 Mental Health Nursing - Assessing Mental Health
 Mental health assessments typically include a physical exam, to rule out physical ailments. This can include urine tests, blood tests tests or even brain scans.
Psychologists utilize a variety tools for assessing mental health. These tools can range from paper and pencil test forms to more in-depth interviews or self-completed postal questionnaires.
Affect and mood
Mood and affect are the most important elements of the mental state examination (MSE) and are the first thing to be observed by a medical professional. They are the general mood that can range from joy to sadness or irritability to anger. Affect can be assessed by watching facial expressions and demeanour as well as the response to external or internal stimuli (e.g. smiling at a joke or crying at the loss of a loved one).
Affect is a feeling that lasts only a few minutes but mood is a more long-lasting emotional state. It is often described as being either euthymic (normal) or dysphoric, meaning depressed. However, psychiatric professionals must be careful not to mix the two as they have varying definitions and are affected by a variety of factors.
The MSE is a helpful tool for diagnosing clinical problems however, it can be difficult to interpret based on the subjective report of a patient. Inquiring about the feelings of patients in the last few weeks is more effective than relying on just the observations of a doctor. Recent research showed that the assessment tools were different in their ability to detect a substantial portion of symptoms. This included those that were classified under the same disorder. This could be due to the differing emphasis on cognitive, emotional or physical symptoms, as well as differences in the duration and frequency of reporting symptom reports.
It is possible that the MSE relies on self-reports, which may be prone to bias. For example, a patient who complains of a headache and anxiety will likely report less than someone who has only a headache. Patients tend to minimize negative emotions while exaggerating positive ones.
Affect and mood can have a direct influence on the thought content. This can impact decision-making, interpersonal behavior, and physical functioning. They can be affected by stress, fatigue social interactions, world events, hormones and weather. In fact positive moods have been proven to boost thinking and creativity. A negative mood can reduce concentration and lead to confusion. A thorough and meticulous workplace mental health assessment health assessment must be able to consider both the patient's mood and affect as well as the other factors.
Thought content
Examining the way a patient thinks is one the most important 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 thought processes. Normal thought processes are focused and rational. Thought processing can be altered in several mental health conditions. Examples include hallucinations and delusions as well as loose associations.
Insight and judgement are also assessed in a mental status test. Insight is the ability to recognize problems. Judgment is the ability to make a well-considered choice after receiving information. Both are impaired in several mental health assessment skills health conditions, such as schizophrenia and depression. If a patient has impaired judgment or insight, they are at a higher risk of causing harm to themselves or others. If they are in danger, their sensible judgement would suggest leaving the premises immediately. However, someone with impaired judgment might suggest staying in the building and attempting to put the fire out.
The thoughts of a patient include the subject matter, themes and beliefs. Generally, examiners comment on the clarity, relevance and the content of a patient's thinking. They will note any thoughts that are circumstantial or tangential or thoughts, and also if the patient is prone to having a flurry of ideas (digressions from the subject of conversation). They will also comment on the speed of someone's thoughts, including whether they appear fast or slow.
Other areas to be considered are whether the patient's thoughts are mood and in tune with their surroundings. Patients suffering from depression may hear angry voices, whereas those suffering from schizophrenia might experience a hallucination that a soothing voice is speaking. The patient should be questioned about any suicidal or homicidal ideation. Although they are not common, they can be life-threatening and must be taken into consideration during every mental health assessment.
Observation
The nurse's ability to observe is crucial in an assessment of mental health. They are a thorough review of the appearance, behavior, any unusual beliefs and perceptions (such as hallucinations or delusions) mood, and aspects of cognition (including attention to orientation, attention, memory). A nursing mental status examination also incorporates observation of the ability to move, which includes physical movement such as eating, drinking, brushing teeth, using the toilet and putting on shoes.
The Observation component of the mental state exam is vital in determining if the patient poses a risk to them or anyone else. This is done by assessing whether the patient appears to be acting in a manner which suggests they are in danger of harming themself or someone else.
In addition, a detailed assessment of the content of thoughts is conducted by observing the patient throughout the interview and determining their thoughts and concerns. It is essential to determine whether the patient is experiencing suicidal, homicidal or delusional thoughts.
A global assessment of functioning (GAF) is a numerical rating on a scale ranging from 0 to 100 that combines the capacity of a person to perform in daily life and their ability to cope with the stresses in their lives. The GAF is a key part of the mental state examination and aids in making the treatment decisions.
It is important to recognize that observing the behaviour of a patient could cause anxiety. It is crucial that the process be conducted in a manner that does not provoke 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 last.
Nursing observation is a vital skill that should be a central part of any nursing process. It is crucial to keep in mind that patients can disagree with staff about the level of observation. If they cannot come to an agreement with staff, they must be able access an advocate service to represent their interests and assist them in any discussions about their treatment. This should be a fundamental part of local observation policy and practice with the participation of user groups to ensure that patients are a part in the development of written information as well as staff training on this aspect of clinical governance.
Questioning
Many people have a difficult time talking about their mental health issues however, family members are often able to tell when something is wrong. They can also urge the person to seek an assessment. These assessments can cover a wide range of subjects that include mood, appearance and the thought process. In addition to these tests, a mental health professional will also ask the individual questions about their personal life, including what's happened recently and what their feelings have been like.
The assessment also includes a cognitive evaluation that is focused on the ability of the person to think clearly and remember information. The test taker may be asked to complete a few basic tasks, such as keeping their attention on an alphabet of objects or words and recollecting lists of basic information or solving math problems. The test can also be used to assess the individual's judgment and ability to make good choices. The test determines a person's insight which is their understanding of their illness and how it affects them.
Another important component of the mental health assessment is the person's attitude toward others, himself and his illness. The patient's tone of voice, facial expression and body language may convey hostility, anger depression or a feeling of powerlessness. It is important to observe whether the patient appears seek help or accepting their situation.
In more serious cases the mental health assessment may include an assessment of the patient's thinking that may include hallucinations (false sensory perceptions without real stimuli) or illusions (misperceptions of real stimuli). These conditions can be dangerous and even deadly.
A mental health assessment must be holistic and focus on the person's interaction with their environment. A health professional could use images, music, art or a range of assessment tools using electronic technology to better understand the person and their unique perspective on the world around them. They should also discuss the challenges that led the person to seek help, and assure them that there is nothing wrong with seeking out an expert in mental wellbeing Assessment health.
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