How can you identify patients with mental health needs?

Nurses are uniquely situated to identify patients who may have undiagnosed mental health problems.

“Nurses often spend as much or more time with patients as the MDs do, so they have a great opportunity to draw out complaints, symptoms and watch for signs,” says Dr. Lynne D. Johnson, psychologist at Brief Therapy Center.

The best thing a registered nurse can do to help a patient with a mental health concern is to recognize their need in the first place. Patients may shut down or outright deny having problems if they’re directly questioned about issues like anxiety or depression. Instead, Dr. Johnson recommends asking purposeful questions and listening carefully to the patient’s answers to determine if there may be an underlying mental health concern.

Asking the following questions can open the door to a useful conversation about a patient’s mental health:

• Have you been feeling stressed lately?
• How are you sleeping?
• How is your appetite?
• How are your relationships?

Dr. Johnson recommends RNs listen carefully for signs of stress, fear, worry or hopelessness, which could point to more serious issues. Problems with eating or sleeping can also be symptoms of a larger mental health concern.

Though open conversation is one of the best ways for nurses to identify a patient with mental health needs, standardized checklists are also available for nurses to use. Dr. Johnson notes that checklist resources like the PHQ-9 or the GAD-7 can be a simple way for nurses to identify mental health problems. “Interviews are great, but there is some evidence that people are more open on checklists than face-to-face [questioning].”

How can you help mentally ill patients?

RNs can suggest various behavioral changes that may boost a patient’s mood, such as increasing exercise, eating a healthy diet and keeping a gratitude journal, according to Dr. Johnson. These techniques are simple, but they can make a big difference to patients.

But some cases may require help from a mental health professional. In these situations, every RN should follow their clinic’s policy for making referrals. Some nurses may have the freedom to refer a client to a mental health professional on their own, while others may need a doctor’s approval.

“Nurses are becoming more valuable as physician extenders, and if the clinic permits, patients might appreciate a referral,” Johnson says.

In any case, Dr. Johnson says nurses should add their notes and observations about a patient to their electronic health record so the doctor has all the necessary information and can make an informed decision about what’s best for the patient.

Are you ready to make a difference?

There’s no doubt that the mental health system in the United States is in rough shape. As a future RN, you’re in the perfect position to help those suffering from mental illness and do your part to fix the mental health crisis.