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Mental Health Nursing – Assessing Mental Health A physical examination is typically included in mental health assessments to rule out physical ailments. This may involve blood work or urine tests, as well as brain scans. Psychologists utilize a variety instruments to evaluate mental health. These tools can be anything from pencil and paper test forms to more in-depth interviews or self-completed postal questionnaires. Mood and affect Mood and affect are the most important components of the mental health exam (MSE) and are the first things to be observed by a doctor. They define the patient's general emotional state that can range from happiness to sadness or irritability to anger. The degree of affect can be determined by watching facial expressions and manner of speaking as well as the reactivity to internal or external stimuli (e.g. You can express your emotions by smiling at a joke, or crying when you lose a beloved one. Affect refers to an emotion that is temporary, while mood is a long-lasting emotion. It is often described as being either euthymic (normal) or dysphoric, which translates to depressed. However, psychiatric specialists should be cautious not to misunderstand the terms as they have varying definitions and are influenced by a variety of factors. While the MSE is a useful tool for clinical use however, it isn't always easy to interpret based on subjective patient report. The process of asking patients to share their experiences in the last few weeks is more effective than relying on just observations from a physician. A recent study showed that a significant proportion of symptoms, which includes those grouped together under the same disorder category, vary between assessment tools. This could be due the different emphasis on emotional, cognitive or physical symptoms as and also the different duration and frequency of symptom reporting. It is possible that the MSE relies solely on self-reporting, which could be biased. Patients who report both a headache and anxiety is likely to get a lower score compared to one who reports only migraine. Patients tend to minimize negative emotions while exaggerating positive feelings. Affect and mood influence the content of thoughts and can affect the way we make decisions, our interpersonal behavior, and physical functioning. They can be affected by stress, fatigue social interactions, global events, hormones and weather. A positive mood can boost creativity and mental energy. A negative mood can affect concentration and cause confusion. A thorough and meticulous mental health evaluation must take into account both the patient's mood and affect, as well as fundamental factors. Thought content One of the most crucial aspects of a mental state examination is assessing how the patient thinks. Evaluation of thought process and content. Thought process refers to the coherence, logic, and organization of a patient's thinking. Normal thought processes are goal directed and logical. Thought processing can be distorted in several mental health conditions. Examples include delusions, hallucinations and loose associations. Insight and judgement are also assessed in a mental status test. Insight is being able to recognize problems. Judgement is the process to make a well-considered choice after receiving information. Both are affected by several mental health conditions, such as schizophrenia and depression. If a patient is impaired in judgment or insight, they are at greater chance of harming themselves or others. For instance, if they are at risk of burning their home down and they have a good sense of judgement, it would be wise for that they should leave the premises immediately. However, a patient with impaired judgment might suggest staying in the building and trying to put out the fire. The contents of a patient's mind encompasses the subject matter, themes and beliefs. Typically, examiners discuss the clarity, relatedness and content of a patient's thought. They will take note of any thoughts that are circumstantial or tangential and also whether the patient has flights of thoughts (digressions from the subject of conversation). They will also provide feedback on a person's pace of thinking, for example, if they seem fast or slower. It is also important to determine if the patient's mood is similar to their environment. A person suffering from depression could hear angry voices, whereas a person suffering from schizophrenia may have a hallucination that a soothing voice is speaking. The patient should be questioned about any suicidal or homicidal ideation. These are uncommon, but could be life-threatening and should be considered during every mental health assessment. Observation The nurse's ability to watch is crucial in a mental assessment. They are a thorough review of appearance, behaviour, any unusual beliefs and perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention to the environment, orientation memory, and orientation). The mental status exam for nurses also involves the observation of the movement. This includes any physical movement like eating, drinking or brushing teeth. The Observation element of the mental health examination is a crucial aspect of determining if a patient may pose a risk to themselves or others. This is accomplished by determining whether the patient appears be acting in a way that suggests they are about harm themselves or another person. A detailed evaluation of the thought-based content is also made by monitoring the patient during the interview and determining their preoccupations. It is essential to check if the patient is having suicidal or violent thoughts and to determine if they are experiencing delusions. Global assessment of functioning (GAF) is a numerical rating from 0 to 100, measures the capacity of a person to perform in everyday life along with their capacity for coping with stressors. The GAF is an important component of the mental health examination and helps to guide the treatment decisions. It is crucial to be aware that watching a patient's behaviour can cause anxiety and it is important that the procedure is carried out in a way that does not provoke the patient or make them feel intrusive. It is essential that the patient is fully aware of the reason for the observation and the duration of the process. Nursing observation is a vital skill that must be a central part of any nursing process. It is crucial to keep in mind that patients might disagree on the extent of observation. If they cannot reach a consensus with the staff, they should be able to use an advocate service to represent their interests and assist in any discussions regarding their treatment. This should be a fundamental part of the local policy and practice, including the involvement of user groups to ensure that patients are included in the creation of written documents and staff training to support this aspect of governance in the clinic. Questioning Many people are reluctant to discuss their mental health issues, however family members are often able to discern when something isn't right. They can also help the person to seek an assessment. These assessments can be very broad and cover a variety of topics including appearance, mood, memory, thinking process and many more. In addition to these tests, mental health professionals will also ask the individual questions regarding their personal life, including what's been happening recently and what their emotions have been like. The assessment also includes a cognitive test that is focused on the person's ability to think clearly and remember information. The test subject may require the person to complete simple tasks such as focussing on a list or objects, memorizing lists, or solving math questions. The test can also be used to check the person's judgment and ability to make sound decisions. The test also evaluates the patient's insight that reflects their understanding of the illness and its effects on them. The attitude of the patient towards others, himself and the illness is also an important element of a mental evaluation. The tone of voice, the facial expression, and the body expressions of a patient could convey anger, depression, or a feeling of utter powerlessness. It is also important to note whether the patient appears to be seeking help or just living with their condition. In more serious instances the mental health assessment might include an examination of the patient's mental state that could include hallucinations (false sensory perceptions without real stimuli) or illusions (misperceptions of real stimuli). These conditions can be dangerous and even deadly. A mental health assessment must be holistic and focus on the person's interactions with their social world. A health professional may employ photographs, music, art or a variety of electronic assessment tools to better understand the person and their unique view of the world around them. mental health diagnosis assessment should also talk about the challenges that led the person to seek help, and reassure that there is nothing wrong with seeking out a mental healthcare professional.