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Mental Health Nursing – Assessing Mental Health Mental health assessments usually include a physical exam, to rule out physical ailments. This could include urine tests, blood test or even brain scans. Psychologists also use a wide variety of tools to assess mental health. These tools can range from paper and pencil test forms to more in-depth interviews or self-completed postal questionnaires. Mood and affect The affect and mood are the most crucial components of the mental health examination (MSE) and are the first to be viewed by the clinician. They are the most accurate indicators of a patient's emotional state. It can be anything from sadness to happiness or irritability and anger. The patient's mood can be measured through facial expressions, overall attitude and reaction to external or internal stimuli. You can express your emotions by smiling at the joke or crying when you lose a loved one. Affect is an emotion that is temporary, while mood is a state of constant emotion. It is usually described as euthymic (normal) or dysphoric, which means depressed. Psychologists should be cautious to not confuse the two terms, as they are interpreted differently and can be affected by a variety of factors. While the MSE is a valuable tool for clinical use however, it can be difficult to interpret based upon subjective patient reports. private bipolar assessment 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 revealed that assessment tools were different in their ability to identify a significant part of symptoms. This included the symptoms that were classified under the same disorder. This can be because of the different emphasis on emotional or cognitive symptoms, and also the differences between the time intervals and frequency of reporting symptoms. It is also possible that the MSE relies on self-report, which may be prone to bias. For instance, a person who reports anxiety and headaches is likely to report an lower score than a patient who reports only the sensation of a headache. In addition, there is an inclination for patients to minimize negative feelings and overestimate the severity of positive feelings. Mood and affect have a direct impact on thoughts which influences the way we make decisions, our interpersonal behavior and physical functioning. They can be affected by stress, fatigue and social interactions. A positive mood can actually enhance creativity and mental power. However, a mood that is negative can decrease concentration and cause confusion. A thorough and thoughtful mental health assessment must take into account both the patient's mood and affect as well as the other factors. Thought content The ability to determine how a patient thinks is one the most crucial aspects of a mental state examination. Assessment of thought process and content. The thought process is the coherence, logic and structure of the patient's thoughts. Normal thought processes are rational and goal-oriented. In a variety of mental health conditions however, thought processing is distorted. Examples include hallucinations, delusions, and loose associations. A mental health assessment also examines judgment and insight. Insight is the ability to identify the presence of a problem. Judgement is the process of making a well-considered decision after receiving information. Both can be impaired in many mental health conditions such as depression and schizophrenia. Patients with impaired insight or judgment is more likely to hurt themselves or others. If they are in danger, their sensible judgment would advise them to leave the premises immediately. A patient with impaired judgement might suggest that they remain in the building to try and get rid of the fire. The thoughts of a patient encompasses their themes, subject matter and beliefs. Examiners will assess the clarity, connection, and content of patient's thoughts. They will take note of any tangential or circumstantial thoughts and also whether the patient is prone to having a flurry of thoughts (digressions from the subject of conversation). They will also make comments on the pace of a person's thoughts, for instance, whether they seem to be fast or slow. It is also important to determine whether the patient's mood is in line with the environment in which they live. For example, a patient who is depressed might hear voices that sound hostile and frightening, whereas a person with schizophrenia might have a hallucination of an ethereal and calm voice. The patient should be asked about any suicidal or homicidal thought. Although they are uncommon, they can be life-threatening and should be taken into consideration in every mental health evaluation. Observation The nurse's ability to watch is crucial in the mental assessment. They involve a thorough evaluation of behavior, appearance and any unusual beliefs or perceptions (such hallucinations or delusions) and mood cognition (including memory, attention, orientation). The nursing mental status exam is also a way of the observation of motility. This includes any physical movement, such as eating, drinking, or brushing teeth. The Observation element of the mental status examination is a crucial aspect of determining if the patient is posing the risk to themselves or others. This is determined by assessing if the patient appears to be acting in a deliberate manner that suggests they are planning to harm themselves or another person. Additionally, a thorough assessment of the content of thoughts is conducted by observing the patient throughout the interview and determining their thoughts and concerns. It is particularly important to check if the patient is suffering from suicidal or homicidal thoughts and to determine if they're having delusions. A global assessment of functioning (GAF) is a numerical rating on a scale ranging from 0 to 100 that combines the capacity of a person to function in daily life with their ability to deal with the stresses in their lives. The GAF is a key part of the mental state exam and assists in making the treatment decisions. It is important to understand that observing the behaviour of a patient may cause anxiety. Therefore, it is essential that the procedure is conducted in a way that doesn't cause or make the patient feel uncomfortable. It is crucial that the patient is aware of the reason for the observations and the duration of the procedure. Nursing observation is a vital skill that should be a central part of any nursing program. However, it should be noted that patients might not agree with the degree of observation and if they cannot reach an agreement with the staff, they should have access to an advocate service that can represent their needs and help their discussions on their care. This should be a part of the local policy and practice, with the involvement and participation of user groups. Questioning Many people are hesitant to discuss their mental health issues, however family members can usually tell when something is amiss. They can also help the person to take a look at an assessment. These tests can be extremely broad and cover a wide range of topics such as mood, appearance as well as thought process, memory and more. In addition to these tests, a mental health professional will also ask the individual questions regarding their personal life, such as what has been going on recently and what their emotions have been like. The test also includes a cognitive assessment that is focused on the ability of the individual to think clearly and retain information. The person may be asked to complete simple tasks, like focusing their attention on a list of objects or words and recollecting lists of basic information or solving math problems. The test may also test the person's ability to make informed decisions and use judgment. The test also evaluates the patient's insight, which reflects their level of understanding about the illness and its effects on them. Another vital aspect of the mental health assessment is the patient's attitude towards other people, himself and the illness. The patient's expression, facial expression and body language may convey hostility, anger or depression, or a feeling of insecurity. It is also important to know whether the patient appears to be seeking help or just living with their condition. In more serious situations an assessment of mental health may include an examination of the patient's mental state, which could involve hallucinations (false perceptions of sensory stimuli that are not real stimuli) or illusions (misperceptions of real stimuli). It is crucial to recognize the presence of these conditions because they can be extremely hazardous and even life-threatening. In general an assessment of mental health should be holistic and look at the person's interactions with their social environment. A health professional might use photographs, music, art or a range of assessment tools that are electronic to help the person understand themselves and their unique view of the world around them. They should also speak to the person about the issues that have caused them to seek assistance and assure them that there is nothing wrong with seeking out a mental health professional.