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Mental Health Nursing – Assessing Mental Health A physical exam is usually included in mental health tests to rule out any physical conditions. This may include blood tests or urine tests, as well as brain scans. Psychologists use a variety of tools to assess mental health. They can use tests that are written on paper and pen to deep interviews or self-fill postal questionnaires. Affect and mood The clinician will first notice the patient's mood and emotional state. They describe the patient's general emotional tone that can range from happiness to sadness, or even irritability to anger. The effect can be analyzed through facial expressions, overall behavior and reaction to internal or external stimuli. You can express your feelings by laughing at a joke, or crying when you lose a beloved one. Affect is an emotion that is only temporary, whereas mood is a state of sustained emotion. It is often described as either euthymic (normal) or dysphoric, which means 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 many factors. While the MSE is a useful diagnostic tool, it isn't always easy to interpret based on subjective patient report. It is therefore helpful to inquire about how patients have been feeling over the last few weeks, as opposed to relying solely on the observations of doctors. Recent research has revealed that assessment tools were different in their ability to detect a substantial 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 the time intervals and frequency of the reporting of symptoms. It is also possible that the MSE is based on self-reporting, which may be prone to bias. For example, a patient who reports anxiety and a headache will likely report an lower score than a person who describes only an occasional 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 the way we make decisions, our interpersonal behavior, and physical performance. They are affected by stress, fatigue and social interactions. A positive mood can boost creativity and mental energy. A negative mood can cause confusion and lower concentration. A thorough and meticulous mental health evaluation must be able to consider the patient's mood as well as affect, as well as other factors. Thought content Assessing how the patient thinks is among the most crucial aspects of a mental health examination. Assessment of the thought process and its content. The thought process is the coherence, logic and structure of a patient’s thoughts. Normal thought processes are rational and focused on goals. In a variety of mental health conditions, however, thought processing can be altered. Examples include hallucinations, delusions, and loose associations. A mental status examination also assesses the quality of insight and judgement. Insight is the ability to see the presence of a problem, while judgement is the ability to make a rational decision when presented with information. Both can be impaired in various mental health conditions, like schizophrenia and depression. A patient with impaired insight or judgment is more prone to harm themselves or others. If they are in danger, their sensible judgement would suggest leaving the home immediately. A patient with impaired judgement might suggest they stay in the building to try and get rid of the fire. The thoughts of a patient includes their subject matter, themes, and beliefs. Generally, examiners comment on the clarity, relevance and the content of a patient's thinking. They will take note of any thoughts that are tangential or circumstantial and also whether the patient is prone to having a flurry of ideas (digressions from the topic of conversation). They will also make comments on the speed of a person's thoughts, for instance, whether they seem fast or slow. It is also crucial to determine if the patient's mood is in line with their surroundings. Patients suffering from depression may hear voices of anger, while a person suffering from schizophrenia may experience a hallucination that a soothing voice is speaking. Ask the patient if they have any thoughts of suicide or homicide. They are not common, but they can be life-threatening and should be considered during every mental health assessment. Observation The nurse's ability to observe is crucial in an assessment of mental health. They involve a thorough evaluation of appearance, behavior, any unusual beliefs or perceptions (such delusions or hallucinations), mood, and cognition (including attention, memory, orientation). A nursing mental status examination also includes observing mobility, which includes any physical movement, such as eating or drinking, brushing your teeth or using the toilet, as well as putting on shoes. The observation component of the mental status examination is a key component of determining whether a patient may pose a risk to themselves or others. This is accomplished by determining whether the patient appears to be acting in a manner that suggests that they are in danger of harming themself or someone else. A detailed evaluation of the thought-based content is also accomplished by observing the patient during the interview and determining the thoughts and concerns. It is particularly important to determine if the patient is having suicidal or violent thoughts and to determine if they're experiencing thoughts of suicide or delusions. Global assessment of functioning (GAF), which is a numerical score ranging between 0 and 100, evaluates the ability of an individual to perform in everyday life and their capability of coping with stressors. The GAF is an essential part of the mental health examination and assists in making treatment decisions. It is important to be aware that watching an individual's behavior could cause anxiety, and it is essential that the procedure is carried out in a manner that does not provoke the patient and does not feel intrusive. It is also essential that the patient is aware of the reason for the observation as well as the length of time it will last. Nursing observation is an essential skill that should be a central part of any nursing process. However, it should be noted that patients might be dissatisfied with the quality of observation and if they cannot reach an agreement with staff then they should have access to an advocate service that will represent their interests and assist patients in any discussions about their care. This should be an integral element of the local observation policy and practice, with the involvement of user groups, to ensure that patients are included in the development of written documents and staff training for this aspect of governance in the clinic. Questioning Many people are hesitant to talk about their mental health issues, however family members can often detect if something is not right. They can also assist the person obtain an assessment. These assessments can be very broad and cover a variety of subjects including appearance, mood as well as thought process, memory and much more. A mental health professional can also inquire about the person's personal life. They will ask what they have been feeling and what's happened recently. The assessment also includes a cognitive test, which focuses on the ability of the individual to think clearly and retain information. The test subject may ask to complete simple tasks, such as focusing their attention on a list of objects or words, memorizing simple lists or solving math problems. The test can also check the ability of the individual to make good decisions and make good judgments. The test determines a person's perception, which is their knowledge of their condition and how it affects them. The person's attitude toward others, himself and the illness is also an important aspect of a mental assessment . The tone of voice, the facial expression, and the body language of a patient can indicate depression, anger, or a feeling of helplessness. It is also important to note whether the patient appears to be seeking help or is content living with their condition. In more serious instances the mental health assessment could include a thorough 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 as they can be extremely risky and even life-threatening. A mental health assessment should be comprehensive and look at the person's interactions with their environment. Health professionals can employ photographs, music, art, or any other electronic assessment tool to better understand the individual. They should also speak to the person about the issues that have led them to seek help and assure them that there is nothing wrong with seeking out an expert in mental health.