Mental Health Assessment Skills

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The assignment will discuss the importance of assessment in Mental Health nursing, focusing on a 54 year old lady suffering from major depression. The Department of Health (DoH, 2010) pointed out that depression is a disorder of mood and may be characterised by low mood and feelings of unhappiness, exhaustion, self blame and suicidal thoughts. The assessment scale called Health of the Nations Outcome Scales (HONOS) (see appendix B) and the rational for using this scale will be explored. A brief profile of the patient and the practice setting will be discussed. The scale will be used on the patient and the details of the patient and the hospital will not be disclosed to protect the patient’s identity according to the Nursing and Midwifery code of conduct (NMC, 2008), hence the name used will be fictitious. The process of the assessment and the involvement of the service user, family, carer and contribution of the multi-professional team will be highlighted in relation to the patient’s future care planning needs. The good and drawbacks of the scale will be explored. A summary of the experience of using the assessment scale will be written. Assessment is described as ‘the first step of the nursing process,’ Wolters et al. (2010 p.36). She pointed out that it is the act of collecting, organizing, evaluating and documenting information about the client’s wellbeing, while Varcarolis (2011) mentioned that an assessment is an interview which examines the mental state of a patient. Furthermore, the National Institute for Clinical Excellence (NICE 2009) guidelines give emphasis to early access to assessment and treatment for people with psychological problems. Assessment is essential because the health care professionals need to know the physical, social, psychological, and cultural aspect of the patient’s life Wolters et al. (2008). An assessment is done to obtain information to create a detailed history about the patient, and to distinguish problems and to create a nursing diagnosis along with a suitable care-plan Varcarolis (2010 pp. 4-5). The DoH (2001) pointed out that it is essential to carry out an assessment because patients suffering from mental health problems may have problems with their physical wellbeing, such as poor diet. Assessment is crucial so as to look for vital signs such as checking for urinary tract infection, temperature, weight, pulse, respiration and blood pressure (Harris, 2002). Assessment is essential because health care professionals need to know the patient’s cognitive functioning: what they are thinking, their emotions, their values and beliefs and most of all ‘what they might do next’ such as suicide or serious self harm Barker (2009p.). Assessment may disclose any changes in the patient’s family dynamics or lifestyle changes. It may reveal their beliefs or rituals. HoNOS was first published in 1996 and there has been on- going review of the tool to improve its validity (The Royal College of Psychiatrist 2000). The tool consists of 12 items with 5-point scale which are completed by professionals within few minutes after an assessment, admissions and discharge of patients. The scale can be grouped into 4 section of which 1 to 3 measure behaviour, 4 and 5 measures impairment, 6 to 8 measure severity of symptoms, and 9 to 12 measure social functioning. The scale considers different aspects of mental health, each on scale 0-4, of which 0 means, ‘no problem’, 1 means ‘minor problem requiring no action’, 2 means ‘mild problem but definitely present’, 3 means ‘moderately severe problem’ 4 means severe to very severe problem and 9 means the professional do not know and the total score ranging from (0) being best and (48) being (worst) British Journal of Psychiatry 2002). The rational for choosing this assessment tool is to broaden my experience as a student nurse and to increase an in-depth knowledge of this particular tool as it is used in this placement area and its extensive use in mental health settings....
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