must be holistic and focus on the person's interactions with their environment. A health professional can use images, music, or art, or any other assessment tool to gain a better understanding of the person. They should also talk with the person about the challenges that caused them to seek assistance and reassure them that there is nothing wrong with visiting a mental health professional.