Mental health

1. MENTAL HEALTH ASSESSMENT
Process whereby a professional e.g. Doctor,
Psychologist, Psychiatric checks to see if one has
a mental problem and the type of treatment to
help him/her.
The assessment is mainly focused on identifying
the presence of specific symptoms clusters, for
the dual purposes of psychiatric multiracial
diagnosis and treatment.

2. Implications for psychiatric nursing
assessment
• A full personal, medical, social and family history to
identify basic vulnerabilities
• History of patient`s psychiatric problem , its pattern
and stressors before the onset or worsening of
symptoms
• Thorough assessment of one`s functional abilities will
determine the impact of the psychiatric symptoms on
their lifestyle activities

3. Cont..
• Thorough assessment of the presence and action of
the personal and environmental protective factors
being practiced in the person`s life is necessary to
determine the focus of the intervention.

4. Constituencies of Psychiatric nursing
assessment interview
1. Patient`s history
• Biological and social functioning
• Previous psychiatric treatment
• Premorbid personality(preceding onset of symptoms)
• Stress factors

5. 2. Patients mental condition
• Patient`s present psychological functioning
Explore symptoms and problems in terms of:
Frequency
Duration
Context / type of situation
Content
Feelings
Behaviour

6. 3. Patient`s physical condition
• Physical well being of patient

7. a) Biographic data
• Name
• Gender
• Marital status
• Date of birth

8. b) Chief complaints
• Describe the main complaint in your own words
• Listen to HOW the patient presents the problem
• Listen to WHAT the patient says about the problem
NB: The nurse’s knowledge and what the patient says
may not correspond
If information was not given by patient, record from
whom it was obtained

9. c) History of present illness
• Give history in chronological order of development
• Course of symptoms/ behaviour
• Describe the symptom
• State whether change occurred suddenly or gradually
• Name the precipitating stress factor at the
commencement of the illness
• Determine any relationship between physical and
psychological symptoms

10. Cont..
• Onset ,severity, and frequency of symptoms
• Any secondary gain from illness
• How symptoms influence social functioning e.g.
school, work, church
• Patient`s sources of support and present strong
points.

11. d) Previous illness
• Emotional and mental disorders:
Symptomatology (study of symptoms)
Type of treatment
Name of hospital
Duration of illness
Effect of treatment
Patient compliance

12. Psychosomatic disorder:
• Hay fever
• Asthma
• Hyperthyroidism
• Skin disorders

13. Medical disorder:
• Ask about general medical condition

14. Neurological disorder
• Craniocerebral trauma
• Convulsions
• Tumours

15. e) Personal history
•Information provides insight onto the origin and
course of the psychiatric disturbance
•To obtain precise picture and historical perspective of
the patient`s developmental process.
•Helps understand nature of symptoms and their
meaning to the patient
•Helps identify factors that made the person vulnerable
to developing the psychiatric condition

16. Cont..
• The more vulnerability factors present, the greater the
likelihood of becoming ill in terms of stress,
particularly if they cannot cope with the stress.

17. Vulnerability factors
• Biological factors
Normal children born from mentally ill parents, later
become ill

18. • Genetic factors
• Hereditary factors play a role in mental illness,
however, not everyone with family history of mental
health becomes ill.

19. • Early psychosocial factors
• Persistent negative early childhood experiences may
result in the development of a poor self concept or
esteem, which is not strong enough to cope with the
stresses of life

20. f) Prenatal history ( developmental history)
Pregnancy and birth:
Abnormalities during birth
Birth injuries
Planned or unplanned infant
Early childhood (0-3 years):
Feeding habit; bottle fed, breast fed or feeding
problems

21. g) Early development
When were developmental milestones reached?
Note any indication of: unfulfilled needs, separation
anxiety and maternal deviation
Toilet training
Symptoms of behavioural problems; thumb sucking,
tantrums, head-bashing, nightmares, bed-wetting
Personality as child; shy, restless, withdrawn, nagging,
friendly
Early or recurrent dreams or fantasy

22. h) Adulthood
• Occupational history
• Social relationships and activities
• Adult sexuality
• Premarital relationships
• Marital history: roles played by spouse, family
planning
• Attitude to pregnancy and attempt, number of
children and age
• National service

23. i) Family history
• Information about family customs, child rearing
methods, present support system
• Composition of the family
• Physical and emotional health
• Genetic hereditary patterns in the family
• Economic circumstances
• Occupation of parents
• Relationships in the family
• Parents` personalities