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Mental Health Nursing – Assessing Mental Health A physical exam is often included in mental health assessments to rule out physical issues. This may include blood tests and urine tests as well as brain scans. Psychologists also utilize a array of tools to measure mental health. These tools can vary from pencil and paper test forms, to in-depth interviews or self-completed questionnaires via mail. Mood and affect The clinician will first notice the patient's mood and emotional state. They are the most accurate indicators of a patient's emotional tone. It can vary from joy to sadness or anger and irritability. Affect can be measured by watching facial expressions and demeanour as well as the response to external or internal stimuli (e.g. smiling at an absurd joke or crying over the loss of a loved one). Affect is a feeling that is temporary, while mood is a state of sustained emotion. It is usually described as either euthymic (normal) or dysphoric, which means depressed. Psychologists should be cautious to avoid confusion between the terms because they are interpreted differently and can be affected by a variety of factors. While the MSE is a useful tool for clinical use, it can be difficult to interpret based on subjective patient report. It is therefore important to inquire about how patients have been feeling over the last few weeks, rather than relying solely on the observations of doctors. A recent study revealed that a significant proportion of symptoms, which includes those that are grouped under 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 the different time periods and frequency in the reporting of symptoms. It is possible that the MSE relies on self-reports which is susceptible to bias. For instance, a person who reports anxiety and a headache will likely have an lower score than a patient who reports only a headache. Patients tend to minimize negative feelings while exaggerating positive feelings. The mood and the affect of a person can have a direct impact on the content of thought. This can affect the way we make decisions, our interpersonal behavior, and physical function. They are affected by stress, fatigue and social interactions. A positive mood can increase creativity and mental strength. A negative mood can lead to confusion and decrease concentration. A thorough and meticulous mental health evaluation must take into account the patient's mood and affect as well as the underlying factors. Thought content The ability to determine how a patient thinks is one the most important aspects of a mental health examination. Assessment of the thought process and its content. The thought process is the logic, coherence and organization of the patient's thoughts. The normal process of thinking is focused and logic-based. In several mental health conditions, however, thought processing can be altered. Examples include hallucinations, delusions, and loose associations. Insight and judgement are evaluated during a mental status test. Insight is the ability to recognize the presence of a problem, and judgement is the ability to make a considered decision based on information. Both are impaired in many mental health conditions such as depression and schizophrenia. If a patient is impaired in insight and/or judgement, they are at greater risk of harming themselves or others. If they are in danger, their rational judgment would advise them to leave the premises immediately. However, a patient with impaired judgment might recommend staying in the house and trying to put the fire out. Thought content includes the subject matter, themes and beliefs that a patient holds. Typically, examiners discuss the clarity, relevance and the content of a patient's thought. They will take note of any thoughts that are tangential or circumstantial, and whether the patient is having flashes of thoughts (digressions from the conversation subject). They will also make comments on the pace at which a person is thinking, for example, if they seem to be more or less fast. Other important aspects to consider are whether the patient's thoughts are and in tune with their surroundings. Patients suffering from depression may be able to hear angry voices, whereas a person suffering from schizophrenia might experience a hallucination that a soothing voice is speaking. Patients should be asked about any homicidal or suicidal thoughts. Although they are not common, they can be life-threatening and should be taken into consideration in every mental health evaluation. Watching The nurse's ability to watch is essential in the mental assessment . They involve a thorough evaluation of appearance, behavior and any peculiar beliefs or perceptions (such hallucinations or delusions) and mood cognition (including memory, attention and orientation). A mental state examination for nurses also incorporates observation of the ability to move, which includes physical activity like eating, drinking, brushing teeth using the toilet and putting on shoes. The Observation portion of the mental state exam is essential in determining whether the patient poses a risk to themselves or anyone else. This is done by assessing whether the patient appears be acting in a way that suggests they are planning to harming themselves or someone else. A thorough assessment of the thought content is also accomplished by observing the patient during the interview and determining their thoughts and concerns. It is important to check whether the patient is suffering from suicidal, homicidal or delusional thoughts. A global assessment of functioning (GAF) is an evaluation of the numerical value on a scale from zero to 100 that evaluates the ability of a person to perform in daily life along with their capacity to handle the stressors in their life. The GAF is a crucial part of the mental status exam and assists in guiding the treatment decisions. It is crucial to be aware that watching the behavior of a patient can cause anxiety and it is essential that the process is conducted in a way that does not provoke the patient or make them feel intrusive. It is crucial that the patient be fully informed of the purpose of the observations and the length of the process. Nursing observation is a crucial ability and should be an integral element of the nursing process. It is important to remember that patients can disagree with staff about the extent of observation. If they cannot come to an agreement with the staff, they must be able access an advocate service that can represent their interests and assist in any discussions regarding their care. This should be an integral element of the local observation policy and practice with the involvement of user groups, to ensure that patients are included in the creation of written information and staff training to support this aspect of clinical governance. Questioning Many people are hesitant to discuss their mental health issues, but their family members can usually discern when something isn't right. They can also help the person take steps to obtain an assessment. These assessments can cover a wide range of topics, including mood, appearance and the thought process. In addition to these tests, the mental health professional will also ask the person questions about their life, including what's happened recently and what their feelings have been like. The assessment also includes a cognitive evaluation that is focused on the ability of the individual to think clearly and recall information. The test taker may be asked to complete basic tasks, like focusing their attention on the list of objects or words and recollecting lists of basic information or solving math problems. The test can be used to test the ability of the person's judgement and to make sound decisions. The assessment also determines the patient's insight and knowledge of the illness and its effects on them. Another crucial aspect of an assessment of mental health is the person's attitude toward others, himself and his illness. The tone of expression, facial expression and body language can convey anger, hostility depression or a feeling of insecurity. It is also important to note whether the patient is seeking help or resigned to living with their condition. In more serious instances the assessment of mental health may include an examination the patient's thoughts that may include hallucinations or even illusions. These conditions can be harmful and even fatal. In general an assessment of mental health must be holistic and examine the person's connection to their social environment. A health professional could use art, music, photos or a variety of assessment tools that are electronic to help understand the person and their unique perspective on the world around them. They should also talk about the issues that led to the person to seek help, and assure them that there is nothing wrong in seeing a mental healthcare professional.