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Mental Health Nursing – Assessing Mental Health A physical examination is typically part of mental health assessments to rule out physical conditions. These can include urine tests, blood test or even brain scans. Psychologists utilize a variety instruments to evaluate mental health. They can use tests that are written on paper and pen to deep interviews or self-fill postal questionnaires. Mood and affect The doctor will first observe the patient's mood and emotional state. They define the patient's general mood that can range from happiness to sadness or irritability to anger. The patient's mood can be measured by facial expressions, overall demeanor and the reaction to external or internal stimuli. You can express your feelings by smirking at a joke, or crying when you lose a beloved one. Affect refers to an emotion that is temporary, whereas mood is a state of sustained emotion. It is often described as euthymic (normal) or dysphoric, which means depressed. Professionals in psychiatry must be careful to avoid confusion between the terms, as they are interpreted differently and can be affected by many factors. While the MSE is a useful clinical tool, it can be difficult to interpret based on subjective patient report. It is therefore beneficial to ask patients how they have been feeling over the last few weeks, as opposed to relying solely on the observations of doctors. Recent research has revealed that assessment instruments differed in their capacity to capture a significant portion of symptoms. This included those that were classified under the same disorder. This can be because of the different emphasis placed on cognitive or emotional symptoms as well as differences between the time intervals and frequency of the reporting of symptoms. It is possible that the MSE is based on self-reporting which could be susceptible to bias. A patient who reports both a headache and anxiety is likely to report lower scores than one who reports only headache. In addition there is an inclination for patients to downplay negative emotions and underestimate the severity of positive ones. Affect and mood influence thoughts which influences the way we make decisions, our interpersonal behavior, and physical functioning. They can be influenced by fatigue, stress social interactions, global events, hormones and even the weather. In actual fact, a positive mood has been shown to enhance creativity and thinking power. A mood that is negative can cause confusion and decrease concentration. Therefore, a thorough and thorough mental health assessment needs to take into account the patient's current mood and state of mind as in addition to the underlying causes. Thought content One of the most crucial elements of a mental status examination is assessing how the patient thinks. Particularly, it is assessing thought process and thought content. The thought process is the logic, coherence and organization of a patient's thoughts. The normal process of thinking is focused and rational. Thought processing can be altered in a variety of mental health conditions. Examples include hallucinations, delusions and loose associations. Insight and judgement are evaluated during a mental status test. Insight is the ability to recognize the presence of a problem. Judgment is the ability to make a well-considered choice after receiving information. Both are affected by various mental health conditions, such as depression and schizophrenia. If a patient is impaired in insight and/or judgement in any way, they are at a higher risk of causing harm to themselves or others. For instance when they are at risk of burning their home down the sensible judgment would tell that they should leave the premises immediately. However, a person with impaired judgment may decide to stay in the building and trying to put the fire out. The content of a patient's thoughts include the subject matter, themes, and beliefs. Generally, mental assesment comment on the clarity, connection and quality of a patient's thought. They will note tangential thoughts or those that are merely circumstantial, and in the event that the patient's thoughts diverge (digressions away from the subject of the conversation). They will also discuss the speed of a person's thoughts, including whether they seem fast or slow. It is also crucial to determine whether the patient's mood matches their surroundings. For instance, a person who is depressed could hear voices that are hostile and frightening, whereas a person with schizophrenia might have a hallucination of an ethereal and calm voice. Ask the patient if they are experiencing any suicidal or homicidal ideas. These are uncommon, but could be life-threatening and should be taken into consideration in every mental health evaluation. Observation The observation skills of nurses are essential to a mental health assessment. They are a thorough review of the appearance, behavior, any unusual beliefs and perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention, orientation memory, and orientation). A nursing mental status examination also involves observing mobility, which includes any physical movement, such as eating or drinking, brushing your teeth using the toilet and taking off shoes. The Observation element of the mental state examination is a key component of determining whether the patient is posing an imminent risk to themselves or others. This is determined by assessing whether or not the patient appears to be acting in a manner that suggests they are in danger of harming themselves or anyone else. In addition, a comprehensive assessment of the content of thoughts is conducted by monitoring the patient throughout the interview and determining their preoccupations. It is particularly important to determine if a patient is suffering from suicidal or violent thoughts and to determine if they're experiencing delusions. A global assessment of functioning (GAF) is an assessment of a numerical score on a scale from zero to 100 that evaluates a person's ability to perform in daily life along with their ability to cope with the stresses in their lives. The GAF is a crucial component of the mental health examination and assists in making the treatment decisions. It is important to recognize that observing the behavior of a patient can cause anxiety. It is crucial that the process be conducted in a way that does not cause discomfort or cause discomfort. It is important that the patient is fully informed of the purpose of the observations and the length of the procedure. Nursing observation is an essential skill that should be an integral element of the nursing process. However, it should be noted that patients might be dissatisfied with the quality of observation. If they cannot reach an agreement with staff, then they should be able to access an advocate service which can represent their needs and help them in any discussions regarding their care. This should be a fundamental part of local observation policy and practice, with the involvement of user groups, to ensure that patients are included in the creation of written information as well as staff training for this aspect of clinical governance. Questioning Many people have a difficult to talk about their mental health issues, but loved ones will often be able to recognize the signs of something being wrong. They can also assist the person to take an assessment. These assessments cover a wide range of topics, including mood, appearance and the thought process. A mental health professional can also ask questions regarding the person's personal life. They will ask what they have been feeling and what's happened in the last few days. The assessment also includes a cognitive test that is focused on the person's ability to think clearly and remember information. The person could be asked to complete simple tasks such as focussing on a list or objects, recollecting lists, or solving math questions. The test can also be used to check the individual's judgment and ability to make informed choices. The test determines a person's awareness, which is the understanding of their condition and how it affects them. The attitude of the patient towards himself, others and the illness is also an important aspect of a mental evaluation. The tone of voice, facial expressions, and body language of a patient may signal depression, anger or a sense of utter powerlessness. It is important to check whether the patient appears to be asking for assistance or is accepting their situation. In more serious situations the evaluation of mental health could include a thorough examination of the patient's mental state, which may involve hallucinations or illusions. These conditions can be dangerous and even fatal. A mental health assessment must be holistic and focus on the person's interaction with their environment. A health professional may employ images, music, art or a range of electronic assessment tools to help the person understand themselves and their unique perspective on the world around them. They should also discuss the challenges that led the person to seek help, and reassure them there is nothing wrong in seeing an expert in mental health.