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Mental Health Nursing – Assessing Mental Health A physical examination is typically part of mental health tests to rule out any physical conditions. This may include blood tests and urine tests as well as brain scans. Psychologists also utilize a 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 via mail. Affect and mood Mood and affect are among the most important elements of the mental state examination (MSE) and are the first to be observed by a clinician. They describe the patient's general emotional state that can range from happiness to sadness, or anger to anger. The degree of affect can be determined by observing facial expressions and overall manner of speaking as well as the reactivity to internal or external stimuli (e.g. You can express your feelings by smirking at a joke, or crying when you lose a beloved one. Affect is a feeling that lasts only a few minutes, whereas mood is a more long-lasting emotional state. It is typically described as euthymic, dysphoric, or normal (meaning depressed). Professionals in psychiatry must be careful to avoid confusion between the two terms because they are different in their definition and can be affected by various factors. While the MSE is a helpful tool for clinical use however, it isn't always easy to interpret based on subjective patient report. It is therefore beneficial to ask patients how they have been feeling over the last few weeks, rather than relying solely on the observations of doctors. Recent research revealed that assessment tools differed in their ability to detect a substantial portion of symptoms. This included the symptoms that were classified under the same disorder. This could be due to the different emphasis placed on emotional or cognitive symptoms, as well as the different the time intervals and frequency of the reporting of symptoms. It is also possible that the MSE relies on self-report which could be susceptible to bias. A patient who reports both anxiety and a headache is likely to have an lower score than a patient reporting only headache. Patients tend to minimize negative emotions while exaggerating positive ones. Mood and affect directly affect thought content and can affect the way we make decisions, our interpersonal behavior and physical functioning. They are affected by fatigue, stress and social interactions. A positive mood can actually boost creativity and mental energy. A negative mood can cause confusion and decrease concentration. Therefore, a careful and thorough mental health assessment needs to consider the patient's mood and emotional state as well as their underlying factors. Thought content One of the most important elements of a mental status examination is assessing how the patient thinks. Evaluation of thoughts and their content. The term “thought process” refers to the coherence, logic and organization of a patient's thinking. Normal thought processes are rational and goal-oriented. In several mental health conditions, however, thought processing is altered. Examples include hallucinations, delusions and loose associations. A mental state examination also assesses the quality of insight and judgement. Insight is the ability to see the presence of an issue, and judgement is the ability to make an informed decision when presented with information. Both can be impaired in several mental health conditions, like schizophrenia and depression. If a patient is impaired in insight and/or judgement, they are at greater risk of causing harm to themselves or others. If they are in danger, their rational judgement would tell to leave the premises immediately. However, a person with impaired judgment might recommend staying in the house and trying to put the fire out. Thought content is the subject matter, themes and beliefs that a patient has. Generally, examiners comment on the clarity, relevance and content of a patient's thinking. They will also note any thoughts that are circumstantial or tangential or thoughts, and also if the patient is having flashes of thoughts (digressions from the topic of conversation). They will also make comments on the speed of someone's thoughts, for instance, whether they appear fast or slow. Other important areas to consider are whether the patient's thoughts are mood congruent or incongruent with their surroundings. For instance, a person who is depressed could hear voices that are hostile and frightening, whereas someone suffering from schizophrenia could be able to imagine a calm and soothing voice. Ask the patient if they've had any suicidal or homicidal thoughts. Although they are not common but they could be life threatening and should be taken into consideration in every mental health assessment. Observation The nurse's ability to observe is essential in an assessment of mental health. They will conduct a thorough examination of behavior, appearance, any unusual beliefs and perceptions (such as hallucinations or delusions) mood, as well as aspects of cognition (including attention to orientation, attention memory, and orientation). The nursing mental state exam is also a way of observing the movement. This includes any physical movement, like eating, drinking, or brushing your teeth. The Observation component of the mental status exam is an essential element of determining whether or not a patient may pose a risk to themselves or others. This is done by assessing whether the patient appears be moving in a deliberate manner that suggests they are about harm themselves or another person. In addition, a detailed assessment of the content of thoughts is conducted by keeping track of the patient throughout the interview and identifying their thoughts and concerns. It is essential to determine whether the patient is suffering from suicidal, homicidal, or delusional thoughts. Global assessment of functioning (GAF) is a numerical rating between 0 and 100, measures the capacity of an individual to function in daily life with their ability of dealing with stressors. The GAF is a crucial component of the mental health examination and assists in making the treatment decisions. It is important to be aware that watching an individual's behavior can cause distress and it is important that the procedure is carried out in a way that doesn't provoke the patient or make them feel intrusive. It is also essential that the patient is informed about the purpose of the observation and the amount of time it will last. Nursing observation is an essential ability and should be a key element of the nursing process. However, it must be remembered that patients may disagree with the level of observation. If they are unable to reach an agreement with staff then they should have access to an advocate service which can represent their interests and assist patients in any discussions about their treatment. This should be part of local policy and practice, with the participation and the support of groups of patients. Questioning Many people have a difficult time talking about their mental health issues However, loved ones are often able to tell when something is wrong. They can also assist the person take steps to obtain an assessment. These tests can be a variety of topics that include mood, appearance and thought process. In addition to these tests, mental health professionals will also ask the person questions regarding their personal life, such as what's been happening lately and what their feelings have been like. The assessment also includes a cognitive assessment that is focused on the person's ability to think clearly and recall information. The test subject may require the person to complete simple tasks such as focusing on a list or objects, remembering lists, or solving math questions. private mental health assessment near me can be used to test the individual's judgment and ability to make good choices. The test measures a patient's perception, which is their knowledge of their illness and how it affects them. Another important component of the mental health assessment is the person's attitude towards other people, himself and the illness. The tone of expression, facial expression and body language may convey hostility, anger depression or a feeling of helplessness. It is important to check whether the patient appears to be asking for help or accepting their situation. In more serious instances the mental health assessment might include an assessment of the patient's thinking that may include hallucinations (false sensory perceptions that do not correspond to real stimuli) or illusions (misperceptions of real stimuli). It is vital to be aware of the presence of these conditions because they can be extremely dangerous and even life-threatening. A mental health assessment must be holistic and focus on the person's relationship to their world. A health professional may use images, music, or art, or any other assessment tool to gain a better understanding of the person. They should also speak to the person about the challenges that have led them to seek help and assure them that there is nothing wrong with seeking out a mental health professional.