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Mental Health Nursing – Assessing Mental Health A physical exam is usually part of mental health assessments to rule out physical conditions. This may involve blood work or urine tests, as well as brain scans. Psychologists also employ a variety of tools to assess 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 clinician will first notice the patient's mood and affect. They define the patient's general emotional tone that can range from joy to sadness, or even irritability to anger. The affect can be assessed through facial expressions, overall behavior and reaction to internal or external stimuli. You can express your emotions by laughing at an absurd joke, or crying when you lose a beloved one. Affect is a short-term emotion but mood is a more sustained emotional state. It is often described as being either euthymic (normal) or dysphoric, which means depressed. Psychologists should be cautious to avoid confusion between the two terms because they are defined differently and can be affected by various factors. While the MSE is a valuable clinical tool but it isn't always easy to interpret based on subjective patient report. It is therefore beneficial to ask patients how they've been feeling over the last few weeks, as opposed to relying solely on the observations of doctors. A recent study found that a large proportion of symptoms, even those that are grouped under the same disorder category, differ between assessment tools. This can be because of the different emphasis on emotional or cognitive symptoms, as well as differences between time periods and frequency in reporting symptoms. It is possible that the MSE is based on self-reporting which is susceptible to bias. A patient who has anxiety and headache is likely to report lower scores than those who report only a migraine. Additionally, there is an inclination for patients to minimize negative emotions and overestimate the severity of positive feelings. The mood and the affect of a person can have a direct influence on thought content. This could affect the way we make decisions, our interpersonal behavior, and physical functioning. They are affected by fatigue, stress and social interactions. In actual fact positive moods have been shown to enhance the ability to think and be creative. A mood that is negative can cause confusion and reduce concentration. A thorough and thoughtful mental health evaluation must be able to consider the patient's mood and affect, as well as other factors. Thought content Examining the way a patient thinks is one of the most crucial aspects of a mental health examination. Particularly, it is assessing thought process and thought content. The thought process is the coherence, logic and structure of a patient's thoughts. Normal thought processes are focused and logic-based. Thought processing can be altered in several mental health conditions. Examples include hallucinations, delusions and loose associations. A mental status examination also evaluates insight and judgement. Insight is the ability to see the presence of an issue, and judgement is the ability to make a rational decision based on information. Both are affected by many mental health conditions such as depression and schizophrenia. If a patient suffers from impaired insight and/or judgement in any way, they are at a higher chance of harming themselves or others. For example, if they are in danger of destroying their home, sensible judgement would tell them to leave the building immediately. However, a person with impaired judgment may recommend staying in the house and attempting to put out the fire. The contents of a patient's mind encompasses their themes, subject matter, and beliefs. Generally, examiners comment on the clarity, relevance and quality of a patient's thoughts. They will be able to identify tangential ideas or circumstantial ones, as well as when a patient is digressing (digressions away from the 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 and in tune with their environment. For instance, a person who is depressed may hear voices that sound angry and threatening, while someone suffering from schizophrenia could be able to imagine an ethereal and calm voice. A patient should be questioned about any homicidal or suicidal thought. Although they are not common but they could be life-threatening and should be taken into consideration in every mental health assessment. Observation Nurses' observation skills are essential to the mental health assessment. They are a thorough review of appearance, behaviour as well as any unusual beliefs or perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention to orientation, attention memory, and orientation). A nursing mental status examination also incorporates observation of mobility, which includes any physical movement, such as eating drinking, eating, brushing teeth or using the toilet, as well as wearing shoes. The Observation component of the mental status exam is an essential element of determining whether or not the patient is posing an imminent risk to themselves or others. This is accomplished by determining if the patient appears to be acting in a manner that suggests they are trying to harming themselves or someone else. In addition, a comprehensive assessment of thought content is done by keeping track of the patient throughout the interview and determining their main concerns. It is essential to determine if a patient is having suicidal or homicidal ideas and to determine if they are experiencing delusions. Global assessment of functioning (GAF), which is a numerical score ranging from 0 to 100, combines the ability of a person to function in daily life with their ability of coping with stressors. The GAF is an essential part of the mental health examination and aids in making the treatment decisions. It is essential to be aware that observing the behavior of a patient can cause anxiety and it is essential to conduct the procedure in a way that doesn't provoke the patient and doesn't be uncomfortable for them. It is also vital 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 a central part of any nursing program. It is essential to remember that patients might disagree on the level of observation. If they are unable to reach a consensus with staff, they should be able to access an advocate service to represent their interests and assist in any discussions regarding their treatment. This should be a fundamental part of local observation policy and practice, including the involvement of user groups to ensure that patients are a part in the creation of written documents and staff training for this aspect of governance in the clinic. Questioning Many people are hesitant to discuss their mental health issues, however family members can usually discern when something isn't right. They can also urge the person to get an assessment. These tests can be conducted on a variety of subjects that include mood, appearance and the thought process. In addition to these tests, mental health professionals will also ask the person questions regarding their personal life, such as what's been happening recently and what their emotions have been like. The test consists of a cognitive evaluation that focuses on a person's ability 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, memorizing simple lists or solving math problems. The test will also test the ability of the individual to make good decisions and use judgment. The test also evaluates the patient's understanding that reflects their knowledge of their illness and its impact on them. Another vital aspect of an assessment of mental health is the person's attitude toward others, himself and his illness. The tone of voice, the facial expression, and body language of a patient can indicate depression, anger, or a feeling of powerlessness. It is important to observe whether the patient appears be asking for help or accepting their condition. In more serious situations the mental health assessment might include an assessment of the patient's thinking, which could involve hallucinations (false perceptions of sensory stimuli that are not real stimuli) or illusions (misperceptions of real stimuli). assessment for mental health can be extremely dangerous and even deadly. A mental health assessment should be holistic and examine the person's interactions with their social world. A health professional could use photographs, music, art or a range of assessment tools using electronic technology to help the person understand themselves and their unique perspective on the world around them. They should also talk about the issues that led to the person to seek help, and assure that there is nothing wrong with seeking out an expert in mental health.