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Mental Health Nursing – Assessing Mental Health Mental health assessments usually involve a physical examination, to rule out physical problems. This can include blood tests, urine tests or even brain scans. Psychologists also employ a range of tools to evaluate mental health. These range from tests that are written on paper and pen to deep interviews or self-fill questionnaires sent to you by post. Affect and mood The doctor will first observe the patient's mood as well as their affect. They are the most accurate indicators of a patient's emotional tone. This can vary from joy to sadness or anger and irritability. The degree of affect can be determined by watching facial expressions and attitude as well as reaction to external or internal stimuli (e.g. 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, whereas mood is a state of constant emotion. It is usually described as euthymic (normal) or dysphoric, meaning depressed. mental assessments should be cautious to avoid confusion between the two terms, as they are interpreted differently and can be affected by many factors. The MSE is a helpful tool for diagnosing clinical problems, but it is difficult to interpret from a subjective patient report. It is therefore important to inquire about how patients have been feeling over the last few weeks, instead of relying solely on the observations of doctors. A recent study revealed that a significant percentage of symptoms, including those grouped together within the same disorder category, vary between assessment tools. This could be due the differing emphasis on cognitive, emotional or physical symptoms as and also the different the duration and frequency of reporting symptom reports. It is possible that the MSE is based on self-reporting which is susceptible to bias. A patient who reports both a headache and anxiety is likely to report an lower score than one who reports only headache. Patients tend to minimize negative emotions while exaggerating positive ones. The affect and mood of a person directly affect the content of thoughts, which can influence the way people make decisions, their interpersonal behavior and physical functioning. They are affected by fatigue, stress and social interactions. In fact, a positive mood has been proven to increase creativity and thinking power. However, a mood that is negative can decrease concentration and cause confusion. Therefore, a thorough and thorough mental health assessment is required to consider the patient's current mood and emotional state as well as the underlying causes. Thought content One of the most important aspects of a mental health examination is assessing how the patient thinks. Particularly, it is assessing thought process and thought content. The thought process is the coherence, logic, and organization of a patient's thoughts. Normal thought processes are focused and logic-based. In several mental health conditions however, thought processing is altered. Examples include delusions, hallucinations and loose associations. Insight and judgement are assessed in a mental status exam. Insight is being able to identify the presence of a problem. Judgement is the process to make a rational decision after receiving information. Both can be impaired by several mental health conditions such as depression and schizophrenia. A patient with impaired insight or judgement is more likely to hurt themselves or others. For instance, if they are at risk of burning their house down, sensible judgement would tell them to leave the building immediately. A patient with impaired judgement might suggest they stay in the building to try and put out the fire. Thought content is the topics, subject matter, and beliefs that a patient holds. Examiners generally comment on the clarity, connection and quality of a patient's thinking. 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 comment on the speed of a person's thoughts, such as whether they appear fast or slow. Other important aspects to consider are whether the patient's thoughts are mood congruent or incongruent with their surroundings. For instance, a patient who is depressed could hear voices that sound hostile and frightening, whereas those suffering from schizophrenia may be able to imagine an ethereal and calm voice. The patient should also be asked about any homicidal or suicidal thought. Although they are uncommon however, they can be life-threatening and should be taken into account during every mental health assessment. Observation The ability of nurses to observe is vital in an assessment of mental health. They include a careful review 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, and orientation). The nursing mental status exam also involves observing motility. This is any physical activity, like eating, drinking or brushing teeth. The Observation component of the mental state examination is a crucial aspect of determining if the patient could pose the risk to themselves or others. This is done by assessing whether the patient appears to be moving in a way which suggests they are about to harm themselves or anyone else. A detailed evaluation of the content of thoughts is also accomplished by observing the patient during the interview and determining their preoccupations. It is essential to check if the patient has any suicidal or violent thoughts and to determine if they are experiencing thoughts of delusion. Global assessment of functioning (GAF) which is an assessment of functioning in numerical form, ranging between 0 and 100, measures the capacity of the person to function in daily life and their capability of dealing with stressors. The GAF is an important component of the mental health examination and helps to guide the treatment decisions. It is crucial to realize that observing the behaviour of a patient can cause distress. Therefore, it is essential to conduct the procedure in a manner that doesn't cause or cause discomfort. It is also essential that the patient is fully informed about the purpose of the observation and the length of time it will last. Nursing observation is a vital ability that should be at the heart of any nursing program. However, it must be noted that patients might be dissatisfied with the quality of observation and if they cannot reach an agreement with staff then they should be able to access an advocate service that can represent their needs and help them in any discussions regarding their treatment. This should be a component of local policy and practice, with the participation and the support of groups of patients. Questioning Many people have a hard time talking about their mental health problems however, family members can often notice when something is wrong. They can also urge the person to get an assessment. These assessments be a variety of subjects, including mood, appearance and thought process. A mental health professional could also ask questions about the person's private life. They'll ask them what they've been feeling and what's happened in the last few days. The test includes an evaluation of the cognitive capacity that examines a person's ability think clearly and retain information. The test subject may ask to complete basic tasks, such as focusing their attention on an alphabet of objects or words and recollecting lists of basic information or solving math problems. The test may also test the ability of the individual to make sound decisions and use judgment. The test also evaluates the patient's knowledge, which reflects their knowledge of the illness and its effects on them. Another vital aspect of an assessment of mental health is the person's attitude toward others, himself and his illness. The patient's tone of voice, facial expressions and body language may convey anger, hostility or depression, or a feeling of insecurity. It is also important to know whether the patient appears to be seeking help or is content living with their illness. In more serious cases an assessment of mental health 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 harmful and even fatal. In general the mental health assessment must be holistic and look at the person's interactions with their social world. A health professional may use art, music or photos, or any other electronic assessment tool to gain a better understanding of the individual. They should also speak to the person about the difficulties that have led them to seek help and reassure them that there is nothing wrong with visiting a mental health professional.