assessment mental health Nursing - Assessing Mental Health
A physical exam is often included in mental health assessments to rule out physical ailments. This can include urine tests, blood tests tests or even brain scans.
Psychologists also use a wide variety of tools to assess mental health. These tools can be anything from pencil and paper test forms to in depth interviews or self-completed questionnaires for postal mail.
Mood and affect
The clinician will first notice the patient's mood as well as their affect. They define the patient's general emotional tone, which can range from joy to sadness, or even irritability to anger. The patient's mood can be measured by facial expressions, overall attitude and reaction to external or internal stimuli. You can express your emotions by smirking at an absurd joke, or crying when you lose a loved one.
Affect is an emotion that is temporary, whereas mood is a state of constant emotion. It is often described as either euthymic (normal) or dysphoric, meaning depressed. Psychologists should be cautious to not confuse the two terms because they are different in their definition and can be affected by many factors.
The MSE is a helpful 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 is more effective than relying on only observations from a physician. A recent study showed that a large proportion of symptoms, even those that fall within the same disorder category, differ between assessment tools. This can be because of the different emphasis placed on cognitive or emotional symptoms as well as differences between time periods and frequency of the reporting of symptoms.
It is possible that the MSE is based solely on self-reporting which could be biased. For instance, a person who reports anxiety and a headache will likely have an lower score than a person who describes only the sensation of a headache. Additionally there is an inclination for patients to minimize negative feelings and overestimate the severity of positive emotions.
The mood and the affect of a person can have an impact on thought content. This can impact the way people make decisions, their interpersonal behavior and physical function. They can be affected by stress, fatigue and social interactions. In fact, a positive mood has been proven to increase creativity and thinking power. However, a mood that is negative can affect concentration and cause confusion. Therefore, a careful and thorough mental health assessment is required to consider the patient's current mood and state of mind as well as their underlying factors.
Thought content
One of the most essential elements of a mental status examination is to determine how the patient thinks. Specifically, evaluating thought process and thought content. The thought process is the coherence, logic and structure of the patient's thoughts. The normal process of thinking is focused and logical. Thought processing can be altered when a person suffers from mental health issues. Examples include hallucinations, delusions and loose associations.
Insight and judgement are assessed in a mental status exam. Insight is being able to spot the presence of a problem. Judgment is the capability of making a well-considered decision after receiving information. Both can be impaired by various mental health conditions like depression and schizophrenia. A person who isn't able to see or judgment is more likely to hurt themselves or others. For example when they are in danger of burning their home down, sensible judgement would tell that they should leave the premises immediately. However, someone with impaired judgment may decide to stay in the building and attempting to put out the fire.
Thought content is the topics, subject matter, and beliefs that a patient holds. Examiners will comment on the clarity, relatedness, and content of thoughts of the patient. They will also note any thoughts that are tangential or circumstantial and also whether the patient is having flashes of thoughts (digressions from the topic of conversation). They will also provide feedback on the pace at which a person is thinking, such as whether they seem to be more or less fast.
Other areas to be considered are whether the patient's thoughts are compatible or not in line with their surroundings. For instance, a patient who is depressed may hear voices that sound aggressive and threatening, whereas someone suffering from schizophrenia could be able to imagine an ethereal and calm voice. Ask the patient if they are experiencing any thoughts of suicide or homicide. Although these are rare however, they can be life-threatening and must be considered in every mental health assessment.
Watching
The nurse's ability to watch is vital in the mental assessment. They include a careful examination of behavior, appearance, any peculiar beliefs or perceptions (such delusions or hallucinations), mood, and cognition (including attention, memory and orientation). A mental state examination for nurses also includes observing motility, including any physical movement, such as eating, drinking, brushing teeth or using the toilet, as well as wearing shoes.
The Observation element of the mental state exam is an essential element of determining if a patient may pose a risk to themselves or others. This is determined by assessing whether the patient is acting in a manner that suggests that they are about to harm themselves or anyone else.
Additionally, a thorough thought content assessment is made by keeping track of the patient throughout the interview and determining their thoughts and concerns. It is crucial to check if the patient is having suicidal or homicidal thoughts and to determine if they are experiencing delusions.
A global assessment of functioning (GAF) is a numerical rating on a scale ranging from zero to 100 that evaluates a person's ability to function in daily life and their capacity to handle the stresses that come with life. The GAF is an essential part of the mental state examination and helps guide treatment decisions.
It is essential to be aware that observing the behavior of a patient can cause distress and it is essential that the procedure is carried out in a manner that does not provoke the patient or make them be uncomfortable for them. It is also vital that the patient is fully aware of the reason for the observation and the amount of time it will take.
Nursing observation is a crucial skill and it must be an integral part of the nursing process. It is important to remember that patients can disagree with staff about the degree of observation. If they cannot reach an agreement with staff members, they should be able to access an advocate service that can represent their interests and assist in any discussions about their care. This should be a component of the local policy and practice, with the participation and participation of groups of patients.
Questioning
Many people are reluctant to discuss their mental health issues, however family members can often detect if something is not right. They can also help the person to get an assessment. These tests can be extremely broad and cover a range of topics including mood, appearance, memory, thinking process and many more. A mental health professional may also inquire regarding the person's personal life. They will ask what they have been feeling and what's happened in the last few days.
The assessment includes a cognitive evaluation that focuses on a person's ability to think clearly and remember information. The test subject may require the person to complete basic tasks, such as paying attention to a list of objects, recollecting lists, or solving math questions. The test can also be used to check the individual's judgment and ability to make sound decisions. The assessment also determines the patient's knowledge and level of understanding about their condition and its effects on them.
Another important component of the mental health assessment is the person's attitude toward other people, himself and the illness. The tone of voice, facial expressions, and body language of a patient can indicate depression, anger or a sense of helplessness. It is also important to determine whether the patient appears to be seeking help or resigned to living with their condition.
In more serious cases, a mental health assessment might include an assessment of the patient's thinking, which could involve hallucinations (false sensory perceptions that do not correspond to real stimuli) or illusions (misperceptions of real stimuli). These conditions can be harmful and even fatal.
A mental health assessment must be holistic and focus on the person's relationship with their environment. A health professional can use photographs, music, art or any other electronic assessment tool to gain a better understanding of the individual. They should also speak to the person about the challenges that have caused them to seek help and assure them that there is nothing wrong with seeking out an expert in mental health.