Mental Health Nursing - Assessing Mental Health
Mental health assessments usually include a physical exam, to rule out physical conditions. This could include urine tests, blood testing, or even brain scans.
Psychologists also employ a array of tools to measure mental health. These tools can be anything from pencil and paper test forms, to in-depth interviews or self-completed postal questionnaires.
Mood and affect
Mood and affect are the most significant components of the mental status exam (MSE) and are the first things to be viewed by the medical professional. They are the general emotional state that can range from joy to sadness or irritability to anger. Affect can be measured by looking at facial expressions and attitude as well as reactivity to internal or external stimuli (e.g. smiling at an absurd joke or crying over the loss of a loved one).
Affect refers to an emotion that is only temporary, whereas mood is a state of sustained emotion. It is usually described as euthymic, dysphoric or normal (meaning depressed). Psychologists should be cautious to avoid confusion between the terms, as they are different in their definition and are affected by a variety of factors.
While the MSE is a valuable diagnostic tool however, it can be difficult to interpret based on a subjective patient reports. It is therefore beneficial to ask patients how they have felt over the past few weeks, rather than using only the observation of a physician. A recent study showed that a significant percentage of symptoms, even those grouped together within the same disorder category, vary between assessment tools. This could be due to the different emphasis placed on cognitive or emotional symptoms and also the differences between time periods and frequency of symptom reporting.
It is possible that the MSE relies solely on self-reporting which could be biased. For instance, a person who reports anxiety and a headache is likely to report less than a person who describes only an occasional headache. Patients tend to minimize negative feelings while exaggerating positive ones.
The mood and the affect of a person can have an impact on thought content. This could affect the way we make decisions, our interpersonal behavior, and physical functioning. They can be affected by fatigue, stress and social interactions. A positive mood can actually boost creativity and mental energy. A mood that is negative can cause confusion and lower concentration. A thorough and thoughtful mental health assessment must be able to consider the patient's mood as well as affect and the fundamental factors.
Thought content
One of the most important aspects of a mental state examination is to determine how the patient thinks. Particularly, evaluating thought processes and thoughts. The term "thought process" refers to the coherence, logic and organization of a patient's thought processes. Normal thought processes are logical and focused on goals. In a variety of mental health conditions however, the thought process can be altered. Examples include hallucinations, delusions and loose associations.
A mental state examination also examines judgment and insight. Insight is the ability to recognize the presence of a problem, and judgement is the ability to make a rational decision based on information. Both are impaired in many mental health conditions like schizophrenia and depression. Patients with impaired insight or judgment is more likely to harm themselves or others. If they are in danger, their rational judgement would tell to leave the premises immediately. A person with impaired judgment might suggest they stay in the building to try to put out the flame.
The content of a patient's thoughts includes the subject matter, themes and beliefs. Examiners will assess the clarity, connection and the content of the patient's thoughts. They will take note of any tangential or circumstantial thoughts and also whether the patient has flights of ideas (digressions from the conversation subject). They will also comment on the speed of someone's thoughts, such as whether they seem to be fast or slow.
It is also crucial to determine whether the patient's mood is in line with the environment in which they live. For instance, a person who is depressed could hear voices that are aggressive and threatening, whereas a person with schizophrenia might be able to imagine the sound of a calm and soothing voice. The patient should be questioned about any homicidal or suicidal thought. Although they are uncommon but they could be life-threatening and should be taken into consideration in every mental health evaluation.
Observation
A nurse's observation skills are essential to an assessment of mental health. They include a careful review of the appearance, behavior as well as any unusual beliefs or perceptions (such as hallucinations or delusions) mood, as well as aspects of cognition (including attention, orientation, memory). The nursing mental state exam also involves the observation of the movement. This includes any physical movement like eating, drinking and brushing your teeth.
The observation component of the mental health examination is a crucial aspect of determining whether or not a patient may pose a risk to themselves or others. This is accomplished by determining whether the patient appears to be moving in a deliberate manner that suggests they are planning to harming themselves or someone else.
In addition, a comprehensive assessment of the content of thoughts is conducted by monitoring the patient throughout the interview and identifying their main concerns. It is particularly important to determine if a patient is having suicidal or homicidal ideas and to determine if they are experiencing thoughts of delusion.
Global assessment of functioning (GAF) which is an assessment of functioning in numerical form, ranging between 0 and 100, evaluates the ability of an individual to perform in everyday life along with their capacity for dealing with stressors. The GAF is a crucial component of the mental health assessment and aids in making the treatment decisions.
It is crucial to realize that observing the behavior of a patient may cause anxiety. It is crucial to conduct the procedure in a way that doesn't cause or make the patient feel uncomfortable. It is also vital that the patient is fully informed about the purpose of the observation and the length of time it will take.
Nursing observation is a vital skill that should be the core of any nursing program. However, it must be kept in mind that patients could disagree with the level of observation and if they are unable to come to an agreement with staff then they should be able to access an advocate service which can represent their interests and assist them in any discussions regarding their treatment. This should be an integral part of local observation policy and practice with the involvement of user groups, to ensure that patients are a part in the creation of written information as well as staff training for this aspect of clinical governance.
Questioning
Many people have a difficult to talk about their mental health problems However, loved ones can often notice the signs that something is not right. They can also help the person to obtain an assessment. These assessments can be very broad and cover a wide range of subjects such as mood, appearance and thought process, memory and more. In addition to these tests, a mental health professional will also ask the individual questions regarding their personal life, such as what has been going on recently and what their emotions have been like.
The assessment includes an evaluation of the cognitive capacity which focuses on an individual's ability to think clearly and retain information. The person may be asked to complete basic tasks, such as keeping their attention on the list of words or objects, memorizing simple lists or solving math problems. The test can also check the ability of the individual to make good decisions and use judgment. The test also assesses the patient's understanding, which reflects their level of understanding about 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 expression and body language can indicate anger, hostility or depression, or a feeling of helplessness. It is important to check whether the patient seems to seek help or accepting their condition.
In more serious cases the evaluation of mental health could include an examination the patient's thinking which could include hallucinations or illusions. These conditions can be extremely dangerous and even fatal.
In private mental health assessment uk should take a holistic approach and look at the person's relationship to their social life. A health professional may employ art, music, photos or a range of assessment tools that are electronic to help the person understand themselves and their unique perspective on the world around them. They should also talk to the person about the difficulties that have led them to seek help and assure them that there is nothing wrong with seeking out an expert in mental health.