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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 blood tests, urine tests or even brain scans. Psychologists also employ a array of tools to measure mental health. They can use pen and paper test forms to in-depth interviews or self-complete questionnaires sent to you by post. Affect and mood The doctor will first be aware of the patient's mood and emotional state. They describe a patient's general emotional state. This could range from happiness to sorrow or irritability and anger. The effect can be analyzed by facial expressions, overall attitude and reaction to external or internal stimuli. You can express your emotions by laughing at an absurd joke, or crying when you lose a loved one. Affect is a feeling that is temporary, while mood is a long-lasting emotion. It is often described as being either euthymic (normal) or dysphoric, which translates to depressed. However, psychiatric specialists must be careful not to misunderstand the terms because they have different definitions and are influenced by a variety of factors. The MSE can be a valuable instrument for diagnosing clinical conditions, but it is difficult to interpret based on a subjective patient report. Inquiring about the feelings of patients in the last few weeks is more effective than relying solely on the observations of a doctor. A recent study found that a significant proportion of symptoms, including those grouped together under the same disorder category, differ between assessment tools. This can be because of the different emphasis on cognitive or emotional symptoms as well as the different time periods and frequency of the reporting of symptoms. It is possible that the MSE relies solely on self-reporting, which can be biased. A patient who has a headache and anxiety is likely to get lower scores than a patient reporting only a migraine. Patients tend to minimize negative feelings while exaggerating positive ones. The affect and mood of a person directly affect thoughts which influences the way people make decisions, their interpersonal behavior and physical performance. They can be affected by stress, fatigue and social interactions, as well as world events, hormones, and even the weather. A positive mood can actually enhance creativity and mental power. A mood that is negative can cause confusion and decrease concentration. Therefore, a careful and thorough mental health assessment is required to take into account the patient's current mood and emotional state as in addition to the underlying causes. Thought content The ability to determine how a patient thinks is one of the most important aspects of a mental state examination. Particularly, it is assessing thought process and thought content. Thought process refers to the coherence, logic and organization of a patient's thought processes. Normal thought processes are rational and focused on goals. Thought processing can be distorted when a person suffers from mental health issues. Examples include hallucinations, delusions and loose associations. Insight and judgment are evaluated during a mental status exam. Insight is being able to identify problems. Judgment is the ability of making a well-considered decision after receiving information. Both are impaired in several mental health conditions, such as depression and schizophrenia. A patient with impaired insight or judgement is more likely to hurt themselves or others. If they are in danger, their rational judgment would advise them to leave the home immediately. A person with impaired judgment might suggest that they remain in the building to try and get rid of the flame. The content of a patient's thoughts encompasses the subject matter, themes, and beliefs. Typically, examiners discuss the clarity, relevance and content of a patient's thinking. They will take note of any thoughts that are tangential or circumstantial and also whether the patient is having flashes of ideas (digressions from the topic of conversation). They will also provide feedback on a person's pace of thinking, such as if they seem to be faster or slower. It is also important to determine if the patient's mood is in line with their surroundings. A patient with depression might hear angry voices, whereas someone suffering from schizophrenia may have an illusion that a calm voice is speaking. Ask the patient if they are experiencing any thoughts of suicide or homicide. Although they are uncommon but they could be life-threatening and must be considered in every mental health evaluation. Watching The nurse's ability to observe is essential in the mental assessment. They are a thorough review of behavior, appearance as well as any unusual beliefs or perceptions (such as hallucinations or delusions) mood, as well as aspects of cognition (including attention to the environment, orientation memory, and orientation). mental health assessment service www.iampsychiatry.uk nursing mental status examination also includes observing motility, including any physical movement such as eating, drinking, brushing teeth using the toilet and taking off shoes. The observation component of the mental health examination is vital in determining if the patient poses a risk to themselves or anyone else. This is determined by assessing if the patient appears to be acting in a deliberate way that suggests they're trying to harm themselves or another person. Additionally, a thorough assessment of thought content is done by observing the patient throughout the interview and determining their main concerns. It is important to check whether the patient has suicidal, homicidal or delusional thoughts. A global assessment of functioning (GAF) is an evaluation of the numerical value on a scale from 100 to 0 that measures a person's ability to function in daily life with their capacity to handle the stresses that come with life. The GAF is an essential part of the mental state examination and aids in making the treatment decisions. It is essential to be aware that watching an individual's behavior can cause distress and it is essential that the process is conducted in a way that doesn't provoke the patient or make them make them feel uncomfortable. It is also crucial that the patient is informed about the purpose of the observation and the length of time it will take. Nursing observation is a vital skill that must be the core of any nursing process. However, it must be kept in mind that patients could not agree with the degree of observation and if they cannot reach an agreement with staff then they should have access to an advocate service that will represent their needs and help them in any discussions regarding their treatment. This should be an integral element of the local observation policy and practice, with the participation of user groups to ensure that patients are included in the development of written documents and staff training to support this aspect of clinical governance. Questioning Many people are hesitant to talk about their mental health issues, but their family members can often detect if something is not right. They can also help the person to get an assessment. These tests can be extremely broad and cover a variety of subjects, including mood, appearance as well as memory, thinking process and much more. In addition to these tests, the mental health professional will also ask the individual questions regarding their personal life, including what's been happening recently and what their feelings have been like. The test includes an assessment of cognitive ability which focuses on an individual's ability think clearly and retain information. The test taker may be asked to complete simple tasks, such as keeping their attention on an alphabet of words or objects, memorizing simple lists or solving math problems. The test can also be used to assess the ability of the person's judgement and to make good choices. The test also assesses the patient's understanding, which reflects their understanding of the illness and its effects on them. The attitude of the patient towards himself, others and the illness is an important aspect of a mental evaluation. The patient's tone of expression, facial expression and body language can indicate hostility, anger or depression, or a feeling of insecurity. It is crucial to determine whether the patient appears to be seeking assistance or is accepting their situation. In more serious cases the mental health assessment could include a thorough examination of the patient's mental state, which could involve hallucinations (false sensory perceptions that do not correspond to real stimuli) or illusions (misperceptions of real stimuli). These conditions can be dangerous and even fatal. A mental health assessment must be comprehensive and look at the person's interaction with their environment. A health professional could use art, music, photos or a range of electronic assessment tools to better understand the person and their unique view of the world around them. They should also talk with the person about the challenges that caused them to seek assistance and reassure them that there is nothing wrong with visiting a mental health professional.