Mental Health Nursing - Assessing Mental Health
A physical exam is often part of mental health assessments to rule out any physical issues. This may involve blood work, urine tests or brain scans.
Psychologists also utilize a range of tools to evaluate mental health. These range from tests that are written on paper and pen to deep interviews or self-fill postal questionnaires.
Mood and affect
The clinician will first notice the patient's mood and affect. They define the patient's general emotional tone that can range from happiness to sadness, or anger to anger. Affect can be assessed by observing facial expressions and overall manner of speaking as well as the response to external or internal stimuli (e.g. You can express your feelings by smirking at the joke or crying when you lose a beloved one.
Affect is a feeling that lasts only a few minutes, whereas mood is a more sustained emotional state. It is usually described as being either euthymic (normal) or dysphoric, which means depressed. However, psychiatrists should be cautious not to mix the two because they have different definitions and are affected by a variety of factors.
While the MSE is a helpful clinical tool but it can be difficult to interpret based upon subjective patient report. It is therefore beneficial to ask patients how they have been feeling in the last few weeks, as opposed to using only the observation of a physician. Recent research showed that the assessment instruments differed in their capacity to detect a substantial portion of symptoms. This included those that were classified under the same disorder. This could be due the different emphasis placed on cognitive, emotional or physical symptoms as well as differences in time periods and frequency of reporting symptom reports.
It is possible that the MSE relies on self-reports which could be susceptible to bias. For example, a patient who reports a headache and anxiety is likely to report an lower score than a person who describes only the sensation of a headache. Patients tend to minimize negative feelings while exaggerating positive feelings.
Affect and mood can have an impact on thought content. This can impact decision-making, interpersonal behavior, and physical function. They are affected by stress, fatigue and social interactions. Positive moods can boost creativity and mental energy. A negative mood can cause confusion and decrease concentration. A thorough and careful mental health evaluation must take into account both the patient's mood and affect, as well as underlying factors.
Thought content
Examining the way a patient thinks is among the most crucial aspects of a mental state exam. Specifically, evaluating thought process and thought content. The term "thought process" refers to the logic, organization and coherence of a patient's thinking. Normal thought processes are logical and focused on a goal. Thought processing may be altered when a person suffers from mental health issues. Examples include hallucinations and delusions as well as loose associations.
Insight and judgment are assessed during a mental state test. Insight is the ability to spot the presence of a problem. Judgement is the process to make a rational decision after receiving information. Both are impaired in various mental health conditions, like schizophrenia and depression. A patient with impaired insight or judgement is more likely to harm themselves or others. If they are in danger, their sensible judgement would tell to leave the house immediately. A patient with impaired judgement might suggest they stay in the building to try to put out the fire.
Thought content refers to the topics, subjects and beliefs that a patient holds. Examiners will evaluate the clarity, relevance, and content of patient's thoughts. They will take note of any thoughts that are circumstantial or tangential, and whether the patient is having flashes of ideas (digressions from the subject of conversation). They will also provide feedback on a person's pace of thinking, such as if they seem to be faster or slower.
It is also crucial to determine if the patient's mood is in line with their environment. For example, a patient who is depressed could hear voices that are aggressive and threatening, whereas someone suffering from schizophrenia could experience a hallucination of the sound of a calm and soothing voice. Ask the patient if they have any suicidal or homicidal ideas. These are uncommon, but could be life-threatening and should be taken into account in every mental health assessment.
Watching
The nurse's ability to watch is vital in a mental assessment. They involve a thorough evaluation of appearance, behavior and any peculiar beliefs or perceptions (such hallucinations or delusions), mood, and cognition (including memory, attention, orientation). The mental status exam for nurses is also a way of observing the movement. This is any physical activity, like eating, drinking and brushing teeth.
The observation component of the mental state examination is crucial in determining if the patient is a danger to themselves or others. This is done by assessing whether the patient appears be acting in a deliberate manner that suggests they are planning to harm themselves or another person.
A detailed assessment of the content of thoughts is also made by monitoring the patient during the interview and determining concerns. It is crucial to check if the patient has any suicidal or homicidal thoughts and to determine if they're having thoughts of delusion.
A global assessment of functioning (GAF) is an evaluation of the numerical value on a scale from 0 to 100 that combines a person's ability to perform in daily life with their ability to cope with the stresses in their lives. The GAF is a crucial component of the mental health assessment and aids in making the treatment decisions.
It is crucial to be aware that observing an individual's behavior could cause anxiety, and it is important that the procedure is carried out in a way that does not cause anxiety for the patient and doesn't feel intrusive. It is also vital that the patient is fully aware of the reason for the observation and the length of time it will last.
Nursing observation is an essential skill that should be a key element of the nursing process. It is important to remember that patients might disagree on the degree of observation. If they are unable to come to an agreement with staff members, they should be able to use an advocate service that can represent their interests and aid them in any discussions regarding their care. This should be part of local policy and practice, with the participation and the 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 encourage the person to take a look at an assessment. These tests can be extremely broad and cover a variety of subjects including appearance, mood, thought process, memory and many more. In addition to these tests, the mental health professional will also ask the person questions regarding their personal life, including what's happened recently and what their feelings have been like.
The test also includes a cognitive test that focuses on the ability of the person to think clearly and remember information. The person could be asked to complete simple tasks such as paying attention to a list of objects, remembering lists or solving math questions. The test can be used to test the individual's judgment and ability to make sound decisions. The test also evaluates the patient's understanding, which reflects their knowledge of their condition and its effects on them.
The person's attitude towards himself, others and the illness is also an important part of a mental evaluation. The patient's tone of voice, facial expressions and body language can indicate hostility, anger depression or a feeling of insecurity. It is also important to know whether the patient is seeking help or just living with their condition.
In more serious cases, a mental health assessment may include an examination of the patient's mental state that could include hallucinations (false sensory perceptions without real stimuli) or illusions (misperceptions of real stimuli). It is crucial to recognize the presence of these disorders because they can be extremely hazardous and even life-threatening.
A mental health assessment should be comprehensive and look at the person's relationship to their world. assessing mental health might use art, music, photos or a variety of electronic assessment tools to better understand the person and their unique view of the world around them. They should also talk about the issues that led to the person to seek help, and reassure them there is nothing wrong with seeking out a mental healthcare professional.