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Mental Health Nursing – Assessing Mental Health A physical exam is often included in mental health assessments to rule out physical conditions. This can include urine tests, blood tests or even brain scans. Psychologists also employ a range of tools to evaluate mental health. These tools range from paper and pencil test forms, to in-depth interviews or self-completed postal questionnaires. Mood and affect The affect and mood are the most crucial elements of the mental state exam (MSE) and are the first thing to be viewed by the clinician. They define the patient's general mood that can range from happiness to sadness, or even irritability to anger. The patient's mood can be measured through facial expressions, general behavior and reaction to internal or external stimuli. You can express your feelings by smirking at an absurd 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 usually described as either euthymic (normal) or dysphoric, which means depressed. Psychologists should be cautious to avoid confusion between the two terms because they are interpreted differently and are affected by a variety of factors. The MSE can be a useful instrument for diagnosing clinical conditions however it is difficult to interpret from the subjective report of a patient. It is therefore beneficial to inquire about how patients have been feeling in the last few weeks, as opposed to using only the observation of a physician. A recent study revealed that a significant proportion of symptoms, even those grouped together under the same disorder category, vary between assessment tools. This can be due to the different emphasis on cognitive, emotional or physical symptoms as and also the different time periods and frequency of symptom reporting. It is possible that the MSE is based solely on self-reporting, which can be biased. A patient who reports both anxiety and a headache is likely to have a lower score compared to one who reports only headache. Patients tend to minimize negative emotions while exaggerating positive ones. The affect and mood of a person influence thought content, which can influence decision-making, interpersonal behaviour, and physical functioning. They can be affected by stress, fatigue and social interactions. A positive mood can actually increase creativity and mental strength. Conversely, a negative mood can affect concentration and cause confusion. A thorough and meticulous mental health assessment should take into account the patient's mood and affect and the fundamental factors. Thought content One of the most important aspects of a mental health examination is assessing how the patient thinks. Evaluation of thought process and content. Thought process refers the logic, organization and coherence of a patient's thoughts. A normal thought processes is focused and logic-based. 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 being able to spot problems. mental assesment is the process to make a well-considered choice after receiving information. Both can be impaired by a variety of mental health issues such as schizophrenia and depression. If a patient is impaired in judgment or insight in any way, they are at a higher chance of harming themselves or others. If they are in danger, their sensible judgment would advise them to leave the house immediately. However, a person with impaired judgment may decide to stay in the building and attempting to put the fire out. Thought content includes the topics, subjects and beliefs that a patient holds. Examiners generally comment on the clarity, relevance and content of a patient's thought. They will also note any thoughts that are circumstantial or tangential, and whether the patient has flights of ideas (digressions from the topic of conversation). They will also comment on the speed of someone's thoughts, such as whether they appear fast or slow. It is also important to determine if the patient's mood is in line with the environment in which they live. A patient with depression might hear voices of anger, while someone suffering from schizophrenia may experience an illusion that a calm voice is speaking. Ask the patient if they are experiencing any suicidal or homicidal ideas. These are uncommon, but could be life-threatening and should be considered during every mental health assessment. Watching The ability of nurses to observe is crucial in the mental assessment. They involve a thorough evaluation of behavior, appearance and any peculiar beliefs or perceptions (such hallucinations or delusions) mood, cognition (including memory, attention, orientation). The nursing mental state exam also involves observing motility. This includes any physical movement, like eating, drinking or brushing teeth. The Observation component of the mental health examination is crucial in determining if a patient poses a risk to them or anyone else. This is accomplished by determining whether the patient is moving deliberately in a way that suggests they are in danger of harming themself or someone else. In addition, a comprehensive thought content assessment is made by keeping track of the patient throughout the interview and identifying their main concerns. It is important to check whether the patient has suicidal, homicidal or delusional thoughts. A global assessment of functioning (GAF) is a numerical rating on a scale from 0 to 100 that combines a person's ability to function in everyday life and their capacity to handle the stresses in their lives. The GAF is a crucial part of the mental status exam and assists in guiding the treatment decisions. It is crucial to realize that observing the behaviour of a patient may cause distress. It is crucial that the procedure is conducted in a way that doesn't cause or make the patient feel uncomfortable. It is essential that the patient be fully informed of the purpose of the observations and the duration of the process. Nursing observation is a vital skill that must be the core of any nursing procedure. It is essential to remember that patients may disagree about the level of observation. If they are unable to reach an agreement with staff members, they should be able to access an advocate service that can represent their interests and assist in any discussions about their treatment. This should be part of local policy and practice, with the involvement and the support of user groups. Questioning Many people have a hard to discuss their mental health issues however, family members are often able to tell when something is wrong. They can also assist the person take an assessment. These assessments are broad and cover a variety of topics including mood, appearance, thought process, memory and much more. In addition to these tests, mental health professionals will also ask the person questions about their life, including what's happened recently and what their emotions have been like. The assessment also includes a cognitive test, which focuses on the ability of the person to think clearly and retain information. The test subject may require the person to complete basic tasks such as focusing on a list or objects, memorizing lists or completing math problems. The test can also be used to check the person's judgment and ability to make good choices. The assessment determines a patient's insight which is their understanding of their illness and how it affects them. The person's attitude towards others, himself and the illness is also an important part of a mental evaluation. The tone of voice, facial expression, and the body expressions of a patient could convey anger, depression, or a feeling of utter powerlessness. It is important to observe whether the patient appears to seek help or accepting their condition. In more serious cases an assessment of mental health could include a thorough examination of the patient's thoughts that could include hallucinations (false sensory perceptions that do not correspond to real stimuli) or illusions (misperceptions of real stimuli). These conditions can be harmful and even fatal. A mental health assessment should be holistic and examine the person's interactions to their world. A health professional can use art, music or photos, or any other electronic assessment tool to gain a better understanding of the person. They should also talk about the issues that led to the person to seek help, and assure them that there is nothing wrong in seeing a mental healthcare professional.