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Mental Health Nursing – Assessing Mental Health Mental health assessments typically include a physical exam, to rule out physical ailments. This could include blood tests, urine tests or even brain scans. Psychologists use a variety of tools for assessing mental health. They can use pen and paper test forms to in-depth interviews or self-complete questionnaires sent to you by post. Mood and affect The affect and mood are the most significant components of the mental health exam (MSE) and are the first things to be viewed by the medical professional. They are the general emotional tone, which can range from joy to sadness, or even irritability to anger. Affect can be assessed by looking at facial expressions and demeanour as well as the response to external or internal stimuli (e.g. smiling at a joke or crying at the loss of a loved one). Affect is a short-term emotion but mood is a longer-lasting emotional state. It is generally described as euthymic, or dysphoric, or normal (meaning depression). However, psychiatrists should be cautious not to mix the two because they have different definitions and are affected by a variety of factors. The MSE is a helpful instrument for diagnosing clinical conditions, but it is difficult to interpret based on an individual patient's report. It is therefore important to ask patients how they have been feeling in the last few weeks, instead of using only the observation of a physician. Recent research showed that the assessment instruments differed in their capacity to identify a significant part of symptoms. This included the symptoms that were classified under the same disorder. This could be due the different emphasis placed on cognitive, emotional or physical symptoms, as well as differences in the duration and frequency of symptom reporting. It is possible that the MSE relies on self-report which is susceptible to bias. Patients who report both anxiety and a headache is likely to have a lower score compared to one who reports only migraine. Patients tend to minimize negative emotions while exaggerating positive ones. Affect and mood directly affect thoughts and can affect the way people make decisions, their interpersonal behavior, and physical functioning. They are affected by fatigue, stress and social interactions. A positive mood can increase creativity and mental strength. However, a mood that is negative can decrease concentration and cause confusion. Therefore, a careful and thorough mental health assessment needs to consider the patient's current mood and state of mind as in addition to the underlying causes. Thought content One of the most essential aspects of a mental state exam is assessing how a patient thinks. Specifically, evaluating thought process and thoughts. The thought process is the coherence, logic and structure of a patient’s thoughts. The normal process of thinking is goal directed and logic-based. In a variety of mental health conditions however, the thought process can be altered. Examples include hallucinations, delusions, and loose associations. A mental state examination also examines judgment and insight. Insight is the ability to identify the presence of a problem, while judgement is the ability to make a considered decision when presented with information. Both are impaired in many mental health conditions such as schizophrenia and depression. Patients with impaired insight or judgement is more prone to harm themselves or others. For example when they are at risk of burning their house down, sensible judgement would tell them to leave the house immediately. However, a patient with impaired judgment might decide to stay in the building and attempting to put the fire out. The contents of a patient's mind encompasses the subject matter, themes and beliefs. Generally, examiners comment on the clarity, connection and the content of a patient's thought. They will note tangential thoughts or circumstantial ones, as well as if the patient has digressions (digressions off from the main topic of the conversation). They will also make comments on the pace of a person's thoughts, such as whether they appear fast or slow. Other important areas to consider are whether the patient's thoughts are mood and in tune with their surroundings. For instance, a person who is depressed might hear voices that sound angry and threatening, while someone suffering from schizophrenia could be able to imagine an ethereal and calm voice. Patients should be asked about any suicidal or homicidal thought. They are not common, but they can be life-threatening and should be taken into consideration in every mental health evaluation. Watching The ability of nurses to observe is vital in an assessment of mental health. They involve a thorough evaluation of appearance, behavior as well as any unusual beliefs or perceptions (such hallucinations or delusions), mood, and cognition (including attention, memory, orientation). A nursing mental status examination also involves observing mobility, which includes any physical movement such as eating, drinking, brushing teeth, using the toilet and taking off shoes. The Observation component of the mental status examination is a crucial aspect of determining whether a patient may pose a risk to themselves or others. This is accomplished by determining if the patient appears to be acting in a deliberate way that suggests they're planning to harming themselves or someone else. mental health assessment london of the thought-based content is also done by monitoring the patient during the interview and determining their concerns. It is important to check whether the patient has suicidal, homicidal or delusional thoughts. A global assessment of functioning (GAF) is an evaluation of the numerical value on a scale from 100 to 0 that measures a person's ability to function in daily life along with their capacity to handle the stressors in their life. The GAF is a crucial element of the mental state examination and helps to guide treatment decisions. It is important to recognize that observing the behaviour of a patient can cause distress. Therefore, it is essential that the procedure is conducted in a manner that does not provoke or make the patient feel uncomfortable. It is also essential that the patient is fully informed about the purpose of the observation as well as the length of time it will take. Nursing observation is a crucial ability and should be a central part of the nursing process. However, it should be remembered that patients may not agree with the degree of observation and if they cannot 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 a part of the local policy and practice, with the involvement and support of groups of users. Questioning Many people have a hard to talk about their mental health problems, but loved ones are often able to tell when something is wrong. They can also urge the person to get an assessment. These tests can be extremely broad and cover a wide range of subjects, including mood, appearance and thought process, memory and more. In addition to these tests, a mental health professional will also ask the individual questions about their life, such as what's happened recently and what their feelings have been like. The test also includes a cognitive evaluation that focuses on the ability of the person to think clearly and remember information. The person may be asked to complete a few basic tasks, like focusing their attention on a list of words or objects and recollecting lists of basic information or solving math problems. The test can be used to test the individual's judgment and ability to make sound decisions. The assessment determines a patient's perception, which is their knowledge of their illness and how it affects them. The attitude of the patient towards himself, others and the illness is an important part of a mental assessment. The patient's tone of voice, facial expression and body language may convey anger, hostility, depression or a sense of insecurity. It is also important to determine whether the patient appears to be seeking help or resigned to living with their health condition. In more serious cases the evaluation of mental health could include a thorough examination of the patient's mental state that may include hallucinations or even illusions. It is crucial to recognize the presence of these conditions because they can be extremely hazardous and even life-threatening. A mental health assessment should be holistic and focus on the person's relationship with their social world. A health professional may use images, music, or art or any other electronic assessment tool to better understand the person. They should also speak to the person about the challenges that have caused them to seek assistance and reassure them that there is nothing wrong with seeing a mental health professional.