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Mental Health Nursing – Assessing Mental Health A physical exam is often part of mental health assessments to rule out any physical issues. This may involve blood work and urine tests as well as brain scans. Psychologists use a variety of tools for assessing mental health. These tools be anything from pencil and paper test forms to in depth interviews or self-completed postal questionnaires. Affect and mood The clinician will first notice the patient's mood and emotional state. They define a patient's general emotional tone. This could be anything from sadness to happiness or irritability and anger. The affect can be assessed through facial expressions, overall attitude and reaction to external or internal stimuli. You can express your feelings by smirking at an absurd joke, or crying when you lose a beloved one. Affect refers to an emotion that is temporary, whereas mood is a long-lasting emotion. It is generally described as euthymic or normal, or dysphoric (meaning depressed). However, psychiatric professionals should be cautious not to misunderstand the terms because they have different definitions and are influenced by a variety of factors. While the MSE is a helpful tool for clinical use, it isn't always easy to interpret based upon subjective patient report. It is therefore important to inquire about how patients have been feeling in the last few weeks, as opposed to using only the observation of a physician. A recent study showed that a significant percentage of symptoms, which includes those grouped together under the same disorder category, vary between assessment tools. This can be because of the different emphasis on emotional or cognitive symptoms, as well as differences between time periods and frequency in the reporting of symptoms. It is possible that the MSE relies solely on self-reporting, which could be biased. Patients who report both anxiety and headache is likely to have lower scores than a patient reporting only headache. In addition, there is an inclination for patients to minimize negative emotions and underestimate the severity of positive feelings. Mood and affect directly affect thought content and can affect decision-making, interpersonal behaviour and physical performance. They can be influenced by fatigue, stress, social interactions, world events, hormones, and even the weather. A positive mood can enhance creativity and mental power. However, mental assessment that is negative can decrease concentration and cause confusion. A thorough and thoughtful mental health evaluation must take into account the patient's mood and affect as well as the other factors. Thought content One of the most important elements of a mental status examination is assessing how the patient thinks. Particularly, it is assessing thought process and thoughts. The thought process is the logic, coherence and organization of a patient’s thoughts. Normal thought processes are rational and focused on goals. Thought processing can be altered in a variety of mental health conditions. Examples include hallucinations, delusions and loose associations. A mental state examination also evaluates insight and judgement. Insight is the ability to recognize the presence of a problem, while judgement is the ability to make an informed decision based on information. Both are affected by several mental health conditions such as schizophrenia and depression. If a patient suffers from impaired judgment or insight, they are at a higher risk of harming 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 house to try to get rid of the fire. The contents of a patient's mind encompasses their subject matter, themes and beliefs. Examiners will comment on the clarity, connection, and content of thoughts of the patient. They will also note tangential thoughts or circumstantial ones, and in the event that the patient's thoughts diverge (digressions off from the main topic of the conversation). They will also discuss the speed of someone's thoughts, for instance, whether they seem fast or slow. Other areas to be considered are whether the patient's thoughts are and in tune with their environment. For example, a patient who is depressed may hear voices that sound aggressive and threatening, whereas those suffering from schizophrenia may experience a hallucination of a calm and soothing voice. A patient should be questioned about any homicidal or suicidal thoughts. These are rare but can be life-threatening and should be taken into account during every mental health assessment. Observation Nurses' observation skills play an important role in the mental health assessment. They are a thorough review of behavior, appearance, any unusual beliefs and perceptions (such as hallucinations or delusions) mood, as well as aspects of cognition (including attention, orientation, memory). A mental state examination for nurses also includes observing the ability to move, which includes physical activity like eating or drinking, brushing your teeth or using the toilet, as well as putting on shoes. The Observation component of the mental health examination is a key component of determining whether or not a patient may pose an imminent risk to themselves or others. This is accomplished by determining whether the patient appears be acting in a way that suggests they're planning to harm themselves or another person. A detailed evaluation of the thought-based content is also done by monitoring the patient during the interview and determining the preoccupations. It is important to check whether the patient is suffering from suicidal, homicidal or delusional thoughts. Global assessment of functioning (GAF), an assessment of functioning in numerical form, ranging between 0 and 100, measures the capacity of the person to function in daily life and their capability of dealing with stressors. The GAF is a vital element of the mental state exam and assists in guiding treatment decisions. It is important to understand that observing the behavior of a patient may cause anxiety. Therefore, it is essential to conduct the procedure in a way that does not cause discomfort or make the patient feel uncomfortable. It is crucial that the patient is fully informed of the purpose of the observation and the duration of the procedure. Nursing observation is an important ability and should be a central part of the nursing process. However, it must be kept in mind that patients could not agree with the degree of observation. 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 interests and assist them in any discussions regarding their treatment. This should be a component of local policy and practice, with the involvement and participation of groups of users. Questioning Many people have a hard to discuss their mental health issues, but loved ones will often be able to recognize the signs that something is not right. They can also help the person to get an assessment. These tests can be conducted on a variety of topics that include mood, appearance and thought process. In addition to these tests, a mental health professional will also ask the person questions regarding their personal life, including what has been going on recently and what their feelings have been like. The assessment includes an evaluation of the cognitive capacity that examines a person's ability to think clearly and retain information. The test subject may ask to complete basic tasks, such as keeping their attention on an alphabet 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 sound decisions. The test also assesses the patient's knowledge and knowledge of their illness and its impact on them. The patient's attitude toward others, himself and the illness is also an important part of a mental evaluation. The tone of voice, the facial expressions, and body expressions of a patient could signal depression, anger or a sense of powerlessness. It is important to observe whether the patient appears seek assistance or is accepting their situation. In more serious instances, an assessment of mental health may include a look at the patient's mental state which could include hallucinations or illusions. It is vital to be aware of the presence of these disorders because they can be extremely dangerous and even life-threatening. In general an assessment of mental health must be holistic and examine the person's connection to their social environment. A health professional may use images, music, or art or any other electronic assessment tool to gain a better understanding of the individual. They should also speak to the person about the issues that led them to seek help and assure them that there is nothing wrong with seeing an expert in mental health.