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Mental Health Nursing – Assessing Mental Health A physical examination is typically included in mental health assessments to rule out any physical conditions. This could include urine tests, blood tests testing, or even brain scans. Psychologists also employ a variety of tools to assess mental health. These tools be anything from pencil and paper test forms to more in-depth interviews or self-completed questionnaires for postal mail. Mood and affect Mood and affect are among the most crucial components of the mental health exam (MSE) and are the first thing to be viewed by the clinician. They describe a patient's general emotional state. It can vary from joy to sadness or irritability and anger. The patient's mood can be measured through facial expressions, general behavior and reaction to external or internal stimuli. smiling at a joke or crying at the loss of a loved one). Affect is a feeling that is temporary, while mood is a state of constant emotion. It is generally described as euthymic or normal, or dysphoric (meaning depressed). However, psychiatrists should be cautious not to misunderstand the terms because they have different definitions and are affected by a variety of factors. While the MSE is a helpful tool for clinical use, it isn't always easy to interpret based on subjective patient report. Inquiring about the feelings of patients during the past few weeks is more effective than relying on just observations from a physician. A recent study showed that a large proportion of symptoms, including those that are grouped within the same disorder category, differ between assessment tools. 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 symptom reporting. It is possible that the MSE is based solely on self-reporting, which can be biased. For instance, a patient who reports anxiety and headaches is likely to report less than a patient who reports only the sensation of a headache. Furthermore there is a tendency for patients to downplay negative feelings and overestimate the severity of positive feelings. Affect and mood can have a direct impact on the thought content. This can affect the way we make decisions, our interpersonal behavior, and physical functioning. They are affected by stress, fatigue and social interactions, as well as global events, hormones and the weather. In iampsychiatry , a positive mood has been proven to boost the ability to think and be creative. A mood that is negative can cause confusion and decrease concentration. Therefore, a careful and thorough mental health evaluation 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 essential aspects of a mental state examination is assessing how the patient thinks. Evaluation of thoughts and their content. The thought process is the logic, coherence and organization of a patient's thoughts. Normal thought processes are focused and rational. In several mental health conditions however, thought processing is distorted. Examples include delusions, hallucinations and loose associations. Insight and judgment are evaluated during a mental status exam. Insight is the ability to see the presence of a problem, and judgement is the ability to make a considered decision based on information. Both are affected by many mental health conditions like schizophrenia and depression. If a patient is impaired in judgment or insight in any way, they are at greater risk of causing harm to themselves or others. For example, if they are at risk of destroying their home and they have a good sense of judgement, it would be wise for them to leave the house immediately. However, a person with impaired judgment might recommend staying in the house and trying to put the fire out. Thought content refers to the topics, subject matter, and beliefs that a patient holds. Examiners generally comment on the clarity, relevance and quality of a patient's thoughts. They will also note tangential thoughts or those that are merely circumstantial, and if the patient has digressions (digressions off from the main topic of the conversation). They will also make comments on the pace of a person's thoughts, for instance, whether they seem fast or slow. Other important areas to consider are whether the patient's thoughts are and in tune with their surroundings. For instance, a patient who is depressed may hear voices that are angry and threatening, while someone suffering from schizophrenia could have a hallucination of an ethereal and calm voice. Ask the patient if they are experiencing any suicidal or homicidal thoughts. Although they are uncommon however, they can be life-threatening and should be taken into account in every mental health assessment. Watching Nurses' observation skills are essential to a mental health assessment. They involve a thorough evaluation of appearance, behavior and any unusual beliefs or perceptions (such delusions or hallucinations) mood, cognition (including memory, attention and orientation). The mental status exam for nurses also includes the observation of the movement. This includes any physical movement such as eating, drinking or brushing your teeth. The Observation portion of the mental state examination is essential in determining whether the patient poses a risk to themselves or others. This is accomplished by determining whether or not the patient appears to be moving in a way that suggests that they are in danger of harming themselves or anyone else. A detailed assessment of the content of thoughts is also made by monitoring the patient during the interview and determining the thoughts and concerns. It is crucial to determine if a patient is suffering from suicidal or homicidal thoughts and to determine if they are having delusions. A global assessment of functioning (GAF) is an evaluation of the numerical value on a scale from zero to 100 that evaluates a person's ability to perform in daily life and their ability to deal with the stressors in their life. The GAF is a key part of the mental state exam and aids in making the treatment decisions. It is essential to be aware that watching the behavior of a patient can cause distress and it is important that the process is conducted in a manner that does not cause anxiety for the patient and does not be uncomfortable for them. It is crucial that the patient be fully aware of the goal of the observation and the duration of the process. Nursing observation is an essential ability that should be a central part of any nursing program. It is important to remember that patients might disagree on the level of observation. If they cannot come to an agreement with staff members, they should be able to access an advocate service that can represent their interests and assist them in any discussions about their care. This should be a fundamental element of the local observation policy and practice with the participation of user groups to ensure that patients are a part in the development of written information as well as staff training for this aspect of clinical governance. Questioning Many people are reluctant to talk about their mental health issues, however family members are often able to tell when something is amiss. They can also help the person to get an assessment. These assessments cover a wide range of subjects such as mood, appearance and thought process. A mental health professional could also inquire about the person's personal life. They will ask what they have been feeling and what has happened recently. The test includes a cognitive evaluation that examines a person's ability to think clearly and retain information. The test subject may ask to complete a few basic tasks, such as keeping their attention on an alphabet of words or objects, memorizing simple lists or solving math problems. The test may also test the person's ability to make good decisions and use their judgment. The test also assesses the patient's knowledge, which reflects their understanding of the illness and its effects on them. The attitude of the patient towards others, himself and the illness is an important aspect of a mental assessment. The patient's voice, facial expression and body language can indicate hostility, anger depression or a feeling of helplessness. It is important to observe whether the patient appears to be seeking assistance or is accepting their situation. In more serious cases, a mental health assessment may include an examination of the patient's mental state that may include hallucinations (false perceptions of sensory stimuli that are not real stimuli) or illusions (misperceptions of real stimuli). These conditions can be dangerous and even deadly. A mental health assessment should be holistic and focus on the person's relationship with their social world. A health professional may use photographs, music, art or any other assessment tool to gain a better understanding of the person. They should also discuss the challenges that led the person to seek help, and reassure them that there is nothing wrong with seeking out a mental health professional.