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Mental Health Nursing – Assessing Mental Health A physical examination is typically included in mental health assessments to rule out physical issues. These can include urine tests, blood tests testing, or even brain scans. Psychologists also employ a array of tools to measure mental health. These tools be anything from pencil and paper test forms, to in-depth interviews or self-completed postal questionnaires. Affect and mood The doctor will first observe the patient's mood as well as their affect. They define a patient's general emotional state. This could vary from joy to sadness or irritability and anger. The patient's mood can be measured by facial expressions, overall attitude and reaction to internal or external stimuli. smiling at a joke or crying at the loss of a loved one). Affect refers to an emotion that is only temporary, whereas mood is a long-lasting emotion. It is generally described as euthymic, or normal, or dysphoric (meaning depressed). Psychologists should be cautious to avoid confusion between the terms because they are interpreted differently and are affected by many factors. While the MSE is a useful diagnostic tool but it isn't always easy to interpret based on subjective patient report. Asking patients about their feelings during the past few weeks is more effective than relying on just the observations of a doctor. Recent research showed that the assessment tools differed in their ability to detect a substantial portion of symptoms. This included the symptoms that were classified under the same disorder. This could be due to the different emphasis on emotional or cognitive symptoms, as well as differences between time periods and frequency in symptom reporting. It is possible that the MSE relies solely on self-reporting which could be biased. A patient who reports both anxiety and a headache is likely to have a lower score compared to a patient reporting only headache. Patients tend to minimize negative emotions while exaggerating positive ones. Mood and affect directly affect the content of thoughts, which can influence the way people make decisions, their interpersonal behavior and physical performance. They can be influenced by fatigue, stress and social interactions, as well as world events, hormones, and the weather. In reality, a positive mood has been proven to boost creativity and thinking power. A negative mood can reduce concentration and lead to confusion. Therefore, a careful and thorough mental health assessment is required to take into account the patient's mood and affect as well as the underlying causes. Thought content Examining the way a patient thinks is among the most important aspects of a mental health examination. Assessment of the thought process and its content. The thought process is the coherence, logic, and organization of a patient’s thoughts. Normal thought processes are logical and focused on a goal. Thought processing can be altered when a person suffers from mental health issues. Examples include delusions, hallucinations and loose associations. Insight and judgment are evaluated during a mental status test. Insight is the ability to recognize that there is an issue, and judgement is the ability to make an informed decision based on information. Both are affected by several mental health conditions like depression and schizophrenia. A person who isn't able to see or judgement is more prone to harm themselves or others. If they are in danger, their sensible judgement would suggest leaving 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. Examiners will assess the clarity, connection and content of a patient's thoughts. They will also note any thoughts that are tangential or circumstantial, and whether the patient is prone to having a flurry of thoughts (digressions from the subject of conversation). They will also make comments on the pace at which a person is thinking, such as if they seem to be faster or slower. Other important areas to consider are whether the patient's thoughts are mood compatible or not in line with their environment. A person suffering from depression could be able to hear angry voices, whereas someone suffering from schizophrenia might experience an illusion that a calm voice is speaking. Ask the patient if they are experiencing any suicidal or homicidal thoughts. These are rare but can be life-threatening and should be taken into consideration in every mental health assessment. Observation The ability of nurses to observe is crucial in the mental assessment. They include a careful examination of behavior, appearance and any peculiar beliefs or perceptions (such hallucinations or delusions) and mood cognition (including attention, memory, orientation). A nursing mental status examination also incorporates observation of motility, including any physical movement such as eating drinking, eating, brushing teeth, using the toilet and putting on shoes. The Observation component of the mental health examination is vital in determining if a patient poses a risk to them or anyone else. This is determined by assessing whether or not the patient is acting in a manner which suggests they may be threatening to harm themself or someone else. Additionally, a thorough assessment of thought content is done by keeping track of the patient throughout the interview and determining their thoughts and concerns. It is crucial to determine whether the patient has suicidal, homicidal or delusional thoughts. Global assessment of functioning (GAF) is a numerical rating from 0 to 100, evaluates the ability of an individual to perform in everyday life with their ability of managing stressors. The GAF is a crucial component of the mental state examination and helps guide the treatment decisions. It is crucial to realize that observing the behaviour of a patient may cause distress. It is therefore important that the procedure is conducted in a manner that does not provoke or cause discomfort. what is a mental health assessment www.iampsychiatry.uk is important that the patient is fully aware of the reason for the observations and the duration of the process. Nursing observation is an essential skill that should be a central part of the nursing process. However, it must be remembered that patients may 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 which can represent their needs and help them in any discussions regarding their care. This should be a part of local policy and practice, with the involvement and support of groups of users. Questioning Many people have a difficult time talking about their mental health problems, but loved ones are often able to tell the signs of something being wrong. They can also urge the person to take a look at an assessment. These assessments can be very broad and cover a variety of subjects including appearance, mood as well as memory, thought process and much more. A mental health professional may also inquire about the person's personal life. They will ask what they feel and what's happened in the last few days. The assessment includes an assessment of cognitive ability that examines a person's ability to think clearly and retain information. The test subject may ask to complete simple tasks, such as keeping their attention on the list of objects or words and recollecting lists of basic information or solving math problems. The test can also be used to assess the individual's judgment and ability to make good choices. The test determines a person's insight which is their understanding of their illness and how it affects them. Another crucial aspect of a mental health assessment is the person's attitude toward the world, himself and his illness. The patient's tone of expression, facial expression and body language can convey anger, hostility or depression, or a feeling of helplessness. It is important to check whether the patient appears be asking for help or accepting their condition. In more serious cases, an assessment of mental health might include a thorough examination of the patient's thinking which could include illusions or hallucinations. It is important to note the presence of these conditions as they can be extremely hazardous and even life-threatening. A mental health assessment should be comprehensive and look at the person's relationship with their environment. A health professional may employ photographs, music, art or a variety of assessment tools that are electronic to better understand the person and their unique perspective on the world around them. They should also talk about the difficulties that prompted the person to seek help, and assure them that there is nothing wrong with seeing an expert in mental health.