A Guide To Assessing Mental Health From Start To Finish

Mental Health Nursing - Assessing Mental Health

Mental health assessments usually include a physical exam to rule out physical problems. This could include blood tests, urine tests or even brain scans.

Psychologists employ 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.

Mood and affect

The affect and mood are the most crucial components of the mental status examination (MSE) and are the first thing to be observed by a medical professional. They are the most accurate indicators of a patient's emotional tone. It can vary from joy to sadness or anger and irritability. Affect can be assessed by looking at facial expressions and manner of speaking as well as the reactivity to internal or external stimuli (e.g. smiling at an absurd joke or crying over the loss of a loved one).

Affect refers to an emotion that is temporary, while mood is a state of constant emotion. It is usually described as being either euthymic (normal) or dysphoric, which translates to depressed. However, psychiatric specialists should be cautious not to confuse the terms because they have different definitions and are affected by a range of factors.

The MSE can be a useful instrument for diagnosing clinical conditions, but it is difficult to interpret based on an individual patient's report. Inquiring about the feelings of patients during the past few weeks can be more beneficial than relying on just physician observations. Recent research showed that the assessment tools were different in their ability to capture a significant portion of symptoms. This included those that were grouped under the same disorder. This can be because of the different emphasis placed on emotional or cognitive symptoms, as well as differences between time periods and frequency in symptom reporting.

It is possible that the MSE is based on self-reporting which is susceptible to bias. A patient who has anxiety and headache is likely to have an lower score than those who report only headache. Patients tend to minimize negative feelings while exaggerating positive feelings.

Affect and mood have a direct impact on the content of thoughts which influences the way people make decisions, their interpersonal behavior and physical functioning. They are affected by stress, fatigue and social interactions. In reality, a positive mood has been proven to boost creativity and thinking power. However, a mood that is negative can decrease concentration and cause confusion. A thorough and careful mental health evaluation must be able to consider both the patient's mood and affect, as well as underlying factors.

Thought content

One of the most crucial aspects of a mental state examination is assessing how the patient thinks. Particularly, evaluating thought processes and thoughts. The thought process is the logic, coherence and organization of a patient’s thoughts. Normal thought processes are logical and focused on a goal. In several mental health conditions however, thought processing can be altered. Examples include delusions, hallucinations and loose associations.

A mental health assessment also examines judgment and insight. Insight is being able to recognize the presence of a problem. Judgment is the capability to make a rational decision after receiving information. Both can be impaired by several mental health conditions like depression and schizophrenia. If a patient has impaired judgment and/or insight in any way, they are at a higher chance of harming 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. A patient with impaired judgment might suggest they stay in the building to try and get rid of the fire.

The content of a patient's thoughts encompasses the subject matter, themes and beliefs. Examiners will comment on the clarity, relevance and content of a thoughts of the patient. They will note any thoughts that are circumstantial or tangential, and whether 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 to be fast or slow.

Other areas to be considered are whether the patient's thoughts are mood congruent or incongruent with their environment. For instance, a person who is depressed may hear voices that are angry and threatening, while a person with schizophrenia might have a hallucination of the sound of a calm and soothing voice. A patient should also be asked about any homicidal or suicidal thoughts. These are rare but can be life-threatening and should be taken into consideration during every mental health assessment.

Observation

Nurses' observation skills are crucial in the mental health assessment. They include a careful examination of appearance, behavior as well as any peculiar beliefs or perceptions (such delusions or hallucinations) and mood cognition (including memory, attention and orientation). The mental status exam for nurses also includes observing motility. This is any physical activity, like eating, drinking, or brushing your teeth.

The observation component of the mental state exam is vital in determining if the patient poses a risk to them or anyone else.  assessment in mental health  is accomplished by determining if the patient appears to be moving in a deliberate way that suggests they are trying to harming themselves or someone else.

A detailed assessment of the thought content is also done by monitoring the patient during the interview and determining concerns. It is important to check whether the patient has suicidal, homicidal or delusional thoughts.

Global assessment of functioning (GAF), which is a numerical score ranging from 0 to 100, combines the ability of the person to function in daily life along with their capacity for coping with stressors. The GAF is a key part of the mental health examination and assists in making treatment decisions.

It is important to recognize that observing the behaviour of a patient may cause anxiety. It is crucial that the procedure is conducted in a manner that does not cause discomfort or cause discomfort. It is essential that the patient is aware of the goal of the observations and the length of the process.

Nursing observation is an essential skill and it must be an integral element of the nursing process. However, it should be kept in mind that patients could be dissatisfied with the quality of observation and if they are unable to come to an agreement with staff then they should be able to access an advocate service that can represent their interests and support their discussions on their care. This should be an integral element of the local observation policy and practice, including the involvement of user groups, to ensure that patients are a part in the creation of written information as well as staff training on this aspect of governance in the clinic.

Questioning

Many people have a difficult to talk about their mental health problems however, family members are often able to tell the signs of something being wrong. They can also help the person to get an assessment. These assessments can be very broad and cover a range of topics such as mood, appearance and memory, thinking process and much more. A mental health professional may also inquire regarding the person's personal life. They will ask what they feel and what's happened recently.

The test consists of a cognitive evaluation that examines a person's ability think clearly and retain information. The test subject may require the person to complete basic tasks such as paying attention to a list of objects, remembering lists or completing math problems. The test can also be used to check the person's judgment and ability to make good choices. The test also evaluates the patient's knowledge, which reflects their knowledge of their condition and its effects on them.

The patient's attitude towards others, himself and the illness is an important aspect of a mental evaluation. The patient's tone of voice, facial expressions and body language can indicate hostility, anger depression or a feeling of powerlessness. It is crucial to determine whether the patient seems to be asking for help or accepting their situation.

In more serious cases the evaluation of mental health could include a look at the patient's mental state that may include illusions or hallucinations. It is vital to be aware of the presence of these conditions because they can be extremely risky and even life-threatening.

In general the mental health assessment should take a holistic approach and look at the person's relationship to their social life. A health professional might use images, 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 talk with the person about the challenges that have caused them to seek assistance and assure them that there is nothing wrong with visiting a mental health professional.