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Mental Health Nursing – Assessing Mental Health Mental health assessments often include a physical exam to rule out physical conditions. This can include urine tests, blood tests test or even brain scans. Psychologists employ a variety of tools for assessing mental health. These tools vary from pencil and paper test forms to more in-depth interviews or self-completed questionnaires via mail. Mood and affect The doctor will first be aware of the patient's mood and affect. They describe a patient's general emotional state. This can range from happiness to sorrow or anger and irritability. Affect can be assessed by looking at facial expressions and manner of speaking as well as the reaction to external or internal stimuli (e.g. smiling at an absurd joke or crying over the loss of a loved one). Affect is a temporary emotion while mood is a more sustained emotional state. It is often described as being either euthymic (normal) or dysphoric, meaning depressed. However, psychiatric specialists must be careful not to misunderstand the terms since they have different definitions and are influenced by a variety of factors. The MSE is a helpful tool for clinical diagnosis however it is difficult to interpret from a subjective patient report. It is therefore beneficial to ask patients how they've felt over the past few weeks, rather than relying on physician observation only. Recent research revealed that assessment tools differed in their ability to identify a significant part of symptoms. This included the symptoms that were classified under the same disorder. This could be due to the different emphasis on cognitive or emotional symptoms as well as the different time periods and frequency of reporting symptoms. It is possible that the MSE is based 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 a migraine. Patients tend to minimize negative emotions while exaggerating positive feelings. Mood and affect influence thoughts which influences the way we make decisions, our interpersonal behavior and physical performance. They are affected by fatigue, stress and social interactions. In reality, a positive mood has been shown to enhance thinking and creativity. However, a mood that is negative can affect concentration and cause confusion. A thorough and careful mental health evaluation must consider the patient's mood as well as affect, as well as underlying factors. Thought content Examining the way a patient thinks is one the most crucial aspects of a mental state exam. Assessment of thoughts and their content. The term “thought process” refers to the logic, organization and coherence of a patient's thoughts. The normal process of thinking is goal directed and logic-based. In many mental health disorders however, the thought process is distorted. Examples include hallucinations and delusions as well as loose associations. Insight and judgment are evaluated during a mental status exam. Insight is the ability to identify the presence of a problem. Judgment is the ability to make a rational decision after receiving information. Both can be impaired by a variety of mental health issues such as schizophrenia and depression. If a patient suffers from impaired judgment or insight in any way, they are at greater chance of harming themselves or others. For example when they are in danger of destroying their home, sensible judgement would tell them to leave the building immediately. A patient with impaired judgment may suggest that they stay in the building to try to put out the fire. Thought content refers to the subject matter, themes and beliefs that a patient holds. Examiners generally comment on the clarity, relevance and quality of a patient's thoughts. They will also note tangential thoughts or circumstantial ones, as well as when a patient is digressing (digressions away from the subject of the conversation). They will also comment on the speed of someone's thoughts, such as whether they appear fast or slow. It is also essential to determine whether the patient's mood is in line with their surroundings. Patients suffering from depression may hear angry voices, whereas those suffering from schizophrenia might experience the illusion that a peaceful voice is speaking. The patient should be questioned about any homicidal or suicidal thoughts. Although they are uncommon, they can be life threatening and should be taken into account in every mental health assessment. Observation The ability of nurses to observe is essential in an assessment of mental health. They will conduct a thorough examination of the appearance, behavior and any strange beliefs or perceptions (such as hallucinations or delusions) mood, and aspects of cognition (including attention to orientation, attention memory). The nursing mental status exam also includes monitoring motility. This includes any physical movement such as eating, drinking, or brushing teeth. The observation component of the mental state exam is crucial in determining if the patient poses a risk to themselves or anyone else. This is done by assessing whether or not the patient is acting in a manner that suggests they are in danger of harming themselves or anyone else. A detailed evaluation of the thought-based content is also done by monitoring the patient during the interview and determining preoccupations. It is particularly important to determine if a patient is suffering from suicidal or homicidal ideas and to determine if they're having thoughts of delusion. A global assessment of functioning (GAF) is an assessment of a numerical score on a scale ranging from 0 to 100 that combines the ability of a person to function in everyday life along with their ability to cope with the stresses that come with life. The GAF is a crucial component of the mental state exam and helps guide the treatment decisions. It is crucial to be aware of the fact that observing a patient's behaviour can cause anxiety and it is essential that the procedure is carried out in a way that doesn't provoke the patient and doesn't feel intrusive. It is also essential that the patient is fully aware of the reason for the observation and the length of time it will take. Nursing observation is a vital ability that should be the core of any nursing program. However, it should be remembered that patients may disagree with the level of observation and if they are unable to reach an agreement with the staff, they should be able to access an advocate service that can represent their interests and support patients in any discussions about their care. This should be part of the local policy and practice, with the involvement and the support of groups of users. Questioning Many people have a difficult to discuss their mental health issues however, family members can often notice the signs of something being wrong. They can also urge the person to seek an assessment. These assessments can be conducted on a variety of subjects such as mood, appearance and the thought process. In addition to these tests, mental health professionals will also ask the person questions regarding their personal life, including what's happened recently and what their feelings have been like. The test also includes a cognitive test that focuses on the ability of the individual to think clearly and recall information. The person may be asked to complete basic tasks, like focusing their attention on a list of words or objects as well as storing lists and lists for solving math problems. The test will also test the person's ability to make sound decisions and use judgment. The assessment determines a patient's perception, which is their knowledge of their condition and how it affects them. The person's attitude towards others, himself and the illness is an important element of a mental evaluation. The patient's expression, facial expression and body language can convey hostility, anger, depression or a sense of powerlessness. Main Page is important to observe whether the patient appears seek assistance or is accepting their situation. In more serious situations, a mental health assessment might include an examination of the patient's thoughts, which could involve hallucinations (false sensory perceptions without real stimuli) or illusions (misperceptions of real stimuli). It is crucial to recognize the presence of these disorders because they can be extremely risky and even life-threatening. In general the mental health assessment should take a holistic approach and look at the person's relationship to their social life. A health professional could use images, music, art or a range of assessment tools that are electronic to help the person understand themselves and their unique view of the world around them. They should also talk to the person about the difficulties that caused them to seek assistance and reassure them that there is nothing wrong with visiting an expert in mental health.