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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 involve blood work or urine tests, as well as brain scans. Psychologists utilize a variety instruments to evaluate mental health. They can use pen and paper test forms to in-depth interviews or self-complete postal questionnaires. Affect and mood The doctor will first be aware of the patient's mood as well as their affect. They define a patient's general emotional tone. This could be anything from sadness to happiness or anger and irritability. The affect can be assessed through facial expressions, general behavior and reaction to external or internal stimuli. You can express your feelings by smirking at a joke, or crying when you lose a beloved one. Affect is a feeling that is temporary, while mood is a state of sustained emotion. It is often described as euthymic (normal) or dysphoric, which means depressed. However, psychiatric professionals should be cautious not to confuse the terms since they have different definitions and are affected by a variety of factors. While the MSE is a useful diagnostic tool, it can be difficult to interpret based on a subjective patient report. Asking patients about their feelings during the past few weeks is more effective than relying on only the observations of a doctor. A recent study showed that a significant percentage of symptoms, even those that are grouped under the same disorder category, vary between assessment tools. This can be because of the different emphasis on cognitive or emotional symptoms as well as the different time periods and frequency of the reporting of symptoms. It is possible that the MSE is based solely on self-reporting, which could be biased. For example, a patient who complains of a headache and anxiety will likely report a lower score than someone who has only an occasional headache. Patients tend to minimize negative feelings while exaggerating positive feelings. Mood and affect influence thoughts which influences the way we make decisions, our interpersonal behavior, and physical functioning. They can be influenced by fatigue, stress and social interactions, as well as world events, hormones, and weather. In actual fact positive moods have been proven to boost creativity and thinking power. A negative mood can lead to confusion and reduce concentration. A thorough and careful mental health assessment must be able to consider the patient's mood as well as affect, as well as underlying factors. Thought content One of the most crucial aspects of a mental health examination is to determine how the patient thinks. Assessment of thought process and content. Thought process refers the coherence, logic and organization of a patient's thought processes. Normal thought processes are logical and focused on goals. In many mental health disorders however, thought processing is altered. Examples include delusions, hallucinations and loose associations. A mental health assessment also examines judgment and insight. Insight is being able to identify a problem. Judgment is the capability to make a well-considered choice after receiving information. Both can be impaired by several mental health conditions such as depression and schizophrenia. Patients with impaired insight or judgment is more likely to hurt themselves or others. For instance if they are at risk of destroying their home the sensible judgment would tell that they should leave the premises immediately. A patient with impaired judgment may suggest that they stay in the building to try and put out the fire. The thoughts of a patient include the subject matter, themes and beliefs. Generally, examiners comment on the clarity, relatedness and the content of a patient's thoughts. They will also note tangential thoughts or those that are merely circumstantial, and if the patient has digressions (digressions off from the main topic of the conversation). They will also make comments on the speed at which someone is thinking, such as if they seem fast or slower. It is also essential to determine whether the patient's mood is similar to their surroundings. For instance, a person who is depressed could hear voices that are aggressive and threatening, whereas those suffering from schizophrenia may experience a hallucination of an ethereal and calm voice. Ask the patient if they have any thoughts of suicide or homicide. These are uncommon, but could be life-threatening and should be considered in every mental health assessment. Watching The observation skills of nurses play an important role in a mental health assessment. They include a careful review of the appearance, behavior as well as any unusual beliefs or perceptions (such as hallucinations or delusions) mood, as well as aspects of cognition (including attention, orientation memory). full mental health assessment IamPsychiatry nursing mental status examination also involves observing the ability to move, which includes physical movement such as eating or drinking, brushing your teeth, using the toilet and wearing shoes. The observation component of the mental state examination is vital in determining if the patient poses a risk to them or anyone else. This is done by assessing if the patient appears to be moving in a deliberate way that suggests they are trying to harming themselves or someone else. A thorough assessment of the thought-based content is also done by monitoring the patient during the interview and determining preoccupations. It is important to check whether the patient has suicidal, homicidal or delusional thoughts. A global assessment of functioning (GAF) is an assessment of a numerical score on a scale ranging from 0 to 100 that combines a person's ability to perform in daily life and their ability to deal with the stresses that come with life. The GAF is an essential part of the mental state exam and aids in making treatment decisions. It is important to be aware of the fact that observing an individual's behavior can cause anxiety and it is crucial to conduct the procedure in a manner that does not provoke the patient and doesn't make them feel uncomfortable. It is also vital that the patient is informed about the purpose of the observation and the length of time it will last. Nursing observation is an important skill that should be an integral element of the nursing process. However, it should be noted that patients might disagree with the level of observation. If they cannot reach an agreement with staff then they should have access to an advocate service that will represent their interests and support them in any discussions regarding their treatment. This should be a fundamental part of the local policy and practice, with the involvement of user groups to ensure that patients are included in the creation of written information as well as staff training to support this aspect of clinical governance. Questioning Many people have a difficult to discuss their mental health issues, but loved ones can often notice when something is wrong. They can also urge the person to take a look at an assessment. These tests can cover a wide range of topics that include mood, appearance and thought process. In addition to these tests, mental health professionals will also ask the person questions about their personal life, such as what's been happening lately and what their feelings have been like. The test also includes a cognitive assessment, which focuses on the person's ability to think clearly and recall information. The person may be required 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 ability of the person's judgement and to make good choices. The assessment also determines the patient's insight, which reflects their understanding of the illness and its effects on them. Another important component of the mental health assessment is the patient's attitude towards others, himself and his illness. The patient's tone of voice, facial expression and body language can indicate hostility, anger or depression, 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 situations the assessment of mental health might include a look at the patient's thoughts which could include hallucinations or even illusions. These conditions can be dangerous and even fatal. A mental health assessment should be holistic and focus on the person's interactions to their world. A health professional could use art, music, photos or a range of assessment tools that are electronic to help the person understand themselves and their unique perspective on the world around them. They should also talk about the issues that led to the person to seek help, and reassure that there is nothing wrong in seeing an expert in mental health.