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Mental Health Nursing – Assessing Mental Health Mental health assessments often include a physical exam to rule out physical ailments. This can include urine tests, blood testing, or even brain scans. Psychologists also employ a range of tools to evaluate mental health. These range from pen and paper test forms to deep interviews or self-fill questionnaires for postal delivery. Mood and affect The affect and mood are the most important components of the mental health examination (MSE) and are the first things to be observed by a medical professional. They define the patient's general emotional tone that can range from joy to sadness, or even irritability to anger. The effect can be analyzed through facial expressions, overall behavior and reaction to external or internal stimuli. smiling at a joke or crying at the loss of a loved one). Affect is a short-term emotion while mood is a longer-lasting emotional state. It is generally described as euthymic or dysphoric, or normal (meaning depression). Professionals in psychiatry must be careful to avoid confusion between the two terms, as they are different in their definition and are affected by various factors. The MSE is a helpful tool for clinical diagnosis however, it can be difficult to interpret from the subjective report of a patient. The process of asking patients to share their experiences over the past few weeks is more helpful than relying solely on observations from a physician. Recent research has revealed that assessment instruments differed in their capacity to detect a substantial part of symptoms. This included the symptoms that were classified under the same disorder. This can be due to the differing emphasis on emotional, cognitive or physical symptoms as along with differences in time periods and frequency of reporting symptom reports. It is also possible that the MSE is based on self-reporting, which may be prone to bias. A patient who reports both anxiety and a headache is likely to have lower scores than a patient reporting only migraine. Furthermore there is a tendency for patients to minimize negative emotions and underestimate the severity of positive feelings. Affect and mood can have an impact on the content of thought. This can impact the way people make decisions, their interpersonal behavior and physical function. They can be affected by stress, fatigue social interactions, world events, hormones, and even the weather. In actual fact, a positive mood has been proven to increase thinking and creativity. A negative mood can affect concentration and cause confusion. Therefore, a careful and thorough mental health assessment needs to take into account the patient's mood and emotional state as well as their underlying factors. Thought content Assessing how the patient thinks is one the most crucial aspects of a mental health exam. Specifically, evaluating thought process and thoughts. The term “thought process” refers to the coherence, logic, and organization of a patient's thinking. The normal process of thinking is objective-oriented and rational. Thought processing can be distorted in a variety of mental health conditions. Examples include hallucinations and delusions as well as loose associations. Insight and judgement are assessed in a mental status exam. assess your mental health is the ability to recognize the presence of a problem, and judgement is the ability to make a rational decision when presented with information. Both can be impaired by several mental health conditions such as schizophrenia and depression. If a patient has impaired insight and/or judgement, they are at greater risk of harming themselves or others. For example if they are at risk of burning their house down the sensible judgment would tell that they should 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 thoughts of a patient encompasses the subject matter, themes and beliefs. Examiners will assess the clarity, relevance and the content of the patient's thoughts. They will also note any thoughts that are circumstantial or tangential, and whether the patient has flights of thoughts (digressions from the conversation subject). They will also comment on the speed at which someone is thinking, such as whether they seem fast or slower. It is also important to determine if the patient's mood is similar to the environment in which they live. A person suffering from depression could hear angry voices, whereas a person suffering from schizophrenia may experience an illusion that a calm voice is speaking. The patient should be asked about any suicidal or homicidal thought. They are not common, but they can be life-threatening and should be taken into account during every mental health assessment. Watching Nurses' observation skills play an important role in a mental health assessment. They are a thorough examination of appearance, behavior and any unusual beliefs or perceptions (such hallucinations or delusions) and mood cognition (including attention, memory and orientation). The mental status exam for nurses also involves the observation of the movement. This includes any physical movement such as eating, drinking, or brushing your teeth. The Observation element of the mental status exam is an essential element of determining if the patient is posing an imminent risk to themselves or others. This is done by assessing if the patient appears to be acting in a deliberate way that suggests they are about harming themselves or someone else. A detailed evaluation 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 has suicidal, homicidal or delusional thoughts. Global assessment of functioning (GAF) is which is a numerical score ranging between 0 and 100, combines the ability of the person to perform in everyday life along with their capacity for dealing with stressors. The GAF is a crucial component of the mental health exam and assists in guiding the treatment decisions. It is crucial to be aware that observing an individual's behavior can cause anxiety and it is important that the procedure is carried out in a way that does not provoke the patient and doesn't be uncomfortable for them. It is also essential that the patient is informed about the purpose of the observation and the amount of time it will last. Nursing observation is an important ability and should be a central part of the nursing process. It is important to remember that patients might disagree on the level of observation. If they are unable to come to an agreement with staff, they must be able access an advocate service that can represent their interests and aid them in any discussions about their care. This should be a fundamental element of the local observation policy and practice, with the involvement of user groups, to ensure that patients are included in the development of written information and staff training on this aspect of governance in the clinic. 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 take steps to obtain an assessment. These assessments can be very broad and cover a range of subjects, including mood, appearance, memory, thought process and much more. A mental health professional may also ask questions about the person's personal life. They will ask what they have been feeling and what's happened recently. The test includes an assessment of cognitive ability that examines a person's ability think clearly and retain information. The person may be asked to complete basic tasks, such as keeping their attention on an alphabet of objects or words, memorizing simple lists or solving math problems. The test may also test the ability of the individual to make sound decisions and use their judgment. The test measures a patient's perception, which is their knowledge of their condition and how it affects them. Another important component of an assessment of mental health is the patient's attitude towards others, himself and his illness. The tone of voice, facial expression, and body expressions of a patient could signal depression, anger or a sense of utter powerlessness. It is also important to determine whether the patient is seeking help or just living with their condition. In more serious instances the mental health assessment may include an examination of the patient's mental state that could include hallucinations (false sensory perceptions without real stimuli) or illusions (misperceptions of real stimuli). It is important to note the presence of these conditions because they can be extremely risky and even life-threatening. A mental health assessment should be holistic and focus on the person's interaction to their world. A health professional may employ art, music, photos or a range of assessment tools using electronic technology to help understand the person and their unique view of the world around them. They should also discuss the challenges that led the person to seek help, and reassure them there is nothing wrong with seeing a mental healthcare professional.