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Mental Health Nursing – Assessing Mental Health A physical examination is typically part of mental health assessments to rule out any physical issues. This could include urine tests, blood tests test or even brain scans. Psychologists also use a wide range of tools to evaluate mental health. They can use tests that are written on paper and pen to deep interviews or self-fill questionnaires sent to you by post. Affect and mood The doctor will first observe the patient's mood and affect. They describe the patient's general emotional tone that can range from happiness to sadness or irritability to anger. The affect can be assessed by facial expressions, overall behavior and reaction to internal or external stimuli. You can express your feelings by smirking at the joke or crying when you lose a loved one. Affect is a feeling that lasts only a few minutes but mood is a more long-lasting emotional state. It is often described as euthymic (normal) or dysphoric, which translates to depressed. Psychologists should be cautious to avoid confusion between the terms, as they are defined differently and are affected by a variety of factors. While the MSE is a useful diagnostic tool however, it can be difficult to interpret based on a subjective patient report. The process of asking patients to share their experiences in the last few weeks can be more beneficial than relying on only the observations of a doctor. Recent research 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 could be due to the differing emphasis on emotional, cognitive or physical symptoms as well as differences in time periods and frequency of symptom reporting. It is possible that the MSE relies on self-reporting, which can be biased. A patient who has a headache and anxiety is likely to get a lower score compared to a patient reporting only headache. Furthermore, there is a tendency for patients to downplay negative emotions and underestimate the severity of positive emotions. The mood and the affect of a person can have a direct influence on the content of thought. This could affect the way people make decisions, their interpersonal behavior and physical function. They are affected by fatigue, stress and social interactions. In actual fact positive moods have been proven to boost creativity and thinking power. A negative mood can reduce concentration and lead to confusion. A thorough and thoughtful mental health assessment should be able to consider both the patient's mood and affect and the other factors. Thought content One of the most crucial aspects of a mental state exam is assessing how a patient thinks. Assessment of thought process and content. The thought process is the coherence, logic, and organization of the patient's thoughts. Normal thought processes are logical and goal-oriented. Thought processing may be altered in several mental health conditions. Examples include hallucinations and delusions as well as loose associations. A mental status examination also evaluates insight and judgement. Insight is being able to spot the presence of a problem. Judgment is the capability to make a well-considered choice after receiving information. Both are affected by several mental health conditions, like schizophrenia and depression. If a patient has impaired judgment and/or insight, they are at greater risk of causing harm to themselves or others. For instance when they are at risk of destroying their home the sensible judgment would tell them to leave the building immediately. A patient with impaired judgement might suggest that they remain in the house to try to get rid of the fire. The contents of a patient's mind include the subject matter, themes, and beliefs. Examiners will assess the clarity, relatedness and the content of the thoughts of the patient. They will note tangential thoughts or circumstantial ones, and in the event that the patient's thoughts diverge (digressions away from the subject of the conversation). They will also make comments on a person's pace of thinking, such as if they seem to be faster or slower. Other important aspects to consider are whether the patient's thoughts are mood compatible or not in line with their environment. For example, a patient who is depressed might hear voices that sound hostile and frightening, whereas someone suffering from schizophrenia could experience a hallucination of a calm and soothing voice. The patient should be asked about any homicidal or suicidal thought. Although these are rare, they can be life-threatening and should be considered in every mental health assessment. Watching mental assessments to watch is vital in an assessment of mental health. They are a thorough review of the appearance, behavior 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 mental health assessment for nursing also incorporates observation of the ability to move, which includes physical movement such as eating drinking, eating, brushing teeth or using the toilet, as well as putting on shoes. The Observation element of the mental status examination is a key component of determining whether a patient may pose the risk to themselves or others. This is done by assessing whether the patient is moving in a way which suggests they are in danger of harming themself or someone else. Additionally, a thorough assessment of the content of thoughts is conducted by monitoring the patient throughout the interview and identifying their main concerns. It is particularly important to check if the patient has any suicidal or homicidal thoughts and to determine if they are experiencing thoughts of delusion. Global assessment of functioning (GAF) which is which is a numerical score ranging between 0 and 100, measures the capacity of an individual to function in daily life along with their capacity for coping with stressors. The GAF is an important part of the mental status exam and assists in guiding the treatment decisions. It is essential to be aware of the fact that observing the behavior of a patient can cause anxiety and it is crucial to conduct the procedure in a manner that doesn't provoke the patient and does not feel intrusive. It is essential that the patient be fully aware of the reason for the observations and the duration of the procedure. Nursing observation is a vital ability that should be a central part of any nursing process. However, it must be noted that patients might be dissatisfied with the quality of observation and if they are unable to come to 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 treatment. This should be part of the local policy and practice, with the participation and support of groups of patients. Questioning Many people have a hard to discuss their mental health issues However, loved ones will often be able to recognize when something is wrong. They can also assist the person take steps to obtain an assessment. These tests can be a variety of topics such as mood, appearance and thought process. In addition to these tests, the mental health professional will also ask the person questions about their personal life, including what's been happening lately and what their feelings have been like. The test consists of an evaluation of the cognitive capacity that focuses on a person's ability to think clearly and retain information. The person may be asked to complete basic tasks, such as keeping their attention on the list of words or objects as well as storing lists and lists for solving math problems. The test can be used to test the ability of the person's judgement and to make informed choices. The assessment also determines the patient's knowledge, which reflects their level of understanding about the illness and its effects on them. The person's attitude towards others, himself and the illness is also an important element of a mental evaluation. The tone of voice, the facial expression, and body language of a patient can signal depression, anger or a sense of helplessness. It is also important to know whether the patient is seeking help or is content living with their health condition. In more serious instances, a mental health assessment could include a thorough 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). These conditions can be harmful and even deadly. In general an assessment of mental health must be holistic and examine the person's connection to their social environment. Health professionals can employ photographs, music, art, or any other assessment tool to gain a better understanding of the person. They should also speak to the person about the issues that have led them to seek help and assure them that there is nothing wrong with seeking out an expert in mental health.