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Mental Health Nursing – Assessing Mental Health A physical exam is often included in mental health tests to rule out physical issues. This could include urine tests, blood tests tests or even 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 The doctor will first observe the patient's mood and affect. They describe a patient's general emotional state. This can be anything from sadness to happiness or irritability and anger. The affect can be assessed by facial expressions, overall demeanor and the reaction to external or internal stimuli. You can express your feelings by laughing at an absurd joke, or crying when you lose a beloved one. Affect is a temporary emotion while mood is a more long-lasting emotional state. It is typically described as euthymic, dysphoric, or normal (meaning depression). Psychologists should be cautious to avoid confusion between the two terms because they are different in their definition and can be affected by a variety of factors. While the MSE is a useful tool for clinical use, it can be difficult to interpret based upon subjective patient report. It is therefore important to inquire about how patients have been feeling over the last few weeks, rather than using only the observation of a physician. Recent research showed that the assessment instruments differed in their capacity to identify a significant 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 differences between the time intervals and frequency of reporting symptoms. It is possible that the MSE is based solely on self-reporting, which can be biased. For instance, a person who complains of anxiety and headaches will likely report less than a patient who reports only the sensation of a headache. Patients tend to minimize negative emotions while exaggerating positive feelings. Affect and mood can have an impact on the content of thought. This can affect decision-making, interpersonal behavior, and physical performance. They can be affected by fatigue, stress and social interactions. In fact, a positive mood has been shown to enhance thinking and creativity. A negative mood can lead to confusion and lower concentration. A thorough and meticulous mental health evaluation must take into account the patient's mood as well as affect and the fundamental factors. Thought content One of the most crucial aspects of a mental health exam is assessing how a patient thinks. Particularly, it is assessing thought process and thoughts. Thought process refers to the coherence, logic, and organization of a patient's thought processes. Normal thought processes are goal directed and logical. Thought processing can be distorted in several mental health conditions. Examples include hallucinations, delusions and loose associations. Insight and judgment are assessed during a mental state test. Insight is the ability to identify the presence of a problem, while judgement is the ability to make an informed decision when presented with information. Both are impaired in several mental health conditions, such as depression and schizophrenia. A person who isn't able to see or judgment is more likely to harm themselves or others. For instance if they are at risk of burning their house down and they have a good sense of judgement, it would be wise for that they should leave the premises immediately. However, a person with impaired judgment may recommend staying in the house and attempting to put the fire out. Thought content includes the topics, subject matter, and beliefs that a patient holds. Examiners generally comment on the clarity, relatedness and quality of a patient's thoughts. They will take note of any thoughts that are circumstantial or tangential or thoughts, and also if the patient has flights of thoughts (digressions from the topic of conversation). They will also comment on the speed of someone's thoughts, for instance, whether they seem to be fast or slow. Other areas to be considered are whether the patient's thoughts are mood compatible or not in line with their environment. Patients suffering from depression may hear voices of anger, while those suffering from schizophrenia may experience an illusion that a calm voice is speaking. The patient should be asked about any suicidal or homicidal thoughts. These are rare but can be life-threatening and should be considered in every mental health evaluation. Observation The observation skills of nurses are essential to a mental health assessment. They include a careful review of the appearance, behavior and any strange beliefs or perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention, orientation, memory). The mental status exam for nurses also includes the observation of motility. This includes any physical movement, like eating, drinking or brushing your teeth. The observation component of the mental state examination is essential in determining whether the patient poses a risk to themselves or others. This is done by assessing whether the patient appears to be acting in a way that suggests they are about harming themselves or someone else. In addition, a comprehensive 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 important to check whether the patient is experiencing suicidal, homicidal or delusional thoughts. A global assessment of functioning (GAF) is an evaluation of the numerical value on a scale ranging from 100 to 0 that measures a person's ability to function in daily life along with their ability to cope with the stressors in their life. The GAF is an important element of the mental state exam and assists in guiding the treatment decisions. It is important to recognize that observing the behavior of a patient can cause distress. It is therefore important that the process be conducted in a manner that does not cause discomfort or make the patient feel uncomfortable. It is also vital that the patient is fully aware of the reason for the observation as well as the length of time it will take. Nursing observation is an important skill that should be a central part of the nursing process. However, it should be kept in mind that patients could be dissatisfied with the quality of observation. If they are unable to reach an agreement with the staff, they should have access to an advocate service that can represent their interests and support patients in any discussions about their care. This should be a fundamental element of the local observation policy and practice with the participation of user groups to ensure that patients are included in the development of written information and staff training on this aspect of clinical governance. Questioning Many people have a hard time talking about their mental health issues however, family members are often able to tell the signs that something is not right. They can also encourage the person to take a look at an assessment. These assessments can be very broad and cover a variety of topics including appearance, mood as well as memory, thinking process and more. In addition to these tests, mental health professionals will also ask the individual questions about their personal life, including what has been going on recently and what their feelings have been like. The test includes an assessment of cognitive ability that focuses on a person's ability to think clearly and remember information. The person may be asked to complete simple tasks, like focusing their attention on an alphabet of words or objects and recollecting lists of basic information or solving math problems. The test can also be used to check the individual's judgment and ability to make sound decisions. The test also evaluates the patient's insight that reflects their understanding of their illness and its impact on them. Another crucial aspect 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 anger, hostility or depression, or a feeling of insecurity. It is also important to note whether the patient is seeking help or resigned to living with their health condition. In more serious cases the evaluation of mental health might include an examination the patient's thoughts that may include hallucinations or even illusions. comprehensive psychiatric assessment IamPsychiatry can be harmful and even fatal. A mental health assessment should be comprehensive and look at the person's relationship with their social world. A health professional might use photographs, music, art or a range of assessment tools using electronic technology to help understand the person and their unique perspective on the world around them. They should also discuss the issues that led to the person to seek help, and reassure that there is nothing wrong in seeing a mental health professional.