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Mental Health Nursing – Assessing Mental Health Mental health assessments typically involve a physical examination, to rule out physical conditions. This could include blood tests, urine testing, or even brain scans. Psychologists employ a variety of tools for assessing mental health. These tools can range from paper and pencil test forms to in depth interviews or self-completed questionnaires for postal mail. Mood and affect The clinician will first notice the patient's mood and affect. They define a patient's general emotional tone. This could vary from joy to sadness or anger and irritability. The degree of affect can be determined by watching facial expressions and demeanour as well as the reaction to external or internal stimuli (e.g. smiling at a joke or crying at the loss of a loved one). Affect is an emotion that is only temporary, whereas mood is a long-lasting emotion. It is typically described as euthymic, normal, or dysphoric (meaning depression). Professionals in psychiatry must be careful to avoid confusion between the two terms, as they are defined differently and are affected by many factors. The MSE can be a useful tool for clinical diagnosis, but it is difficult to interpret from the subjective report of a patient. The process of asking patients to share their experiences in the last few weeks is more helpful than relying solely on physician observations. A recent study found that a significant proportion of symptoms, which includes those that fall under the same disorder category, differ between assessment tools. This can be due to the differing emphasis on emotional, cognitive or physical symptoms, as along with differences in the duration and frequency of reporting symptoms. It is possible that the MSE is based on self-reporting which is susceptible to bias. A patient who reports both a headache and anxiety is likely to report an lower score than a patient reporting only headache. Additionally there is the tendency for patients to downplay negative feelings and overestimate the severity of positive emotions. Affect and mood can have a direct influence on thought content. This could affect decision-making, interpersonal behavior, and physical functioning. They are affected by stress, fatigue and social interactions. Positive moods can increase creativity and mental strength. A mood that is negative can cause confusion and reduce concentration. Therefore, a thorough and thorough mental health assessment needs to take into account the patient's current mood and affect as well as the underlying causes. Thought content Examining the way a patient thinks is among the most crucial aspects of a mental state examination. Evaluation of thoughts and their content. The thought process is the logic, coherence and organization of a patient’s thoughts. A normal thought processes is goal directed and logic-based. Thought processing can be altered in a variety of mental health conditions. Examples include hallucinations, delusions and loose associations. A mental state examination also assesses the quality of insight and judgement. Insight is the ability to identify problems. Judgement is the process of making a well-considered decision after receiving information. Both are impaired in many mental health conditions like schizophrenia and depression. A person who isn't able to see or judgment is more prone to harm themselves or others. If they are in danger, their rational judgement would suggest leaving the house immediately. A person with impaired judgment may suggest that they stay in the building to try and put out the fire. Thought content is the topics, subject matter, and beliefs that a patient holds. Examiners will evaluate the clarity, relatedness and the content of the thoughts of the patient. They will note tangential thoughts or those that are merely circumstantial, and when a patient is digressing (digressions away from the subject of the conversation). They will also comment on the pace at which a person is thinking, such as if they seem to be faster or slower. It is also essential to determine if the patient's mood matches their surroundings. A person suffering from depression could be able to hear angry voices, whereas a person suffering from schizophrenia may have the illusion that a peaceful voice is speaking. Ask the patient if they've had any thoughts of suicide or homicide. Although they are not common but they could be life-threatening and should be considered in every mental health assessment. Observation The nurse's ability to watch is essential in a mental assessment. They are a thorough review of behavior, appearance, any unusual beliefs and perceptions (such as hallucinations or delusions) mood, and aspects of cognition (including attention to orientation, attention, memory). A nursing mental status examination also includes observing motility, including any physical movement such as eating, drinking, brushing teeth using the toilet and putting on shoes. The Observation component of the mental state exam is crucial in determining if the patient poses a risk to them or others. This is done by assessing whether the patient appears to be acting in a manner which suggests they may be threatening to harm themself or someone else. In addition, a detailed assessment of thought content is done by monitoring the patient throughout the interview and determining their preoccupations. It is particularly important to check if the patient is having suicidal or homicidal ideas and to determine if they are experiencing delusions. A global assessment of functioning (GAF) is a numerical rating on a scale of 100 to 0 that measures the capacity of a person to function in everyday life with their capacity to handle the stressors in their life. The GAF is a crucial component of the mental health assessment and aids in making treatment decisions. It is important to recognize that observing the behaviour of a patient may cause anxiety. It is crucial that the procedure is conducted in a manner that does not cause discomfort or make the patient feel uncomfortable. It is also essential that the patient is aware of the reason for the observation as well as the length of time it will take. Nursing observation is an essential skill that should be a key part of the nursing process. It is important to remember that patients can disagree with staff about the degree of observation. If they cannot reach an agreement with the staff, they should be able to access an advocate service to represent their interests and assist them in any discussions about their treatment. This should be a fundamental part of the local policy and practice, including the involvement of user groups, to ensure that patients are a part in the development of written information and staff training for this aspect of clinical governance. Questioning Many people have a difficult to talk about their mental health problems However, loved ones can often notice when something is wrong. They can also urge the person to take a look at an assessment. These assessments are broad and cover a variety of subjects including mood, appearance as well as memory, thinking process and more. In addition to these tests, the mental health professional will also ask the person questions about their personal life, such as what's been happening recently and what their feelings have been like. The assessment also includes a cognitive assessment, which focuses on the person's ability to think clearly and recall information. The test subject may require the person to complete simple tasks such as paying attention to a list of objects, remembering lists or completing math problems. mental health assessment uk www.iampsychiatry.uk may also test the person's ability to make sound decisions and make good judgments. The assessment determines a patient's insight which is their understanding of their illness and how it affects them. The patient's attitude towards himself, others and the illness is an important element of a mental assessment. The tone of voice, facial expression and body language can convey hostility, anger depression or a feeling of powerlessness. It is important to observe whether the patient appears be asking for help or accepting their condition. In more serious instances, a mental health assessment might include an assessment of the patient's thinking that may include hallucinations (false perceptions of sensory stimuli that are not real stimuli) or illusions (misperceptions of real stimuli). It is crucial to recognize the presence of these disorders because they can be extremely dangerous and even life-threatening. In general, a mental health assessment should be holistic and consider the person's connection to their social world. Health professionals can employ art, music or photos, or any other assessment tool to better understand the person. They should also speak to the person about the difficulties that have caused them to seek help and reassure them that there is nothing wrong with seeking out an expert in mental health.