Mental Health Nursing - Assessing Mental Health
A physical exam is often included in mental health assessments to rule out any physical conditions. mental health assessment uk can include urine tests, blood tests or even brain scans.
Psychologists also use a wide array of tools to measure mental health. These range from tests that are written on paper and pen to in-depth interviews, or self-complete questionnaires for postal delivery.
Affect and mood
Mood and affect are the most important elements of the mental state exam (MSE) and are the first thing to be viewed by the doctor. They define the patient's general mood that can range from happiness to sadness or irritability to anger. Affect can be assessed by watching facial expressions and manner of speaking as well as the reaction to external or internal stimuli (e.g. You can express your emotions by laughing at an absurd joke, or crying when you lose a loved one.
Affect is a feeling that lasts only a few minutes, whereas mood is a more sustained emotional state. It is often described as either euthymic (normal) or dysphoric, meaning depressed. However, psychiatric specialists should be cautious not to confuse the terms because they have different definitions and are affected by a range of factors.
The MSE can be a valuable tool for diagnosing clinical problems however it is difficult to interpret from a subjective patient report. Asking patients about their feelings over the past few weeks can be more beneficial than relying solely on the observations of a doctor. Recent research showed that the assessment tools were different in their ability to detect a substantial part of symptoms. This included the symptoms that were classified under the same disorder. This can be due to the different emphasis on emotional, cognitive or physical symptoms, as along with differences in the duration and frequency of reporting symptoms.
It is possible that the MSE relies on self-reports which could be susceptible to bias. For example, a patient who complains of anxiety and a headache will likely report a lower score than a patient who reports only an occasional headache. Patients tend to minimize negative feelings while exaggerating positive ones.
The affect and mood of a person influence thoughts which influences the way we make decisions, our interpersonal behavior and physical performance. They can be affected by fatigue, stress and social interactions. A positive mood can boost creativity and mental energy. A negative mood can cause confusion and decrease concentration. A thorough and careful mental health assessment should take into account the patient's mood as well as affect and the underlying factors.
Thought content
The ability to determine how a patient thinks is one the most crucial aspects of a mental state examination. Particularly, evaluating thought processes and thought content. The thought process is the logic, coherence and organization of the patient's thoughts. The normal process of thinking is objective-oriented and rational. Thought processing can be altered in a variety of mental health conditions. Examples include delusions, hallucinations and loose associations.
A mental status examination also evaluates insight and judgement. Insight is the ability to see the presence of a problem, while judgement is the ability to make a considered decision based on information. Both can be impaired by various mental health conditions such as depression and schizophrenia. A patient with impaired insight or judgment is more likely to hurt themselves or others. For instance, if they are at risk of burning their home down, sensible judgement would tell that they should leave the premises immediately. A patient with impaired judgement may suggest that they stay in the building to try and get rid of the flame.
The content of a patient's thoughts include the subject matter, themes, and beliefs. Examiners generally comment on the clarity, relevance and content of a patient's thoughts. They will note tangential thoughts or those that are merely circumstantial, and when a patient is digressing (digressions away from the topic of the conversation). They will also provide feedback on the speed at which someone is thinking, such as whether they seem fast or slower.
It is also essential to determine whether the patient's mood is in line with their environment. A patient with depression might hear voices of anger, while a person suffering from schizophrenia may have the illusion that a peaceful voice is speaking. Patients should be asked about any suicidal or homicidal thoughts. Although these are rare however, they can be life-threatening and should be taken into account in every mental health assessment.
Watching
The observation skills of nurses play an important role in an assessment of mental health. They are a thorough examination of appearance, behavior as well as any peculiar beliefs or perceptions (such hallucinations or delusions), mood, and cognition (including memory, attention, orientation). The nursing mental state exam also involves observing motility. This includes any physical movement like eating, drinking, or brushing teeth.
The Observation portion of the mental state examination is crucial in determining if the patient is a danger to themselves or anyone else. This is done by assessing whether the patient is moving deliberately in a way that suggests that they are in danger of harming themself or someone else.
In addition, a comprehensive thought content assessment is made by keeping track of the patient throughout the interview and determining their thoughts and concerns. It is important to check whether the patient is suffering from suicidal, homicidal, or delusional thoughts.
A global assessment of functioning (GAF) is a numerical rating on a scale from 0 to 100 that combines the capacity of a person to function in everyday life with their capacity to handle the stresses that come with life. The GAF is a key part of the mental health examination and assists in making the treatment decisions.
It is important to understand that observing the behavior of a patient may cause anxiety. Therefore, it is essential that the procedure is conducted in a way that does not provoke or feel intrusive. It is crucial that the patient is fully informed of the purpose of the observations and the duration of the process.
Nursing observation is a crucial skill that should be an integral element 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 an agreement with the staff, they should be able to use an advocate service to represent their interests and assist them in any discussions about their care. This should be a fundamental part of local observation policy and practice with the involvement of user groups to ensure that patients are included in the creation of written information as well as staff training to support this aspect of clinical governance.
Questioning
Many people have a hard time talking about their mental health issues, but loved ones can often notice the signs that something is not right. They can also encourage the person to seek an assessment. These tests can cover a wide range of topics, including mood, appearance and thought process. In addition to these tests, a mental health professional will also ask the individual questions about their personal life, such as what's happened recently and what their emotions have been like.
The test includes a cognitive evaluation which focuses on an individual's ability think clearly and retain information. The person may be required to complete basic tasks, such as focusing on a list or objects, recollecting lists or solving math questions. The test can also check the ability of the individual to make sound decisions and use their judgment. The test determines a person's awareness, which is the understanding of their condition and how it affects them.
Another important component of a mental health assessment is the patient's attitude towards others, himself and his illness. The patient's voice, facial expressions and body language can convey hostility, anger or depression, or a feeling of helplessness. It is also important to know whether the patient is seeking help or just living with their illness.
In more serious instances an assessment of mental health might include an assessment of the patient's thinking that may include hallucinations (false sensory perceptions that do not correspond to real stimuli) or illusions (misperceptions of real stimuli). These conditions can be extremely dangerous and even deadly.
In general, a mental health assessment should be holistic and consider the person's interactions with their social life. Health professionals can employ photographs, music, art or any other electronic assessment tool to gain a better understanding of the individual. They should also talk with the person about the issues that caused them to seek help and reassure them that there is nothing wrong with visiting a mental health professional.