Mental Health Nursing - Assessing Mental Health
A physical exam is often part of mental health assessments to rule out physical ailments. This may involve blood work, urine tests or brain scans.
Psychologists employ a variety of instruments to evaluate mental health. They can use tests that are written on paper and pen to deep interviews or self-fill questionnaires for postal delivery.
Mood and affect
The doctor will first be aware of the patient's mood as well as their affect. They are the general mood that can range from happiness to sadness, or even irritability to anger. The effect can be analyzed through facial expressions, overall demeanor and the reaction to internal or external stimuli. You can express your emotions by smiling at an absurd joke, or crying when you lose a beloved one.
Affect is a feeling that is temporary, while mood is a long-lasting emotion. It is generally described as euthymic or dysphoric or normal (meaning depression). Psychiatric professionals should be careful to avoid confusion between the two terms because they are defined differently and are affected by many factors.
The MSE can be a useful tool for clinical diagnosis however, it can be difficult to interpret from a subjective patient report. Inquiring about the feelings of patients during the past few weeks can be more beneficial than relying on just observations from a physician. A recent study showed that a significant percentage of symptoms, even those that are grouped within the same disorder category, differ between assessment tools. This can be because of the different emphasis on cognitive or emotional symptoms as well as differences between time periods and frequency in reporting symptoms.
It is possible that the MSE is based solely on self-reporting, which can be biased. For instance, a patient who describes experiencing anxiety and a headache will likely have an lower score than someone who has only an occasional headache. In addition, there is a tendency for patients to minimize negative emotions and overestimate the severity of positive ones.
The affect and mood of a person directly affect thoughts which influences the way we make decisions, our interpersonal behavior and physical performance. They can be affected by stress, fatigue and social interactions. In fact, a positive mood has been proven to increase thinking and creativity. A negative mood can cause confusion and lower concentration. A thorough and meticulous mental health assessment should consider the patient's mood and affect and the other factors.
Thought content
One of the most essential elements of a mental status examination is assessing how the patient thinks. Particularly, evaluating thought processes and thoughts. The thought process is the logic, coherence and organization of the patient's thoughts. A normal thought processes is focused and rational. In several mental health conditions however, thought processing is altered. Examples include hallucinations, delusions and loose associations.
A mental state examination also evaluates insight and judgement. Insight is being able to identify the presence of a problem. Judgment is the capability of making a well-considered decision after receiving information. Both are affected by various mental health conditions, like schizophrenia and depression. If a patient suffers from impaired judgment or insight, they are at greater risk of harming themselves or others. For example, if they are at risk of burning their house down and they have a good sense of judgement, it would be wise for them to leave the building immediately. A patient with impaired judgement may suggest that they stay in the building to try and put out the fire.
Thought content includes the topics, subjects and beliefs that a patient has. Examiners will assess the clarity, relevance and the content of the thoughts of the patient. They will also note tangential thoughts or circumstantial ones, and in the event that the patient's thoughts diverge (digressions away from the topic of the conversation). They will also comment on a person's pace of thinking, for example, if they seem fast or slower.
It is also important to determine if the patient's mood is in line with their environment. For instance, a patient who is depressed may hear voices that sound angry and threatening, while those suffering from schizophrenia may have a hallucination of a calm and soothing voice. Ask the patient if they have any suicidal or homicidal thoughts. Although they are uncommon, they can be life threatening and should be taken into consideration in every mental health assessment.
Watching
The ability of nurses to observe is crucial in the mental assessment. They will conduct a thorough examination of behavior, appearance and any strange beliefs or perceptions (such as hallucinations or delusions) mood, and aspects of cognition (including attention to the environment, orientation memory). A nursing mental status examination also includes observing the ability to move, which includes physical activity like eating, drinking, brushing teeth or using the toilet, as well as putting on shoes.
The observation component of the mental state exam is essential in determining whether the patient is a danger to themselves or others. This is accomplished by determining if the patient appears to be acting in a way that suggests they are planning to harm themselves or another person.
A thorough assessment of the content of thoughts is also done by monitoring the patient during the interview and determining the concerns. It is essential to determine if the patient is having suicidal or homicidal ideas and to determine if they are experiencing thoughts of delusion.
A global assessment of functioning (GAF) is an evaluation of the numerical value on a scale from 100 to 0 that measures the ability of a person to function in daily life along with their ability to deal with the stresses that come with life. The GAF is a crucial component of the mental state examination and aids in making the treatment decisions.
It is important to understand that observing the behaviour of a patient could cause anxiety. Therefore, it is essential to conduct the procedure in a manner that does not cause discomfort or cause discomfort. It is also essential that the patient is informed about the purpose of the observation and the length of time it will last.
Nursing Get More Information is an important ability and should be an integral element of the nursing process. However, it should be kept in mind that patients could disagree with the level of observation and if they are unable to reach an agreement with the staff, they should have access to an advocate service which can represent their interests and support patients in any discussions about their treatment. This should be a fundamental part of the local policy and practice, including the involvement of user groups to ensure that patients are involved in the creation of written documents and staff training on this aspect of governance in the clinic.
Questioning
Many people have a difficult to talk about their mental health issues, but loved ones can often notice the signs of something being wrong. They can also assist the person take an assessment. These tests can cover a wide range of topics, including mood, appearance and thought process. A mental health professional could also inquire regarding the person's personal life. They'll ask them what they've been feeling and what's happened recently.
The assessment also includes a cognitive test that focuses on the person's ability to think clearly and recall information. The person could be asked to complete basic tasks, such as focussing on a list or objects, memorizing lists or solving math questions. The test may also test the person's ability to make informed decisions and make good judgments. The test also evaluates the patient's insight that reflects their knowledge of their condition and its effects on them.
Another vital aspect of the mental health assessment is the patient's attitude towards other people, himself and the illness. The tone of voice, facial expressions and body language can indicate anger, hostility, depression or a sense of helplessness. It is important to observe whether the patient seems to be seeking help or accepting their situation.
In more serious cases an assessment of mental health may include an examination of the patient's mental state 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 fatal.
A mental health assessment should be holistic and examine the person's interaction with their social world. A health professional could use photographs, music, art or a variety of electronic assessment tools to help the person understand themselves and their unique perspective on the world around them. They should also speak to the person about the issues that led them to seek help and reassure them that there is nothing wrong with seeking out an expert in mental health.