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Mental Health Nursing – Assessing Mental Health A physical exam is usually part of mental health tests to rule out any physical ailments. This could include blood tests, urine tests or even brain scans. Psychologists employ a variety of tools to assess mental health. They can use tests that are written on paper and pen to in-depth interviews or self-complete questionnaires sent to you by post. Mood and affect Mood and affect are the most crucial components of the mental health exam (MSE) and are the first things to be viewed by the doctor. They define the patient's general emotional tone, which can range from joy to sadness, or even irritability to anger. Affect can be measured by watching facial expressions and attitude as well as reaction to external or internal stimuli (e.g. smiling at an absurd joke or crying over the loss of a loved one). Affect is a short-term emotion, whereas mood is a more long-lasting emotional state. It is generally described as euthymic or dysphoric, or normal (meaning depressed). However, psychiatrists should be cautious not to confuse the terms because they have different definitions and are affected by a range of factors. While the MSE is a helpful diagnostic tool, it can be difficult to interpret based upon subjective patient report. Asking patients about their feelings in the last few weeks can be more beneficial than relying on only physician observations. A recent study showed that a significant proportion of symptoms, even those that fall within the same disorder category, vary between assessment tools. This could be due to the different emphasis placed on cognitive or emotional symptoms and also the differences between 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. For instance, a person who reports a headache and anxiety will likely have a lower score than a patient who reports only a headache. In addition, there is the tendency for patients to minimize negative emotions and overestimate the severity of positive ones. Affect and mood directly affect thoughts, which can influence the way people make decisions, their interpersonal behavior, and physical functioning. They are affected by stress, fatigue and social interactions. In fact positive moods have been proven to increase creativity and thinking power. A negative mood can cause confusion and reduce concentration. A thorough and careful mental health evaluation must be able to consider both the patient's mood and affect and the fundamental factors. Thought content One of the most important elements of a mental status examination is to determine how the patient thinks. Particularly, evaluating thought processes and thought content. Thought process refers to the coherence, logic and organization of a patient's thought processes. A normal thought processes is goal directed and logical. In several mental health conditions however, thought processing is altered. Examples include hallucinations, delusions and loose associations. Insight and judgement are assessed during a mental state test. Insight is the ability to spot a problem. Judgment is the ability of making a well-considered decision after receiving information. Both can be impaired by a variety of mental health issues such as schizophrenia and depression. If a patient suffers from impaired judgment or insight in any way, they are at a higher risk of causing harm to themselves or others. If they are in danger, their sensible judgement would tell to leave the house immediately. However, a patient with impaired judgment may recommend staying in the house and attempting to put out the fire. Thought content refers to the topics, subject matter, and beliefs that a patient has. Examiners generally comment on the clarity, relatedness and quality of a patient's thinking. They will take note of any thoughts that are tangential or circumstantial or thoughts, and also if the patient is having flashes of thoughts (digressions from the conversation subject). They will also discuss the pace of a person's thoughts, including whether they seem fast or slow. It is also essential to determine if the patient's mood matches their environment. Patients suffering from depression may hear angry voices, whereas those suffering from schizophrenia might experience a hallucination that a soothing voice is speaking. Ask the patient if they have any suicidal or homicidal ideas. These are uncommon, but could be life-threatening and should be considered in every mental health assessment. Observation The ability of nurses to observe is essential in the mental assessment. They are a thorough review of appearance, behaviour as well as any unusual beliefs or perceptions (such as hallucinations or delusions) mood, as well as aspects of cognition (including attention to orientation, attention memory). The nursing mental state exam is also a way of observing the movement. This is any physical activity, such as eating, drinking and brushing your teeth. The Observation component of the mental status exam is an essential element of determining if the patient is posing a risk to themselves or others. This is accomplished by determining whether or not the patient appears to be moving deliberately in a way that suggests they are in danger of harming themselves or anyone else. In addition, a detailed assessment of the content of thoughts is conducted by monitoring the patient throughout the interview and determining their preoccupations. It is essential to determine whether the patient is suffering from suicidal, homicidal or delusional thoughts. Global assessment of functioning (GAF) which is a numerical rating between 0 and 100, evaluates the ability of the person to function in daily life with their ability of coping with stressors. The GAF is a key part of the mental state exam and aids in making the treatment decisions. It is important to be aware that watching an individual's behavior could cause anxiety, and it is important to conduct the procedure in a manner that doesn't provoke the patient and doesn't be uncomfortable for them. It is important that the patient be fully aware of the goal of the observations and the duration of the procedure. Nursing observation is a vital ability that should be at the heart of any nursing program. It is important to remember that patients can disagree with staff about the degree of observation. If they are unable to reach a consensus with the staff, they should be able to access an advocate service that can represent their interests and assist them in any discussions about their treatment. This should be an integral part of local observation policy and practice with the participation of user groups to ensure that patients are involved in the development of written information and staff training on this aspect of governance in the clinic. Questioning A lot of people are hesitant to discuss their mental health issues, however family members can usually discern when something isn't right. They can also assist the person take steps to take an assessment. These assessments be a variety of topics, including mood, appearance and thought process. In addition to these tests, a mental health professional will also ask the person questions about their life, including what has been going on recently and what their emotions have been like. The assessment also includes a cognitive assessment that is focused on the ability of the individual to think clearly and retain information. The test subject may require the person to complete simple tasks such as focusing on a list or objects, remembering lists or completing math problems. Recommended Web-site can also be used to check the person's judgment and ability to make informed choices. The assessment determines a patient's awareness, which is the understanding of their illness and how it affects them. The person's attitude towards himself, others and the illness is also an important part of a mental assessment. The patient's voice, facial expressions and body language may convey anger, hostility depression or a feeling of helplessness. It is crucial to determine whether the patient appears be asking for help or accepting their situation. In more serious instances, an assessment of mental health might include a look at the patient's thoughts, which may involve hallucinations or even illusions. It is crucial to recognize the presence of these conditions as they can be extremely risky and even life-threatening. In general an assessment of mental health should be holistic and look at the person's connection to their social environment. Health professionals can employ photographs, music, art, or any other electronic assessment tool to better understand the individual. They should also talk to the person about the challenges that have caused them to seek assistance and reassure them that there is nothing wrong with seeing a mental health professional.