401013 Promoting Mental Health And Wellbeing 1

401013 Promoting Mental Health And Wellbeing 1

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401013 Promoting Mental Health And Wellbeing 1

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401013 Promoting Mental Health And Wellbeing 1

3 Downloads3 Pages / 729 Words

Course Code: 401013
University: Western Sydney University

MyAssignmentHelp.com is not sponsored or endorsed by this college or university

Country: Australia

Question: 

1a) Using the case study provided, identify an urgent risk area. Ensure your answer details why you have identified this risk area including specific information about the client and current literature. (2 marks)
1b) Identify one nursing / midwifery intervention you would undertake directly with your client to address the risk area noted in question 1a and include a rationale for the intervention. (2 marks for the intervention and 2 marks for the rationale)  
2a) Using the case study provided, identify a mental health concern. Ensure your answer details why you have identified this concern including specific information about the client and current literature. (2 marks)
2b) Identify one nursing / midwifery intervention you would undertake directly with your client to address the mental health concern noted in question 2a and include a rationale for the intervention. (2 marks for the intervention and 2 marks for the rationale)  
3) Using current literature, identify and discuss (2) two legal, ethical or professional issues a nurse / midwife may need to consider when working with the client in the case study (4 marks).

Answer: 
1a. The urgent risk area that can be identified from the case study provided would be the presence of ‘suicidal ideation’ in Chung. The case study critically mentions that the subject had been experiencing feelings of worthlessness and felt low in the mood. Suicidal ideation has been reported to be a major symptom related to unstable mental health (Polanco-Roman et al.,2013). The case study also mentions that the client had been aware of high doses of lethal medication that could be consumed to overdose. The subject had further reported to think extremely low of himself in terms of his ability to take care of his wife and baby and also on the professional field.
 
1b. The nursing intervention that would be taken in order to address the risk area as identified in the first part would include, ensuring a risk free environment for the client. The midwife would ensure that the client is not left alone at any point of time. The midwife would further involve the client in immediate counselling session so as to effectively minimise the feelings associated with worthlessness and shame. Further, the midwife would contact a registered nurse or a community psychotherapist to immediately conduct a suicide risk assessment of the client. Research studies state that the creation of a positive and risk free environment can help in minimising the tendency of suicidal ideation in client (Klonsky et al.,2016).
2a. The primary mental health concern that can be correlated with the case study would include the development of acute depression. Persistent feeling of sadness coupled with feelings of hopelessness have been tightly linked to the prevalence of depressive symptoms in patients with mental disorders (Polanco-Roman et al., 2013). Further, the abnormal sleeping pattern and reluctance in consuming meals have also been related to the dearth of depression which if not checked would ultimately lead to fatal consequences such as self-destructive behaviour and suicidal ideation tendencies. Therefore, the symptoms must be adequately accessed by the psychotherapist on the basis of the risk assessment tool so as to provide appropriate intervention to the subject and promote positive mental health.
2b. It is recommended that the care giver must engage the client in a session of mindfulness based cognitive behavioural therapy. As reported by research studies, mindfulness based therapy helps in channelizing negative thoughts to positive thoughts and thus improving the mental health condition of the subject (Williams et al., 2014). It encourages the clients to talk about the reason why life is meaningless. Further it elucidates coping strategies that could be administered so as to prevent the client from developing pessimistic thoughts (Goncalves et al., 2016). The psychotherapist would also administer principles of meditation and yoga so as to transform the negative thought content into positive thoughts.
3. The two ethical issues that the midwife might encounter while devising an intervention plan for the subject in case study would include:

It has been mentioned that Chung is a doctor placed at the accident and emergency department. On account of the professional designation disparity, the midwife might encounter serious issues in convincing the client for the proposed interventions (Yousaf et al., 2015)
Research studies state that a stigmatized perception in men exists with regard to seeking help for mental health problems (Yousaf et al., 2015). Hence, the midwife should be extremely sensitive while handling the subject so as to avoid causing any inconvenience and must try to make him feel comfortable.

References:
Gonçalves, M. M., Ribeiro, A. P., Silva, J. R., Mendes, I., & Sousa, I. (2016). Narrative innovations predict symptom improvement: Studying innovative moments in narrative therapy of depression. Psychotherapy Research, 26(4), 425-435.
Klonsky, E. D., May, A. M., & Saffer, B. Y. (2016). Suicide, suicide attempts, and suicidal ideation. Annual review of clinical psychology, 12, 307-330.
Polanco-Roman, L., & Miranda, R. (2013). Culturally related stress, hopelessness, and vulnerability to depressive symptoms and suicidal ideation in emerging adulthood. Behavior therapy, 44(1), 75-87.
Williams, J. M. G., Crane, C., Barnhofer, T., Brennan, K., Duggan, D. S., Fennell, M. J., … & Shah, D. (2014). Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: a randomized dismantling trial. Journal of consulting and clinical psychology, 82(2), 275.
Yousaf, O., Grunfeld, E. A., & Hunter, M. S. (2015). A systematic review of the factors associated with delays in medical and psychological help-seeking among men. Health psychology review, 9(2), 264-276.

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401013 Promoting Mental Health And Wellbeing 1

401013 Promoting Mental Health And Wellbeing 1

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401013 Promoting Mental Health And Wellbeing 1

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401013 Promoting Mental Health And Wellbeing 1

1 Download6 Pages / 1,470 Words

Course Code: 401013
University: Western Sydney University

MyAssignmentHelp.com is not sponsored or endorsed by this college or university

Country: Australia

Questions:
1.

1a) Using the case study provided, identify an urgent risk area. Ensure your answer details why you have identified this risk area including specific information about the client and current literature.
1b) Identify one nursing / midwifery intervention you would undertake directly with your client to address the risk area noted in question 1a and include a rationale for the intervention. (2 marks for the intervention and 2 marks for the rationale)  
Ensure the intervention includes how, who and when you would actually carry out the intervention. Your rationale should state why you would carry out the particular intervention. Ensure literature is included.
2.
2a) Using the case study provided, identify a mental health concern. Ensure your answer details why you have identified this concern including specific information about the client and current literature.
2b) Identify one nursing / midwifery intervention you would undertake directly with your client to address the mental health concern noted in question 2a and include a rationale for the intervention. (2 marks for the intervention and 2 marks for the rationale)  
Ensure the interventions includes how, who and when you would actually carry out the intervention. Your rationale should state why you would carry out the particular intervention. Ensure literature is included when you discuss the rationale.
3.
Using current literature, identify and discuss (2) two legal, ethical or professional issues a nurse / midwife may need to consider when working with the client in the case study.

Answers:

Case Study
Chung is a 35 years-old male who moved to Australia from China five years ago. His parents, older brother and younger sister still live in China. Chung visited his family in China once after a year of moving to Australia. He has not returned to China since, because of his long working hours and need to undertake additional study for promotion.
Chung is a doctor working in Accident and Emergency in a busy inner-city hospital. He is studying for promo-tion to ultimately become an emergency medicine consultant. Two years ago, Chung was under investigation by the hospital Human Resources department due to a drug error. He was very tired and had been on-call over-night with frequent call outs to see patients. The drug error resulted in an eight year-old boy being very sick, requiring intensive care admission. Chung used an intra-muscular medication to treat the boy but administered it intravenously. Chung was subjected to several work-place and medical board investigations and placed on practice supervision for 12 months.
Chung met his wife, Harriett, in Australia four years ago. Harriett is 30 years old. They married two years ago. Unfortunately, Chung’s parents and family could not attend the wedding due to the high costs of travel and his mother has severe arthritis in her hips, making travel very di?cult. Chung found their wedding day emotionally di?cult. He felt the ceremony lacked reference to his Chinese culture. On reflection, he feels that he wasn’t as involved in the wedding planning as he could have been, due to his long working hours. He simply agreed to the suggestions and plans made by Harriett and her family.
Chung and Harriett now have a three week-old baby girl, Charlotte. Charlotte was born by caesarean section, due to birth complications. Harriett has had an infection in the operation site since the birth, resulting in lots of pain, frequent dressings and di?culties moving around. Chung was o? work for one week after the baby’s birth. However, he has now returned to working shifts, often working through the night, where he may go without sleep for 20 – 24 hours. Harriett’s parents are staying with them to support Harriett while Chung is at work. However, he finds that Harriett’s parents are very involved with baby care even when he is home. Given this, Chung finds he gets very little time and space to be with his new daughter.
You are visiting the family in your capacity as a community nurse supporting Harriett with the caesarean section wound care or as a midwife undertaking a post-natal visit. During your visit to the family, you notice Chung looks flat in mood and tearful. His a?ect is sad and restrictive. He is slumped in his chair, with rounded shoulders and starring at the floor for long periods. You inquire about his health. He has very limited eye to eye contact with you. His speech is slowed and purposeful. On occasions, you need to repeat your question several times to get a reply. However, you do manage to obtain the following information from Chung. He has been feeling increasingly anxious during the past two months, given his continuing long hours, shift work, the high pressure of an Accident and Emergency department, Charlotte’s birth and his wife’s health. He has been having palpitations, chest pains and breathlessness for six to seven weeks. He asked a colleague at work, another doctor, to assess him for cardiac issues several weeks ago as he had been experiencing thoughts that he was going to have a heart attack and die. Chung has been feeling very low in mood for the past six weeks, experiencing sleeplessness, particularly initial insomnia and early morning wakening at 3am. He has lost five kilos in weight during the past month, due to reduced appetite and missing meals. He feels he is worthless and a failure at work within his medical role and he is letting his wife and new daughter down. He has been experiencing fleeting thoughts of suicide for the last week. He is aware of high lethality medications which he could take to overdose. Currently, he is hopeless and helpless and wants to die. He states he feels his situation is self-imposed and that treatments will not be of help at this time.
Tasks:

1a)
The identified risk area detected from the case study is the suicidal tendency of the patient. Chung that is patient is seen to be flat in appearance. He appears to be very anxious and suffering from insomnia. He is felling low and has reduced body weight due to lack of sleep and lack of appetite. He also had wandering thoughts of suicide recently. He is contemplating to take an overdose of the lethal medicines in order to end his life (Bandura, A. (2014).1b) Identify one nursing / midwifery intervention you would undertake directly with your client to address the risk area noted in question 1a and include a rationale for the intervention. (2 marks for the intervention and 2 marks for the rationale)  
Ensure the intervention includes how, who and when you would actually carry out the intervention. Your rationale should state why you would carry out the particular intervention. Ensure literature is included.
1b.
One intervention that can be implemented in this situation in order to prevent the patient from committing suicide includes suicidal risk assessment along with the modification of the physical factors of the patient. This will help the patient to understand the situation and thus prevent the occurrences of the suicidal thoughts (Resnick, 2017). A number of psychosocial factors are also associated with risk for suicide and suicide attempts.  These include recent life events such as losses. Psychological states of acute or extreme distress are often present in association with suicidal ideation, planning and attempts. While not uniformly predictive of suicidal ideation and behavior, they are warning signs of psychological vulnerability and indicate a need for mental health evaluation to minimize immediate discomfort and to evaluate suicide risk.
2a).
The most evident mental health concern of the patient, Chung is severe depression and anxiety disorder (Wepa, 2015). . He appears to be very anxious and suffering from insomnia. He is felling low and has reduced body weight due to lack of sleep and lack of appetite. He also had wandering thoughts of suicide recently. He is contemplating to take an overdose of the lethal medicines in order to end his life.
2b) .
Ensure the interventions includes how, who and when you would actually carry out the intervention. Your rationale should state why you would carry out the particular intervention. Ensure literature is included when you discuss the rationale.
One of the interventions in order to manage depression is the cognitive behavioural therapy which is the talking theory. This helps to manage the problems of the patient. It is most commonly used to treat anxiety and depression, but can be useful for other mental and physical health problems (Wepa, 2015). The implementation of cognitive behavioral therapy is advantageous since it tends to be short in duration. Cognitive behavioral therapy can be considered of as a combination of psychotherapy and behavioral therapy. The psychotherapy mainly focuses on the importance of personal meaning that we place on the things around us. The behavioural theory on the other hand, is involved in paying close attention to the relation existing between the problems along with the behaviour and the thoughts.
3.
The ethical issue that a nurse needs to consider in this situation mainly involves confidentiality of the situation since the patient himself is a doctor by profession. The issue of confidentiality is one of the ethical principles of health care. Any breach in the confidentiality might lead to a reason for disciplinary action. Any issues related to confidentiality might be brought to a clinical ethics committee or a group in the form of individual cases or in considering hospital policies. 
Additionally the professional issue here might be cultural safety since the patient here is suffering from problems related to his culture (Resnick, 2017).
References
Bandura, A. (2014). Social cognitive theory of moral thought and action. In Handbook of moral behavior and development (pp. 69-128). Psychology Press.
Bertolote, J. M., & Fleischmann, A. (2015). A global perspective in the epidemiology of suicide. Suicidologi, 7(2).
Bolton, J. M., Gunnell, D., & Turecki, G. (2015). Suicide risk assessment and intervention in people with mental illness. BMJ: British Medical Journal (Online), 351.
Resnick, L. B. (2017). Toward a cognitive theory of instruction. In Learning and motivation in the classroom(pp. 5-38). Routledge.
Segal, Z. V., Williams, M., & Teasdale, J. D. (2018). Mindfulness-based cognitive therapy for depression. Guilford Publications.
Wepa, D. (Ed.). (2015). Cultural safety in Aotearoa New Zealand. Cambridge University Press.

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Palliative care services are designed to improve the life of patient with progressive disease. People receiving palliative care have illness that has no prospect of cure.  As per the World Health Organisation, palliative care is a care given to patient suffering from life threatening illness to improve their quality of life by preventing and providing relief from sufferings by early recognition , assessment and trea…
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Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome (HIV/AIDS) is the spectrum of medical conditions caused due to human immunodeficiency virus (HIV) following which the patient suffers from a series medical complications due to suppression of the immune system of the body. With the progression of the disease, the patient is likely to suffer from a wide range of infections like tuberculosis and other opportu…
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Introduction
Leadership in the hospital is the ability to influence the staff toward providing quality health care. Leadership involves influencing human behavior to create a positive working environment (Langlois, 2012). Good leadership enables healthy relationships among staffs in the hospital enhancing quality delivery of health care services. Leadership is responsible to building teams that have trust, respect, support and effecti…
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According to the researchers, it can be said that the management of the health care organizations has become a difficult task nowadays and the reason behind this is the occurrence of various issues in this sector (Hall et al., 2014). Therefore, the administrative employees of the organization should incorporate various revolutionized strategies for enriching the worth of care provided by the hospital to its clients and re…
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401013 Promoting Mental Health And Wellbeing 1

401013 Promoting Mental Health And Wellbeing 1

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401013 Promoting Mental Health And Wellbeing 1

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401013 Promoting Mental Health And Wellbeing 1

3 Downloads9 Pages / 2,109 Words

Course Code: 401013
University: Western Sydney University

MyAssignmentHelp.com is not sponsored or endorsed by this college or university

Country: Australia

Question:

1 Apply primary health care principles in the promotion of mental health & wellbeing in diverse settings.
2 Distinguish the mental health priorities in relation to meeting the needs of individuals and their families/signifificant others in the community.
3 Relate the principles of stress, mental health assessment, risk assessment and management in promoting mental health and wellbeing.
4 Explain the principles and skills of therapeutic communication and interventions related to caring for people experiencing alterations in thought, behaviour, and mood.
5 Apply ethico-legal implications in relation to the care of people with mental health concerns and/or illnesses
6 Develop an understanding of the lived experiences and recovery for individuals with mental health concerns and/or illnesses.

 
Answer:

QN: 1
Mental status examination or mental state examination (MSE) is an important clinical assessment in psychiatric practice. It is an ordered manner of describing and observing the psychological functioning of patient’s. The main parameters which are taken into consideration include appearance, attitude, mood, behaviour, thought process, thought content, perception, insight, cognition, judgement and mood. The assessment helps in comprehensive cross-sectional description of the mental state of the patient and helps the clinician to ascertain the proper diagnosis and formulation for coherent treatment planning (Mitchell, 2013). The mental state examination of Chung from the perspective of the community nurse who visited the house of Chung is laid down as follows. Appearance: Chung is showcasing flat mood and is tearful. This indicated that he is mentally depressed and is suffering from extremely sorrow and grief (Zimmerman et al., 2013). His mood is sad and restrictive. Here restrictive further highlighted his attitude that he is unwilling to open up his sorrows or reason for despair in front of others. Another reason might be, he is so hopeless that he is not encouraging any discussion for further recovery. His limited eye contact, slowed and purposeful speech indicates that has pre-occupied with certain thoughts and is sharing zero interests in indulging into effective communication. The lack of eye contact further is acting as a determining step indicating that Chung is severely depressed (Alghowinem et al., 2013). His overall thought content is also negative as showed via worthlessness. He is also having a negative perception about himself like thought of getting heart attack and a fleeting mood of committing suicide. This constant disturbed mood, negative cognition or perception of oneself and a escapist attitude via committing suicide indicated that Chung is suffering from severe depression or major depressive disorder (Zimmerman et al., 2013).
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V) is a 2013 updated for of Diagnostic and Statistical Manual of Mental Disorders, a special taxonomic tool that is published by the American Psychiatric Association (APA). According to DSM V, the there are five simplified form of the personality types apart from the previous one (DSM IV) which has 10 different personality types. These five different personality include avoidant, borderline, obsessive-compulsive, schizotypal and antisocial/psychopathic. The condition of Chung is somewhat related to the psychopathic personality trait which is related to the major depressive disorder (American Psychiatric Association, 2013). The main diagnostic criteria of major depressive disorder as indicated b y DSM IV which coincides with the condition of Chung is continuous depressed mood, a feeling of hopelessness, diminished interest in daily living activity (in case of Chung is loss of appetite) insomnia, recurrent thoughts of death and reluctance in making eye contact and zero interest in conversation. However, problem is pyshcomotor skills is not prominently reflected in the case of Chung however, his delusional or near delusional guilt is making evident that he is suffering from major depressive disorder. The delusional guilt includes hopelessness in job field, guilt in not performing well for the family (American Psychiatric Association, 2013).
QN: 2
Stress Vulnerability Model (SVM) is a helpful model that is used for the identification and treatment of the frequent relapses in the mental illness. According to this model, the synchronisation of the intrinsic vulnerability and psychological stressors lead to the development of the mental illness (Fleming & Martin, 2014). Under this model the main factors which are included in intrinsic vulnerability include abnormal brain organisation. The psychological stressors mainly include crisis in life, substance abuse interpersonal stress factor and the occupational stress. The mental health outcomes from the amalgamation of these two factors (intrinsic vulnerability and psychological stress) include psychosis, or depression, or bipolar disorder, post traumatic stress disorder (PTSD) and other anxiety related disorders (Fleming & Martin, 2014). From the case study, it is difficult for a community health nurse to figure out the intrinsic vulnerability of Chung behind the development of the mental illness. However, as a community health nurses, is can be easily identified the main psychological stressors which is influencing the development major depressive disorder in Chung. According to Townsend and Morgan (2017), SVM highlights life-crisis as the main factor behind the development of mental illness.
One life crisis factor in case of Chung’s life is personal crisis in Chung’s life. Chung is struggling with his career progress and is making constant efforts for getting promoted as an emergency medical consultant. However, in the middle of this professional turmoil, he gets married and his life crisis is further increase. The birth of his daughter Charlotte further increases the crisis further. According to Thompson, Amatea and Thompson (2014), birth of child increases financial crisis in the family that is still struggling for professional stability. Chung is away from his native land and from his close family members for the past five years. The lack of interventions and caring attitude coming from his family members has further increased his problems. Giorgi et al. (2015) have highlighted that staying abroad away from the family increases the life crisis during turmoil situation. The birth of Charlotte also made Harriet unwell. Harriet had caesarean section dur to birth complications and this has lead to the development of infection at the site of operation resulting in increase in pain and restricted mobility. It is due to the ill-health of Harriet, that the financial burden of Chung has increased and he was also compelled to take a leave from his work to manage his home. However, taking his promotion and professional advancement into consideration he has again joined his work but does over-time and does is unable to spent adequate time at home.
Another factor is professional stress in Chung’s life. His professional life is also undergoing crisis, occupational stressors due to one medication error committed by him. Lack of proper rest while at home, and personal crisis has increased anxiety in Chung. This anxiety and lack of proper sleep or rest might have resulted in delusional mind state resulting in the drug error. Chernomas and Shapiro (2013) is of the opinion the stress and lack of rest increases the chances of getting affected with the occupational stress, which in turn increases the chances of developing mental health complications. This amalgamation of both professional and personal crisis has lead to the development of extreme psychological stressors leading to the development of the metal health complications.
 
QN: 3
Recovery oriented mental health practice ensures that the mental health service is procured in such a manner that it supports the faster recovery of the mental health consumers (The Department of Health Australia, 2018).
Respect is the first parameter of the mental health recovery. Providing proper respect and importance of the decisions of the mental health service consumer ensures quality outcome. This is because, showing respect to their needs or wishes or opinion make them feel concerned or involved in the life process or the care plan. This in turn increases the sense of their own personal value and thereby helping in faster recovery (Slade et al., 2014). In case of Chung, the respect must come from his family members. Like Chung has highlighted that how he felt emotionally unstable in his wedding as it had less reference to Chinese culture and he also felt sorry and guilty about it. This is because, he make himself responsible for this. He thinks that just because he failed to provide proper opinion in wedding planning dur to his high work-pressure, the weeding become a complete Australian couture altogether. Thus keeping this reference into consideration, Chung’s in-laws must consider seeking decisions from Chung when taking any step in the day-to-day life process of his daughter Charlotte. No matter how busy is Chung they must take an initiative in acknowledging his decision in every aspect of family decision. According to Slade et al. (2014) informed decision making helps in the quality improvement in the overall health outcome. It is also the duty of the mental health nurse to listen attentively to the concerns shared by Chung. Slade et al. (2014) highlighted that active listening via eye-contact helps to showcase respect to the client and thereby improving his mental health state. Chung must also be encouraged to take part in the community health programs where he will get to interact with his native members. Communicating with them in native language will help him to feel at home and guarded for his native culture and this in turn will help to overcome his anxious and depressed state of mind (Slade et al., 2014).
Empowerment is another important aspect of mental health recovery plan. In case empowerment, the first step must come from his family members via enabling Chung to involve in the decision making process. This will make Chung feel empowered, making his feel like his opinion are valued in the family and his family members look up to him for taking any determining steps in life. According to Chronister, Chou and Liao (2013), the sense of empowerment help to overcome the depressive feeling of worthlessness and thereby helping to again positive energy and fast recovery in mental health. Empowerment in the professional life is however, difficult since he has already committed a drug error however, if Chung has successfully completed 12-month supervision practice then, his employer must come forward to encourage him in progressing in future steps in his career more enthusiastically. Chronister, Chou and Liao (2013) stated that this helps to feel successful and reduces the sense of guilt and thereby promoting mental health recovery
Hope is another important thing in the mental health recovery plan. It is the duty of the family members as well as the community health nurses to positive source of energy so that he can overcome is suicidal thoughts or sudden fear of getting heart attack. Chung should be counselled in the domain of how his presence is important in the life of this wife and his infant daughter how their happiness and future is dependent on him. This sense of realization will increase hope among Chung and he will get new enthusiasm to live his life, if not for him but for his family. Cleary et al. (2013) stated that it is the duty of the community health nurse to site example of how any turmoil in personal or professional life can never bring end to an entire life, this sharing of examples will provide Chung hope and a new ray of living.
 
References
Alghowinem, S., Goecke, R., Wagner, M., Parker, G., & Breakspear, M. (2013, September). Eye movement analysis for depression detection. In ICIP (pp. 4220-4224).
American Psychiatric Association. (2013). Diagnostic and Statistical Manual Of Mental Disorders. Fifth Edition. Access date: 20th August. Retrieved from: https://www.sciencetheearth.com/uploads/2/4/6/5/24658156/dsm-v-manual_pg490.pdf
Chernomas, W. M., & Shapiro, C. (2013). Stress, depression, and anxiety among undergraduate nursing students. International Journal of Nursing Education Scholarship, 10(1), 255-266.
Chronister, J., Chou, C. C., & Liao, H. Y. (2013). The role of stigma coping and social support in mediating the effect of societal stigma on internalized stigma, mental health recovery, and quality of life among people with serious mental illness. Journal of Community Psychology, 41(5), 582-600.
Cleary, M., Horsfall, J., O’Hara?Aarons, M., & Hunt, G. E. (2013). Mental health nurses’ views of recovery within an acute setting. International Journal of Mental Health Nursing, 22(3), 205-212.
Fleming, M., & Martin, C. R. (2014). Trauma Exposure, Schizophrenia Symptoms and the Stress Vulnerability Model. Comprehensive Guide to Post-Traumatic Stress Disorder, 1-20.
Giorgi, G., Arcangeli, G., Mucci, N., & Cupelli, V. (2015). Economic stress in the workplace: the impact of fear of the crisis on mental health. Work, 51(1), 135-142.
Mitchell, A. J. (2013). The Mini-Mental State Examination (MMSE): an update on its diagnostic validity for cognitive disorders. In Cognitive screening instruments (pp. 15-46). Springer, London.
Slade, M., Amering, M., Farkas, M., Hamilton, B., O’Hagan, M., Panther, G., … & Whitley, R. (2014). Uses and abuses of recovery: implementing recovery?oriented practices in mental health systems. World Psychiatry, 13(1), 12-20.
The Department of Health Australia. (2018). Principles of recovery oriented mental health practice. Access date: 20th August 2018. Retrieved from: https://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-n-servst10-toc~mental-pubs-n-servst10-pri
Thompson, I., Amatea, E., & Thompson, E. (2014). Personal and contextual predictors of mental health counselors’ compassion fatigue and burnout. Journal of Mental Health Counseling, 36(1), 58-77.
Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.
Zimmerman, M., Martinez, J. H., Young, D., Chelminski, I., & Dalrymple, K. (2013). Severity classification on the Hamilton depression rating scale. Journal of affective disorders, 150(2), 384-388.

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401013 Promoting Mental Health And Wellbeing 1

401013 Promoting Mental Health And Wellbeing 1

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401013 Promoting Mental Health And Wellbeing 1

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401013 Promoting Mental Health And Wellbeing 1

3 Downloads9 Pages / 2,109 Words

Course Code: 401013
University: Western Sydney University

MyAssignmentHelp.com is not sponsored or endorsed by this college or university

Country: Australia

Question:

1 Apply primary health care principles in the promotion of mental health & wellbeing in diverse settings.
2 Distinguish the mental health priorities in relation to meeting the needs of individuals and their families/signifificant others in the community.
3 Relate the principles of stress, mental health assessment, risk assessment and management in promoting mental health and wellbeing.
4 Explain the principles and skills of therapeutic communication and interventions related to caring for people experiencing alterations in thought, behaviour, and mood.
5 Apply ethico-legal implications in relation to the care of people with mental health concerns and/or illnesses
6 Develop an understanding of the lived experiences and recovery for individuals with mental health concerns and/or illnesses.

 
Answer:

QN: 1
Mental status examination or mental state examination (MSE) is an important clinical assessment in psychiatric practice. It is an ordered manner of describing and observing the psychological functioning of patient’s. The main parameters which are taken into consideration include appearance, attitude, mood, behaviour, thought process, thought content, perception, insight, cognition, judgement and mood. The assessment helps in comprehensive cross-sectional description of the mental state of the patient and helps the clinician to ascertain the proper diagnosis and formulation for coherent treatment planning (Mitchell, 2013). The mental state examination of Chung from the perspective of the community nurse who visited the house of Chung is laid down as follows. Appearance: Chung is showcasing flat mood and is tearful. This indicated that he is mentally depressed and is suffering from extremely sorrow and grief (Zimmerman et al., 2013). His mood is sad and restrictive. Here restrictive further highlighted his attitude that he is unwilling to open up his sorrows or reason for despair in front of others. Another reason might be, he is so hopeless that he is not encouraging any discussion for further recovery. His limited eye contact, slowed and purposeful speech indicates that has pre-occupied with certain thoughts and is sharing zero interests in indulging into effective communication. The lack of eye contact further is acting as a determining step indicating that Chung is severely depressed (Alghowinem et al., 2013). His overall thought content is also negative as showed via worthlessness. He is also having a negative perception about himself like thought of getting heart attack and a fleeting mood of committing suicide. This constant disturbed mood, negative cognition or perception of oneself and a escapist attitude via committing suicide indicated that Chung is suffering from severe depression or major depressive disorder (Zimmerman et al., 2013).
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V) is a 2013 updated for of Diagnostic and Statistical Manual of Mental Disorders, a special taxonomic tool that is published by the American Psychiatric Association (APA). According to DSM V, the there are five simplified form of the personality types apart from the previous one (DSM IV) which has 10 different personality types. These five different personality include avoidant, borderline, obsessive-compulsive, schizotypal and antisocial/psychopathic. The condition of Chung is somewhat related to the psychopathic personality trait which is related to the major depressive disorder (American Psychiatric Association, 2013). The main diagnostic criteria of major depressive disorder as indicated b y DSM IV which coincides with the condition of Chung is continuous depressed mood, a feeling of hopelessness, diminished interest in daily living activity (in case of Chung is loss of appetite) insomnia, recurrent thoughts of death and reluctance in making eye contact and zero interest in conversation. However, problem is pyshcomotor skills is not prominently reflected in the case of Chung however, his delusional or near delusional guilt is making evident that he is suffering from major depressive disorder. The delusional guilt includes hopelessness in job field, guilt in not performing well for the family (American Psychiatric Association, 2013).
QN: 2
Stress Vulnerability Model (SVM) is a helpful model that is used for the identification and treatment of the frequent relapses in the mental illness. According to this model, the synchronisation of the intrinsic vulnerability and psychological stressors lead to the development of the mental illness (Fleming & Martin, 2014). Under this model the main factors which are included in intrinsic vulnerability include abnormal brain organisation. The psychological stressors mainly include crisis in life, substance abuse interpersonal stress factor and the occupational stress. The mental health outcomes from the amalgamation of these two factors (intrinsic vulnerability and psychological stress) include psychosis, or depression, or bipolar disorder, post traumatic stress disorder (PTSD) and other anxiety related disorders (Fleming & Martin, 2014). From the case study, it is difficult for a community health nurse to figure out the intrinsic vulnerability of Chung behind the development of the mental illness. However, as a community health nurses, is can be easily identified the main psychological stressors which is influencing the development major depressive disorder in Chung. According to Townsend and Morgan (2017), SVM highlights life-crisis as the main factor behind the development of mental illness.
One life crisis factor in case of Chung’s life is personal crisis in Chung’s life. Chung is struggling with his career progress and is making constant efforts for getting promoted as an emergency medical consultant. However, in the middle of this professional turmoil, he gets married and his life crisis is further increase. The birth of his daughter Charlotte further increases the crisis further. According to Thompson, Amatea and Thompson (2014), birth of child increases financial crisis in the family that is still struggling for professional stability. Chung is away from his native land and from his close family members for the past five years. The lack of interventions and caring attitude coming from his family members has further increased his problems. Giorgi et al. (2015) have highlighted that staying abroad away from the family increases the life crisis during turmoil situation. The birth of Charlotte also made Harriet unwell. Harriet had caesarean section dur to birth complications and this has lead to the development of infection at the site of operation resulting in increase in pain and restricted mobility. It is due to the ill-health of Harriet, that the financial burden of Chung has increased and he was also compelled to take a leave from his work to manage his home. However, taking his promotion and professional advancement into consideration he has again joined his work but does over-time and does is unable to spent adequate time at home.
Another factor is professional stress in Chung’s life. His professional life is also undergoing crisis, occupational stressors due to one medication error committed by him. Lack of proper rest while at home, and personal crisis has increased anxiety in Chung. This anxiety and lack of proper sleep or rest might have resulted in delusional mind state resulting in the drug error. Chernomas and Shapiro (2013) is of the opinion the stress and lack of rest increases the chances of getting affected with the occupational stress, which in turn increases the chances of developing mental health complications. This amalgamation of both professional and personal crisis has lead to the development of extreme psychological stressors leading to the development of the metal health complications.
 
QN: 3
Recovery oriented mental health practice ensures that the mental health service is procured in such a manner that it supports the faster recovery of the mental health consumers (The Department of Health Australia, 2018).
Respect is the first parameter of the mental health recovery. Providing proper respect and importance of the decisions of the mental health service consumer ensures quality outcome. This is because, showing respect to their needs or wishes or opinion make them feel concerned or involved in the life process or the care plan. This in turn increases the sense of their own personal value and thereby helping in faster recovery (Slade et al., 2014). In case of Chung, the respect must come from his family members. Like Chung has highlighted that how he felt emotionally unstable in his wedding as it had less reference to Chinese culture and he also felt sorry and guilty about it. This is because, he make himself responsible for this. He thinks that just because he failed to provide proper opinion in wedding planning dur to his high work-pressure, the weeding become a complete Australian couture altogether. Thus keeping this reference into consideration, Chung’s in-laws must consider seeking decisions from Chung when taking any step in the day-to-day life process of his daughter Charlotte. No matter how busy is Chung they must take an initiative in acknowledging his decision in every aspect of family decision. According to Slade et al. (2014) informed decision making helps in the quality improvement in the overall health outcome. It is also the duty of the mental health nurse to listen attentively to the concerns shared by Chung. Slade et al. (2014) highlighted that active listening via eye-contact helps to showcase respect to the client and thereby improving his mental health state. Chung must also be encouraged to take part in the community health programs where he will get to interact with his native members. Communicating with them in native language will help him to feel at home and guarded for his native culture and this in turn will help to overcome his anxious and depressed state of mind (Slade et al., 2014).
Empowerment is another important aspect of mental health recovery plan. In case empowerment, the first step must come from his family members via enabling Chung to involve in the decision making process. This will make Chung feel empowered, making his feel like his opinion are valued in the family and his family members look up to him for taking any determining steps in life. According to Chronister, Chou and Liao (2013), the sense of empowerment help to overcome the depressive feeling of worthlessness and thereby helping to again positive energy and fast recovery in mental health. Empowerment in the professional life is however, difficult since he has already committed a drug error however, if Chung has successfully completed 12-month supervision practice then, his employer must come forward to encourage him in progressing in future steps in his career more enthusiastically. Chronister, Chou and Liao (2013) stated that this helps to feel successful and reduces the sense of guilt and thereby promoting mental health recovery
Hope is another important thing in the mental health recovery plan. It is the duty of the family members as well as the community health nurses to positive source of energy so that he can overcome is suicidal thoughts or sudden fear of getting heart attack. Chung should be counselled in the domain of how his presence is important in the life of this wife and his infant daughter how their happiness and future is dependent on him. This sense of realization will increase hope among Chung and he will get new enthusiasm to live his life, if not for him but for his family. Cleary et al. (2013) stated that it is the duty of the community health nurse to site example of how any turmoil in personal or professional life can never bring end to an entire life, this sharing of examples will provide Chung hope and a new ray of living.
 
References
Alghowinem, S., Goecke, R., Wagner, M., Parker, G., & Breakspear, M. (2013, September). Eye movement analysis for depression detection. In ICIP (pp. 4220-4224).
American Psychiatric Association. (2013). Diagnostic and Statistical Manual Of Mental Disorders. Fifth Edition. Access date: 20th August. Retrieved from: https://www.sciencetheearth.com/uploads/2/4/6/5/24658156/dsm-v-manual_pg490.pdf
Chernomas, W. M., & Shapiro, C. (2013). Stress, depression, and anxiety among undergraduate nursing students. International Journal of Nursing Education Scholarship, 10(1), 255-266.
Chronister, J., Chou, C. C., & Liao, H. Y. (2013). The role of stigma coping and social support in mediating the effect of societal stigma on internalized stigma, mental health recovery, and quality of life among people with serious mental illness. Journal of Community Psychology, 41(5), 582-600.
Cleary, M., Horsfall, J., O’Hara?Aarons, M., & Hunt, G. E. (2013). Mental health nurses’ views of recovery within an acute setting. International Journal of Mental Health Nursing, 22(3), 205-212.
Fleming, M., & Martin, C. R. (2014). Trauma Exposure, Schizophrenia Symptoms and the Stress Vulnerability Model. Comprehensive Guide to Post-Traumatic Stress Disorder, 1-20.
Giorgi, G., Arcangeli, G., Mucci, N., & Cupelli, V. (2015). Economic stress in the workplace: the impact of fear of the crisis on mental health. Work, 51(1), 135-142.
Mitchell, A. J. (2013). The Mini-Mental State Examination (MMSE): an update on its diagnostic validity for cognitive disorders. In Cognitive screening instruments (pp. 15-46). Springer, London.
Slade, M., Amering, M., Farkas, M., Hamilton, B., O’Hagan, M., Panther, G., … & Whitley, R. (2014). Uses and abuses of recovery: implementing recovery?oriented practices in mental health systems. World Psychiatry, 13(1), 12-20.
The Department of Health Australia. (2018). Principles of recovery oriented mental health practice. Access date: 20th August 2018. Retrieved from: https://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-n-servst10-toc~mental-pubs-n-servst10-pri
Thompson, I., Amatea, E., & Thompson, E. (2014). Personal and contextual predictors of mental health counselors’ compassion fatigue and burnout. Journal of Mental Health Counseling, 36(1), 58-77.
Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.
Zimmerman, M., Martinez, J. H., Young, D., Chelminski, I., & Dalrymple, K. (2013). Severity classification on the Hamilton depression rating scale. Journal of affective disorders, 150(2), 384-388.

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401013 Promoting Mental Health And Wellbeing 1

401013 Promoting Mental Health And Wellbeing 1

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401013 Promoting Mental Health And Wellbeing 1

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401013 Promoting Mental Health And Wellbeing 1

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Course Code: 401013
University: Victoria University

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Question:

You are asked to think about the mental health status of the client making reference to the Mental State Examination. 
Make sure you think about the Mental State Examination (MSE) here and not the overall mental health assessment structure. You will learn more about this in session 2. We want you to think about the present state / presentation of the client in terms of the components of the Mental State Examination such as: appearance and behaviours, affect, mood, thought form, thought content, perception, judgement and insight for example. 
We also want to see that you can think about the client’s presentation with reference to the DSM V. You can do this by thinking about the specific criteria for diagnoses. Show that you can consider the criteria and how they may be relevant for this particular client in the case study. For example: you might want to suggest the client has depression or anxiety so show you have considered the criteria for depression or anxiety which are relevant and how. 
We are expecting that you will have more literature other than the MSE and DSM V for question 1. You should also use other research papers. 
It’s a good idea to aim for 250 words for the Mental State Examination (MSE) and 250 words for the DSM V sub section. 
Asks you to show your understanding, using literature, of the Stress Vulnerability Model. It would be reasonable to use 100 words for this as the maximum marks for this is 2. 
You are also asked to think about 2 contributing factors where you should make reference to the case study and literature. 
You should use 200 words to identify and discuss, critically analyse the literature for each contributing factor. 
A good way to think about contributing factors are possible stressors which could have impacted on how a person thinks, feels and behaves. For example: having a new baby could be a contributory factor as it creates change in the couple’s relationship; may change the time a person has for themselves and their hobbies; may challenge a person’s sense of self; may increase anxiety; lack of sleep as a result of caring for a new baby can result in changes to a person’s energy and mood. 
Asks you to show your understanding of the mental health recovery model / theory and to relate the recovery principles of respect, empowerment and hope to the client in the case study. 
Ensure you relate your answer to the client in the case study and include relevant literature. 
To help direct your thoughts for this question, you might want to ask ‘how can the health professional show respect or exercise a respectful to the client in this particular case study and how could this support his recovery?’ You might want to consider how his family can show a respectful attitude towards the client to better support his recovery or how could his employee be respectful give his current situation to support the client. Thinking about the wider community approach to mental health concerns may also be helpful here. i.e. how can the language used by members of the community support his recovery. ie non-stigmatising language. How can a health professional facilitate self-respect for the client? 
You may want to ask these questions in relation to empowerment also. ie. how can a health profession, family, employer and the wider community offer greater empowerment to the client to support his recovery? How can this be helpful and why? 
Also, how can hope be helpful for the client, particularly given his current presentation and concerns for self and possible self-harm and suicide? How can a family member, employer and community members support greater hope for this client and why? 

Answer:

Analysing the mental health status of the client in the case study:
On critically evaluating the patient history as revealed by the case study a substantial correlation can be found to exist between the subject of the case study Chung and the prevalence of mental health disturbance factors as mentioned by the guidelines of MSE. The MSE is a physical behaviour scrutinising tool that provides an insight to the development of any mental disturbance in the subject under examination (APA,2013). During the midwifery visit, Chung was evidently found to be in a gloomy and depressive mood with tearful eyes. He was seen slumped on his chair with rounded shoulders. He was also seen staring blankly at the floor for abnormally long period of time. Chung is seen to avoid eye-contact at the maximum and any question that requires his response have to be reported several times. On probing the subject with detailed questions about his feelings, he answered that he had been feeling extremely anxious for quite some time and has also been having suicidal thoughts in his mind. All the above said observed traits of Chung can be directly linked to the MSE guidelines. Typically, the prevalence of suicidal thoughts, continued anxiety, lack of attention in being able to perceive the theme of questions and delayed responses can be correlated with the characteristics of depression and anxiety in the subject (Oommen,2013). The behavioural pattern of the subject significantly pinpoints to elevated stress level which must be attended on immediate basis.
The subject is also found to present certain specific behavioural characteristics that can be related to the diagnostic criteria of mental health assessment as per the DSM V standards that serve as a revision of the DSM IV standard of psychological wellbeing. The subject complains of severe anxiety attacks that lead to palpitations and also complains of breathing problems and acute chest pain. Further, it has been also accessed that Chung has been facing disrupted sleep and acute insomnia. He has constantly felt depressed and has been feeling extremely unenthusiastic. Chung has also been reported to develop an aversion towards his dietary intake and his appetite has reduced drastically. These traits can be correlated with the development of mental disorders such as depression, anxiety, feeding and impaired sleep disorder all of which have been listed as mental health disorders according to the DSM V standards (Drake et al.,2014). The criticality of the subject in the case study can be examined by the fact that the subject has developed suicidal thoughts and has become extremely pessimistic. These factors contribute to the serious and worsening condition of the patient which must not be ignored and steps must be undertaken to address the concern spontaneously so as to prevent the condition to degrade to a limit beyond repair. The symptoms also suggest that the current professional and personal environment that Chung is exposed to has led to the development of a huge amount of psychological and mental stress that is disrupting the emotional equilibrium of Chung’s mental state.
Factors to contribute current mental health status of client:
As identified on the thorough evaluation of the psychological factors affecting the mental behaviour of the subject concerned in the case study, it can be associated with the stress-vulnerability model. The stress-vulnerability model was propounded by Zubin and Spring in the year 1977 (Zannas & West,2014). It states that the psychological behaviour in human beings is broadly dependent on two important characteristics that include the genetic trait to develop a mental disorder and the psychological and the social elements that form a part of the immediate environment of an individual (Bolier et al.,2013). On examining the case study closely, two contributing characteristics that can be identified with the development of psychological imbalance in Chung can be summarized as the persistent ‘home-sickness’ that he has felt on being constantly away from his family members. Some of the most important life events of Chung took place in the absence of his dear ones that includes his parents, his elder brother and his younger sister. He had only been to his home town once after moving to Australia. He got married to his beloved wife Harriett in their absence and the event lacked his traditional Chinese grandeur that evoked in him the feeling of home-sickness all the more. In addition to this, quite recently he had been blessed with a beautiful baby girl Charlotte but he could not share the joy with his family members, which resulted in making him feel isolated from the essence of family and his cultural roots. Home sickness has been defined as the emotional disturbance caused because of being distant from the family members. Hence, Chung on not having his family by his side for the most important events of his life feels extremely secluded and helpless in a foreign land away from his home-town.
Another contributing factor that can be identified on the basis of the case study that has been provided includes the long shift hours and the occupational stress that does not allow him to rest sufficiently (Vijendren et al.,2014). The stress generated on account of work pressure and the over involvement of Harriett’s family members in his family members seems to disturb his mental peace. The involvement of Harriett’s family members is broadly based on the continuous absence of Chung because of his strenuous duty hours. His wife needs special care to recover from the post operation infection on delivering the baby through caesarean section and a new born in itself requires a lot of care and comfort. All these factors have triggered emotional stress in Chung by making him feel unworthy both at his professional and personal life. Chung is unable to share his emotional burden with his family members due to the distance factor and at the same time he is unable to confide completely in his wife because of the over-involvement of her family members. Gradually, the stress is seen to pile up which is not allowing him perform well at work. A stressed mind is always exhausted and fatigued physically as revealed by scientific studies (Thibeault,2017).
Contributing factors to client’s speedy recovery:
In order to assist Chung for a rapid recovery the three most important approaches that would be kept in mind while continuing with the process of intervention would include, inclusion of the essence of respect, empowerment and hope. It is important to make Chung feel respected by his wife and her immediate family members. Through one to one counselling Harriett can be made aware of the serious condition that Chung has developed. The counselling session should pin point the massive behavioural changes that have been detected in Chung and intervention would include Harriett making him feel at ease when he is off-duty (Dickens et al.,2013). Familial conflicts in the form of misunderstanding and blaming for negligence can be avoided by Harriett so as to make the subject feel wanted and loved (Giacco et al.,2014). Counselling session with Chung based on personal interview can help in developing a deeper understanding to the determinants of the issues that he has been facing. On being able to recognise the issues, educating Chung about the adverse effects of his upset mental health and involving him in tasks that are based on making ‘real-choices’ can help in empowering him to a great extent. The recovery oriented mental health suggests that empowering a subject involves making the subject aware of his lost strengths and devising small activities to emancipate the subject thereby bringing back the self-confidence in the individual and empowering him to be able to do perform regular activities without hassle. The concept of hope can be implied successfully on the subject by one to one counselling of Chung and his dear wife and intervention in the form of spending quality time with dear ones can be suggested (Reivich et al.,2013). Considering the familial cravings and home sickness of Chung, it is a must for him to go on a holiday with his wife to his home-town China and spend some time so that he is able to get back his family support. Also, the involvement of his in-laws can be curtailed so that Chung gets to spend ample amount of quality time with his new born daughter and his wife after returning home from his strenuous duty hours. Spiritual counselling can also be undertaken by the subject that would help in emancipation of faith and instilling an optimistic perspective towards life (Fried & Nesse,2015). Socialising more with family or to relieve himself from work pressure and mental stress, Chung could also take up a hobby like cooking a meal and sitting together with his family to have it can work wonders to evoke positivity in Chung. Spending time with the baby can work wonders, like the subject could be encouraged to read a bed time story or sing a lullaby to his new born. Hence, to summarise in this way the subject can gradually come to terms with life by finding joy in the little aspects that help in keeping the physical health intact and also promotes mental wellbeing.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub,pp-175-190
Baer, R. A. (Ed.). (2015). Mindfulness-based treatment approaches: Clinician’s guide to evidence base and applications. Elsevier.pp-175-177
Bolier, L., Haverman, M., Westerhof, G. J., Riper, H., Smit, F., &Bohlmeijer, E. (2013). Positive psychology interventions: a meta-analysis of randomized controlled studies. BMC public health, 13(1), 119.
Dickens, C., Cherrington, A., Adeyemi, I., Roughley, K., Bower, P., Garrett, C., …& Coventry, P. (2013). Characteristics of psychological interventions that improve depression in people with coronary heart disease: a systematic review and meta-regression. Psychosomatic medicine, 75(2), 211-221.
Drake, C. L., Pillai, V., & Roth, T. (2014). Stress and sleep reactivity: a prospective investigation of the stress-diathesis model of insomnia. Sleep, 37(8), 1295-1304.
Fried, E. I., &Nesse, R. M. (2015). Depression sum-scores don’t add up: why analyzing specific depression symptoms is essential. BMC medicine, 13(1), 72.
Giacco, D., Matanov, A., & Priebe, S. (2014). Providing mental healthcare to immigrants: current challenges and new strategies. Current opinion in psychiatry, 27(4), 282-288.
Oommen, D. (2013). The relationship between mental distress, assessed in terms of anxiety and depression, and conflict management in the context of cultural adaptation. Journal of Intercultural Communication Research, 42(2), 91-111.
Reivich, K., Gillham, J. E., Chaplin, T. M., & Seligman, M. E. (2013). From helplessness to optimism: The role of resilience in treating and preventing depression in youth. In Handbook of resilience in children (pp. 201-214). Springer, Boston, MA.
Thibeault, M. A. (2017). Cultural Stressors and Depressive Symptoms: When is Positive Ethnic-Racial Affect Protective for Immigrant-Origin Emerging Adults?.The University of North Carolina at Greensboro,pp-195-197
Vijendren, A., Yung, M., & Sanchez, J. (2014). The ill surgeon: a review of common work-related health problems amongst UK surgeons. Langenbeck’s archives of surgery, 399(8), 967-979.
Zannas, A. S., & West, A. E. (2014). Epigenetics and the regulation of stress vulnerability and resilience. Neuroscience, 264, 157-170.

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401013 Promoting Mental Health And Wellbeing 1

401013 Promoting Mental Health And Wellbeing 1

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401013 Promoting Mental Health And Wellbeing 1

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401013 Promoting Mental Health And Wellbeing 1

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Course Code: 401013
University: Western Sydney University

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Country: Australia

Questions:
1. Depression and Suicide are significant areas of concern in Australia.

Investigate and outline the incidence of both depression and suicide in Australia. Ensure you address depression and suicide separately.
Using relevant literature, identify and critically discuss one community group which is at risk of depression AND one different community group which is considered at risk of Suicide.

2. Critically discuss 2 factors that may have contributed to the development of the client’s mental health concerns and risks.
3. Ethical and legal considerations in health care can generate in-depth discussions from different perspectives within a professional health care team. The case study presents areas of risks regarding harm to self and others. Use literature and the case study to define and discuss the ethical principles of beneficence and non-maleficence and aspects of the mental health ACT, 2007, which are relevant to the areas of risk in the case study.
4. Identify a high priority and urgent mental health risk from the case study and provide two relevant interventions. Explain the rationale and possible impact on the client for both interventions drawing on the relevant literature.
5. Identify a mental health problem/need or concern from the case study, and provide two relevant interventions. Explain the rationale and possible impact on the client for both interventions, drawing relevant literature.

Answers:
1.
a.

Depression:  As per the WHO survey, depression is one of the major causes of death in adolescents and youth, between the age group of 10-19 years of age (Ricci, 2015). Although this survey is a worldwide one, these rates are seen prevalent in Australia too, with the adolescents having trouble coping up with the distress and ending up giving their lives to get out of the troubles.
The most prevalent reasons that drive most teenagers to this ultimate means are either biological reasons, and disorders such as bipolar or psychosis, or the developmental factors, such as trouble at school and college, or problems at home. The study done on the depression rates in Australian women, especially, found that there are several reasons for depression, and the most significant among them is the post-natal mental condition. It is found that around 16% of women go across this phase, where they experience what is called baby blues or the post-natal depression.  Although help is provided immediately by the primary care workers, and the constant mental health survey by the Australian government renders new and modified policies, depression seems to be on the rise, as per the latest predictions (Rich, 2013)
Suicide: There has been a considerable increase in the number of deaths due to suicide, between 2006 and 2012. The study conducted by the Australian Bureau of Statistics found that the death due to suicide has increased from 10.2 per 100,000 to 12.6 per 100,000 in the year 2012(Suicide in Australia, 2016). This rate is alarming, as is the fact that they are often triggered by the cluster effect. When a suicide happens one particular group of people, (say youth, indigenous population, and so on), it seems to trigger more among the others in the group(Robinson, 2016).Although the survey reported presented with the number of suicides gives a collective number of suicides in a year, it has been found that the rates are highest among the youth (Longbottom, 2016)
b.
Depression:
One of the particular concerns today, facing the world (and Australia at large) is the mental health of youth. With the adolescent and teenage population more exposed to social media, online games and news, children face depression at a very young age. It is predicted that the young females, at the age group of 12-20 years are twice as much prone to depression and restlessness than the male (Pearce, 2017). This is especially true with older teenagers, at the age group of 18-19 years, where they are more susceptible to peer pressure, stress due to social life, and studies, bullying in the college, and so on. Social media, may also be one of the significant reasons for young girls facing mental health challenges. This depression, as said to be developed at a young age (at adolescent stage) contributes to the mental health in later stages of life.
Suicide:
A survey conducted in 2015 shows that the suicides in indigenous populations and Torres strait islanders are twice as much as those in non-indigenous people (Armstrong, G., 2017). This trend of suicide is a recent one, and mostly seen in younger members of the group. The average age, as predicted by the survey, for suicide among the indigenous population is less than 35 years of age Most of these deaths are attributed to depression, substance abuse and also on the influence of others in the community, what is called the cluster suicides. Sadly though, many suicides or self-harm symptoms are also seen among females who have been hospitalized and suffering from an illness.
2.
In scenario A, Jonathan is a youth of 19 years, with a series of distressing events in his life. With the loss of his one parent, (his mother) and a developing distance between the other, he suddenly feels isolated and lonely. Jonathan is depressed, and with his mother’s anniversary approaching, he feels his only respite would be to end his life. Poor family cohesion, as Grenklo, T. B., et. al (2014) suggests, is one of the reasons for self-destructive behaviour in youth.  A close knit family, disintegrating within a span of months, and the stress of dealing with sickness might have lead Jonathan into a turmoil. Loss of a close relative here, and who has suffered in front of him, with an illness like cancer, has made Jonathan take the fatal step, and understandably, closer to the approaching anniversary of his mother’s death.
Here, two things have happened simultaneously for Jonathan. For one, he has lost his mother, and in an illness which would have lasted for a few months at the most. Second, his father, who might himself be feeling lost due to his wife’s death, is dealing with his grief in his own way, by working overtime. Although monitory issue is also a concern, the father here might have distanced himself to deal with both his own grief and also to repay the loans. Hence, father, the one parent alive, is not there to support Jonathan or share his grief.
Similarly, Jonathan is facing other challenges in life, such asan inability to cope up with everyday work in his workplace. With assignments pending, and attendance lagging behind, Jonathan is worried that he might not be able to clear his training at TAFE. A Youth, especially those who have been doing well in academics or whatever field of interest, suddenly is finding  it daunting to face challenges and is stressed out to keep up with their peers. This is something similar that has happened to Jonathan, and have forced him to take the ultimate decision (Longbottom, 2016). The last straw is the fight with the girlfriend, and a possible change in his relationship status. This one act had finally acted as a trigger, and have Jonathan over the edge, with his pills and drinks. Losing a parent, and then with another not able to provide support, Jonathan seems to have been depending upon his girlfriend for emotional support. Now that he is being threatened by it, and with his mother’s death anniversary approaching, (an event that seems to have triggered everything in the first place), Jonathan has developed self-destruction tendencies and might continue to do so, unless help is offered.
3.
Jonathan in the case study, is 19 years of age. According to the Mental Health Act, 2007, he is at a stage where he can be considered an adult, and no parental supervision is required during his hospitalization. Hence, although any legal issues regarding his admission or questioning by the nursing staff in the emergency department are ruled out, there are always ethical considerations to be noted.
Ethical dilemmas like doing the correct thing in a situation, is often contradicted by other constraints put forth on a medical professional. For instance, in the case of Jonathan, the problem might be that although he is 19, and can very well take decisions on his own. However, the health care professional might need to talk to an elder or a parent to relate the situation and advise on the outcomes. With the mental health of the patient not very stable, and with him susceptible to take the course of action once again, if left unattended, it becomes imperative to put forward the issue to someone close enough to monitor the situation. However, can they do so, without foregoing the legal and ethical implications, is a remarkable question to answer. As the experts say, the psychological question of treating a person, who is responsible to oneself (as an adult, Jonathan is legally responsible for himself), but, does not have the power or resources to act upon it, is confusing, and ethically questionable (Holm, 2014).
Appling the principles of non-maleficence and beneficence in ethics, although the patient has relayed the information and his wish to end his life as a confidential information to the nurse, it is imperative that the information is shared with the physician. The principle of beneficence suggests the use of information to provide a positive outcome, and thus, do good for a person (Jie, 2015). Hence, here, if the nurse has to apply the principle of beneficence and help Jonathan, the information needs to be shared with the health care professionals and relief sought, in the form of a guidance and treatment from mental health experts. The principle of non-maleficence, however, suggests performing a deed that the patient considers right, or it is beneficial for the patient, according to his own predictions. Thus, relating Jonathans wish to end his life, and seeking the help of a mental health professional is not something that Jonathan might want, and therefore, might not be to his advantage. Jie suggests, therefore, to take heed of patient’s own perspective about harm and benefit, while applying the non-maleficence and beneficence principles of ethics to a case study.
4.
Persons withsuicidal tendencies need to be treated with a thorough understanding of their problems, and the root cause of it. Hence, certaininterventions from the nursing professionals can aid in keeping the suicidal tendencies of the patient in control.
In Jonathan’s case, he is a youth in his prime, with a promising career ahead of him, once he finishes his training. So, what made him think of the extreme step, is something that needs to be analysed. Getting to the root cause can help the nurse to work out a treatment plan. It is imperative to speak to Jonathan about his life and help him to pour out his troubles for the professionals to analyse and chart a method of treatment.
A person with suicidal tendency might be amenable to any kind of treatment, if they can make him talk to the nurse about the reasons for his suicidal attempt. Jonathan here, has shared enough information to the nurse in the emergency department about the problems he is facing in life, and has also shared that he wants to die. This thought in mind shows Jonathan has strong suicidal tendencies and needs to be addressed by constantly monitoring him, while in the hospital, and even after he goes home. A person with suicidal tendency might reveal facts like talking about death all the time, and thinking of ways to hurt themselves, and expressing feelings of hopelessness. Safe clinical practices, patient – centred interventions and interpersonal communication and collaboration, are some of the ways to aid the patients with self-destructive thoughts. (Puntil et.al, 2013). Listening carefully to the patient, and recording signs and symptoms of distress can help in taking action when required. An open talk (establishing a therapeutic relationship), can help in identifying the weaknesses and also in finding the cause for suicidal tendencies.
Another fact, which can help in Jonathan’s case is to teach the family and primary care provider about possible symptoms to monitor and provide hotline numbers to contact emergency, if and when help is required. Keeping a track of things that looks like the person’s reactions and his erratic behaviour during the hospital stay is easier for a nurse, since he is under 24 hour supervision of medical professionals. However, doing it at home is the responsibility of the parent, or any primary care provider. Although Jonathan might not require a 24 hour care, the family members need to be taught about certain aspects to look for, to identify potential risk and prevention. Keeping self-medications out of reach and things like, monitoring, for any signs of depression, and not leaving patients to be alone for too long, might help (Sarah, 2015).Questioning the family members after narrating them with the preparatory actions to be taken can keep them ready for action, when required. This can help the family members to be alert for any small signs to take instant preventive action.  Also, in the case of Jonathan, with his case history, the family members should be taught to keep medications away from his reach, and also any other material susceptible to suicide.
Finally, gaining the trust of both the patient and the family members can be a significant and essential intervention to prevent Jonathan from taking this course of action again. Since the family members and the girlfriend, are going to play a significant role in the Jonathans treatment plan, it is essential to involve them at each stage to make the effort successful. Referring them to mental health care agencies and counselling the patients through external source can be the next course of action.
5.
Anxiety is one of the mental health concerns that needs to be addressed due to its potential risks, if left uncontrolled. Anxiety, can be defined as an uneasy or a vague feeling of dread and discomfort, and always accompanied by an automatic response. The source of anxiety in a person is unknown, and usually is a signal or an apprehension for an impending danger. Since everyone is susceptible to anxiety of one magnitude or another. Anxiety interferes with the ability of a person to act normally during a situation and thus, the person can lose concentration, and show visible signs of distress outwards, such as tremors and tachycardia (Lader, 2015)
One of the most significant factors in the treatment of a patient with an anxiety disorder is to maintain calmness while talking to the client, and remain with them, while they are in a highly anxious state. Anxiety can lead to serious threats to self and thus, it is essential to bring them out of that situation. Also, a client will calm down and feel secure, if the person handling them is calm and collected. Talking to them softly, and addressing the concerns they might have, regarding the apprehension, can help them open up to suggestions and treatments. A nurse can recognize the three facts by gaining the trust of the patient – ABC – Alarms, Beliefs based upon previous incidents which has resulted in the present condition and Coping mechanisms, which can be identified as effective, or not over a period of time (Bystritsky, 2013)  These facts, then can be applied in the treatment process, to help patients deal with their disorder.
Similarly, anxiety, as Nathan and Gorman (2015) believe, can be treated with the use of CBT- cognitive behavioural therapy. Putting the client’s perspective into place, recognizing the patterns of anxious behaviour and incorporating methods to transform those thoughts into positive outputs can help a patient in overcoming the fears and anxiety.
A highly anxious patient might pose a threat to not only himself, but others around. Similarly, their anxiety might escalate, in such instances. Also, a client will calm down and feel secure, if the person handling them is calm and collected.Hence, applying the CBT can be a challenging process, unless the nurse can talk to them softly, and write downthe situations which causes apprehension and uncertainty. CBT has been applied to patients with extreme depression symptoms and suicidal tendencies, and have been found to be beneficial in both cases.Applying CBT involves teaching the patients about the coping mechanism and helping them to change their outlook to a positive one. A person, afraid of the dark, or getting anxious in a crowded room can either get out of the room, or learn to block out the crowd with defence mechanism. Although, since each patient is unique, and each situation differently, as Kaczkurkin and his co-authors (2015) concludes, itis essential to determine which component can be used in what situation, to make it effective.
References
Armstrong, G., Pirkis, J., Arabena, K., Currier, D., Spittal, M. J., & Jorm, A. F. (2017). Suicidal behaviour in Indigenous compared to non-Indigenous males in urban and regional Australia: Prevalence data suggest disparities increase across age groups. Australian & New Zealand Journal of Psychiatry, 000486741770405. doi:10.1177/0004867417704059
Bystritsky, A., Khalsa, S. S., Cameron, M. E., & Schiffman, J. (2013, January). Current Diagnosis and Treatment of Anxiety Disorders. Retrieved September 02, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3628173/
Grenklo, T. B., Kreicbergs, U., Valdimarsdóttir, U. A., Nyberg, T., Steineck, G., & Fürst, C. J. (2014, April 04). Self?injury in youths who lost a parent to cancer: a nationwide study of the impact of family?related and health?care?related factors. Retrieved September 02, 2017, from https://onlinelibrary.wiley.com/doi/10.1002/pon.3515/full
Lawrence , D., Johnson, S., Hafekost, J., Haan, K. D., & Sawyer, M. (2015, August). The Mental Health of Children and Adolescents . Retrieved September 1, 2017, from https://www.health.gov.au/internet/main/publishing.nsf/Content/9DA8CA21306FE6EDCA257E2700016945/%24File/child2.pdf
Holm, A. L., & Severinsson, E. (2014). Reflections on the ethical dilemmas involved in promoting self-management.  Nurs Ethics, 21(4), 402-413.
Jie, L. (2015, December). The patient suicide attempt – An ethical dilemma case study. Retrieved September 01, 2017, from https://www.sciencedirect.com/science/article/pii/S2352013215000149
Lader, M. (2015, January 01). Generalized Anxiety Disorder. Retrieved September 02, 2017, from https://link.springer.com/referenceworkentry/10.1007%2F978-3-642-36172-2_317
Longbottom, J. (2016, November 29). Suicide rates for young Australians highest in 10 years. Retrieved September 01, 2017, from https://www.abc.net.au/news/2016-11-30/system-for-suicide-prevention-rates-highest-10-years/8076780
Nathan, P. E., & Gorman, J. M. (2015). A guide to treatments that work. Oxford: Oxford University Press.
O’Connor, P. J., Martin, B., Weeks, C. S., & Ong, L. (2014, April 09). Factors that influence young people’s mental health help seeking behaviour: a study based on the Health Belief Model. Retrieved September 02, 2017, from https://onlinelibrary.wiley.com/doi/10.1111/jan.12423/full
Puntil, C., York, J., et al. (2013). Competency-Based Training for PMH Nurse Generalists.  Journal of the American Psychiatric Nurses Association, 19(4), 205-210.
Ricci, C. (2015, August 26). Mental health rates a key influence on young people’s education outcomes. Retrieved September 01, 2017, from https://www.smh.com.au/national/education/teenage-depression-and-suicide-rates-make-mental-health-an-education-issue-20150826-gj883d.html
Rich, J. L., Byrne, J. M., Curryer, C., Byles, J. E., & Loxton, D. (2013). Prevalence and correlates of depression among Australian women: a systematic literature review, January 1999- January 2010.  BMC Res Notes, 6, 424.
Robinson, J., Too, L. S., Pirkis, J., & Spittal, M. J. (2016). Spatial suicide clusters in Australia between 2010 and 2012: a comparison of cluster and non-cluster among young people and adults. BMC Psychiatry, 16, 417.
Sarah, B. R. (2015, June 11). Nursing Care Plan and Diagnosis for Risk for Self Harm Related to | Suicide, Depression Nanda Nursing Interventions and Outcomes. Retrieved September 01, 2017, from https://www.registerednursern.com/nursing-care-plan-and-diagnosis-for-risk-for-self-harm-related-to-suicide-depression-nanda-nursing-interventions-and-outcomes/
Strauss, C., Cavanagh, K., Oliver, A., & Pettman, D. (2014). Mindfulness-Based Interventions for People Diagnosed with a Current Episode of an Anxiety or Depressive Disorder: A Meta-Analysis of Randomised Controlled Trials. Retrieved September 02, 2017, from https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0096110

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NURS11159 Introduction To Nursing
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Course Code: NURS11159
University: Central Queensland University

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Country: Australia

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Introduction
The The results of the Gallup’s Annual Honesty and Ethical Standards poll (DEC20, 2016) showed that nursing the most trusted profession for the 15th year all way. Trust is a firm belief, of the character, strength or truth of someone of something according to Merriam-Webster (1828). For a person to be trusted by anyone, he must have portrayed a particular character, trait, or individual strength. The character is also …
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