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Mental Health Nursing – Assessing Mental Health Mental health assessments usually include a physical exam, to rule out physical conditions. This can include blood tests, urine test or even brain scans. Psychologists utilize a variety instruments to evaluate mental health. These range from pen and paper test forms to in-depth interviews or self-complete questionnaires sent to you by post. Mood and affect Mood and affect are the most significant elements of the mental state exam (MSE) and are the first things to be observed by the medical professional. They define a patient's general emotional tone. It can be anything from sadness to happiness or anger and irritability. The effect can be analyzed through facial expressions, general demeanor and the reaction to internal or external stimuli. You can express your feelings by laughing at an absurd joke, or crying when you lose a beloved one. Affect is a feeling that lasts only a few minutes while mood is a more sustained emotional state. It is typically described as euthymic or normal, or dysphoric (meaning depression). Psychologists should be cautious to not confuse the two terms because they are different in their definition and are affected by a variety of factors. While the MSE is a helpful clinical tool, it can be difficult to interpret based on subjective patient reports. It is therefore important to ask patients how they've been feeling over the last few weeks, instead of relying solely on the observations of doctors. A recent study found that a significant percentage of symptoms, including those grouped together under the same disorder category, vary between assessment tools. This could be due to the different emphasis placed on emotional, cognitive or physical symptoms, as along with differences in duration and frequency of reporting symptom reports. It is also possible that the MSE relies on self-report which is susceptible to bias. For example, a patient who complains of anxiety and headaches will likely report a lower score than a patient who reports only the sensation of a headache. Patients tend to minimize negative emotions while exaggerating positive feelings. Mood and affect can have an impact on the thought content. This can affect decision-making, interpersonal behavior, and physical performance. private psychology assessment Iam Psychiatry can be influenced by fatigue, stress and social interactions, as well as world events, hormones and even the weather. Positive moods can increase creativity and mental strength. A negative mood can cause confusion and lower concentration. Therefore, a careful and thorough mental health evaluation needs to consider the patient's mood and emotional state as well as their underlying factors. Thought content Assessing how the patient thinks is one of the most important aspects of a mental state exam. Assessment of thought process and content. The thought process is the logic, coherence and organization of the patient's thoughts. Normal thought processes are focused and logic-based. Thought processing may be altered in several mental health conditions. Examples include delusions, hallucinations and loose associations. Insight and judgement are assessed in a mental status exam. Insight is the ability to recognize the presence of an issue, and judgement is the ability to make a considered decision based on information. Both can be impaired by several mental health conditions such as schizophrenia and depression. If a patient suffers from impaired judgment or insight in any way, they are at greater risk of causing harm to themselves or others. For example if they are in danger of burning their house down and they have a good sense of judgement, it would be wise for them to leave the building immediately. A patient with impaired judgement might suggest they stay in the building to try to get rid of the fire. Thought content refers to the subject matter, themes and beliefs that a patient holds. Generally, examiners comment on the clarity, relatedness and the content of a patient's thought. They will note any thoughts that are tangential or circumstantial or thoughts, and also if the patient has flights of thoughts (digressions from the topic of conversation). They will also comment on the speed of a person's thoughts, such as whether they appear fast or slow. It is also important to determine if the patient's mood is similar to the environment in which they live. A person suffering from depression could hear voices of anger, while those suffering from schizophrenia may have the illusion that a peaceful voice is speaking. A patient should be questioned about 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 Nurses' observation skills are essential to an assessment of mental health. They include a careful examination of behavior, appearance, any peculiar beliefs or perceptions (such delusions or hallucinations) and mood cognition (including attention, memory, orientation). A mental health assessment for nursing also incorporates observation of motility, including any physical movement, such as eating, drinking, brushing teeth, using the toilet and putting on shoes. The observation component of the mental status examination is a key component of determining whether or not the patient is posing an imminent risk to themselves or others. This is done by assessing whether the patient appears be moving in a deliberate manner that suggests they are about harming themselves or someone else. In addition, a detailed assessment of the content of thoughts is conducted by monitoring the patient throughout the interview and determining their main concerns. It is important to check whether the patient is experiencing suicidal, homicidal or delusional thoughts. A global assessment of functioning (GAF) is a numerical rating on a scale of 0 to 100 that combines the capacity of a person to perform in daily life and their ability to cope with the stresses in their lives. The GAF is an important part of the mental status assessment and aids in making treatment decisions. It is crucial to realize that observing the behaviour of a patient can cause anxiety. Therefore, it is essential that the procedure is conducted in a way that doesn't cause or feel intrusive. It is crucial that the patient is fully aware of the goal of the observations and the length of the process. Nursing observation is a crucial skill that must be the core of any nursing procedure. However, it should be kept in mind that patients could disagree with the level of observation and if they are unable to reach an agreement with the staff, they should have access to an advocate service that can represent their interests and support patients in any discussions about their care. This should be an integral element of the local observation policy and practice with the involvement of user groups, to ensure that patients are involved in the development of written information as well as staff training on this aspect of clinical governance. Questioning Many people have a difficult to talk about their mental health problems however, family members will often be able to recognize the signs that something is not right. They can also help the person get an assessment. These tests can cover a wide range of topics such as mood, appearance and thought process. A mental health professional may also ask questions regarding the person's personal life. They'll ask them what they've been feeling and what has happened recently. 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, such as focusing their attention on the list of words or objects and recollecting lists of basic information or solving math problems. The test will also test the ability of the individual to make informed decisions and use their judgment. The test determines a person's awareness, which is the understanding of their illness and how it affects them. The patient's attitude towards himself, others and the illness is an important part of a mental evaluation. The tone of voice, the facial expression, and body language of a patient can signal depression, anger, or a feeling of utter powerlessness. It is also important to note whether the patient is seeking help or just living with their condition. In more serious situations, a mental health assessment might include an examination of the patient's thoughts that may include hallucinations (false sensory perceptions that do not correspond to real stimuli) or illusions (misperceptions of real stimuli). It is important to note the presence of these disorders because they can be extremely dangerous and even life-threatening. In general an assessment of mental health should take a holistic approach and look at the person's connection to their social life. A health professional can use photographs, music, art or any other electronic assessment tool to better understand the individual. They should also speak to the person about the challenges that caused them to seek help and assure them that there is nothing wrong with visiting a mental health professional.