Mental Health Nursing - Assessing Mental Health
Mental health assessments typically include a physical exam to rule out physical conditions. This could involve blood tests, urine tests or brain scans.
Psychologists also utilize a array of tools to measure mental health. They can use pen and paper test forms to in-depth interviews, or self-complete questionnaires for postal delivery.
Mood and affect
The clinician will first notice the patient's mood as well as their affect. They describe a patient's general emotional tone. It can be anything from sadness to happiness or anger and irritability. mental health assessment uk can be assessed by looking at facial expressions and manner of speaking as well as the response to external or internal stimuli (e.g. smiling at the joke or crying over 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, normal, or dysphoric (meaning depressed). Psychologists should be cautious to avoid confusion between the terms, as they are interpreted differently and can be affected by many factors.
While the MSE is a valuable tool for clinical use but it isn't always easy to interpret based on a subjective patient report. Asking patients about their feelings in the last few weeks is more helpful than relying solely on observations from a physician. A recent study found that a significant percentage of symptoms, including those grouped together within the same disorder category, vary between assessment tools. This can be because of the different emphasis on emotional or cognitive symptoms, and also the differences between time periods and frequency in reporting symptoms.
It is also possible that the MSE relies on self-report, which may be prone to bias. For instance, a person who describes experiencing anxiety and a headache will likely have a lower score than a person who describes only a headache. In addition there is an inclination for patients to downplay negative feelings and overestimate the severity of positive emotions.
The affect and mood of a person have a direct impact on the content of thoughts which influences the way people make decisions, their interpersonal behavior and physical functioning. They are affected by stress, fatigue, social interactions, world events, hormones, and weather. In reality positive moods have been shown to enhance creativity and thinking power. However, a mood that is negative can reduce concentration and lead to confusion. Therefore, a careful and thorough mental health assessment is required to consider the patient's mood and emotional state as well as the underlying causes.
Thought content
Assessing how the patient thinks is one of the most crucial aspects of a mental state examination. Evaluation of the thought process and its content. Thought process refers the logic, organization and coherence of a patient's thoughts. Normal thought processes are rational and focused on goals. In several mental health conditions, however, thought processing is distorted. Examples include hallucinations, delusions and loose associations.
A mental state examination also examines judgment and insight. Insight is being able to identify problems. Judgement is the process to make a rational decision after receiving information. Both are affected by several mental health conditions, such as depression and schizophrenia. A patient with impaired insight or judgement is more likely to hurt themselves or others. For example if they are at risk of burning their home down, sensible judgement would tell them to leave the house immediately. A person with impaired judgment might suggest they stay in the house to try to get rid of the flame.
The thoughts of a patient includes the subject matter, themes and beliefs. Examiners will comment on the clarity, relevance and content of a thoughts of the patient. They will also note tangential thoughts or circumstantial ones, and when a patient is digressing (digressions away from the topic of the conversation). They will also comment on the pace at which a person is thinking, for example, if they seem to be more or less fast.
Other important aspects to consider are whether the patient's thoughts are congruent or incongruent with their environment. A person suffering from depression could be able to hear angry voices, whereas those suffering from schizophrenia may have an illusion that a calm voice is speaking. Patients should be asked about any homicidal or suicidal ideation. Although they are uncommon however, they can be life-threatening and should be taken into consideration during every mental health assessment.
Watching
The nurse's ability to observe is essential in a mental assessment. They involve a thorough evaluation of appearance, behavior, any unusual beliefs or perceptions (such delusions or hallucinations) and mood cognition (including memory, attention, orientation). The nursing mental state exam also involves the observation of the movement. This is any physical activity, such as eating, drinking and brushing your teeth.
The observation component of the mental health examination is crucial in determining if the patient poses a risk to them or anyone else. This is done by assessing whether the patient is moving in a way which suggests they are about to harm themself or someone else.
A thorough assessment of the content of thoughts is also made by monitoring the patient during the interview and determining the preoccupations. It is important to check whether the patient is experiencing suicidal, homicidal or delusional thoughts.
Global assessment of functioning (GAF) is an assessment of functioning in numerical form, ranging from 0 to 100, measures the capacity of an individual to perform in everyday life and their capability of coping with stressors. The GAF is an essential part of the mental state examination and aids in making treatment decisions.
It is important to understand that observing the behaviour of a patient could cause anxiety. It is therefore important that the process be conducted in a manner that does not provoke or make the patient feel uncomfortable. It is also crucial that the patient is fully informed about the purpose of the observation and the amount of time it will take.
Nursing observation is a vital skill that must be at the heart of any nursing process. However, it must be noted that patients might disagree with the level of observation. If they are unable to come to an agreement with the staff, they should be able to access an advocate service that can represent their interests and support patients in any discussions about their treatment. This should be part of the local policy and practice, with the involvement and support of user groups.
Questioning
Many people have a hard to talk about their mental health issues however, family members can often notice the signs of something being wrong. They can also assist the person to take an assessment. These assessments can be a variety of subjects that include mood, appearance and the thought process. A mental health professional could also inquire regarding the person's personal life. They will ask them what they've been feeling and what's happened recently.
The assessment includes an assessment of cognitive ability that examines a person's ability think clearly and retain information. The person may be asked to complete simple tasks, like focusing their attention on the list of words or objects and recollecting lists of basic information or solving math problems. The test can also check the person's ability to make informed decisions and use their judgment. The test also evaluates the patient's understanding and knowledge of the illness and its effects on them.
Another vital aspect of an assessment of mental health is the person's attitude toward the world, himself and his illness. The tone of voice, facial expression and body language may convey hostility, anger or depression, or a feeling of powerlessness. It is crucial to determine whether the patient appears seek help or accepting their condition.
In more serious situations the assessment of mental health might include an examination the patient's thoughts which could include illusions or hallucinations. It is important to note the presence of these disorders because they can be extremely hazardous and even life-threatening.
In general, a mental health assessment should take a holistic approach and examine the person's relationship to their social world. A health professional can use photographs, music, art or any other electronic assessment tool to better understand the person. They should also speak to the person about the issues that have caused them to seek help and assure them that there is nothing wrong with seeing a mental health professional.