401013 Promoting Mental Health And Wellbeing

401013 Promoting Mental Health And Wellbeing

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401013 Promoting Mental Health And Wellbeing

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401013 Promoting Mental Health And Wellbeing

3 Downloads3 Pages / 696 Words

Course Code: 401013
University: Western Sydney University

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

Country: Australia

Question

Case Study for Assessment 2 
Note: your student assessment work must focus on Chung, regardless of your status as a nursing or midwifery student.
Chung is a 35 years-old male who moved to Australia from China ?ve 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 promotion 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 re?ection, 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 ?nds that Harriett’s parents are very involved with baby care even when he is home. Given this, Chung ?nds 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 ?at in mood and tearful. His a?ect is sad and restrictive. He is slumped in his chair, with rounded shoulders and starring at the ?oor 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 ?ve 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 ?eeting 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.
Questions 
1a) Using the case study provided, identify an urgent risk area. Ensure your answer details why you have identi?ed this risk area including speci?c information about the client and current literature. 
1b) Identify on ensuring/midwifery intervention you would immediately undertake with your client to address the risk area noted in question 1a and include a rationale for the intervention. 
Ensure the intervention includes who and when you would actually carry out the intervention. Your rationale should state how and why you would carry out the particular intervention. Ensure literature is included.
2a) Using the case study provided, identify a mental health concern. Ensure your answer details why this is an area of concern. Include speci?c information about the client and current literature.
2b) Identify one nursing/midwifery intervention you would undertake with your client to address the mental health concern noted in question 2a and include a rationale for the intervention. 
Ensure the interventions includes how, who and when you would actually carry out the intervention. Your rationale should state how and 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.

Answer

1a) An urgent risk area in the case study is the suicidal thoughts that Chung has been experiencing for the past week. The patient is even aware of a highly lethal medication which he could take to overdose and eventually die. Depressed patients experience fleeting thoughts of death due to stressful occurrences in their lives (van Spijker et al., 2015). Mr. Chung feels that he has disappointed his wife, daughter, and the accident and emergency department. His wife gives through caesarean section due to complication; hence making her undergoes extreme pain. The patient also feels that the medical error committed was entirely his fault.
1b) The ideal nursing intervention for suicidal thoughts is to maintain a therapeutic relationship with Mr. Chung. The therapeutic interaction enables the nurse to explain the severe effects of committing suicide (Forkmann et al., 2014). The caregiver builds the relationship by encouraging the patients to share their experiences openly. Furthermore, the nurse should discourage the patient from taking his life and urge the family members to keep him company. The nurse on duty is the person charged with the responsibility of maintaining a therapeutic alliance with the patient. The caregiver should meet the client for forty-five minutes daily. The family of Harriett should allow Chung to spend time with his daughter.  
2a) One critical mental health concern in the case study is a low mood that Chung has been experiencing for the past six weeks. The patient has been feeling worthless, hopeless, helpless, and wants to die. Patients with clinical depression experience a tearful and a flat mood that lasts for over a month (Geraghty et al., 2017). Several factors such as long working hours, shift hours, and the pressure at the hospital are the causes of the low mood. Additionally, Chung gets very little time and space to spend with his new daughter. The fact that his wedding lacked a Chinese reference is another cause of flat mood.
2b) The intervention for the low mood requires the nurse to partner with the family members to cheer up the patient. The caregiver should convince Mr. Chung that the condition of the wife and the daughter are not his fault. The patient should realize that a caesarean section is a conventional method of birth in the Australian hospitals. The nurse should urge Harriett’s parents to allow the patient spent quality time with Charlotte after work. The process of raising the mood of a depressed patient eradicates suicidal thoughts from their minds (Turecki, & Brent, 2016). The nurse should meet the patient and his family for twenty minutes daily.

3) Two ethical issues that arise from the case study are beneficence and confidentiality. Beneficence dictates that the consequences of an action should benefit the people that the activity affects (Doody, & Noonan, 2016). Directing a lot of questions to Mr. Chung can stress him and increase the severity of the depressive symptoms. Therefore the nurse should ask few questions and direct other concerns to the family members. Confidentiality is keeping secrets of an individual from the third party. The caregiver should not avail the information from Chung to anybody without the patient’s permission. Therefore, the nurse should observe the ethical principle of beneficence and confidentiality when attending to Chung.
References
Doody, O., & Noonan, M. (2016). Nursing research ethics, guidance, and application in practice. British Journal of Nursing, 25(14), 803-807.
Forkmann, T., Wichers, M., Geschwind, N., Peeters, F., van Os, J., Mainz, V., & Collip, D. (2014). Effects of mindfulness-based cognitive therapy on self-reported suicidal ideation: results from a randomized controlled trial in patients with residual depressive symptoms. Comprehensive Psychiatry, 55(8), 1883-1890.
Geraghty, A. W., Santer, M., Williams, S., Mc Sharry, J., Little, P., Muñoz, R. F., … & Moore, M. (2017). ‘You feel like your whole world is caving in’: A qualitative study of primary care patients’ conceptualizations of emotional distress. Health: 21(3), 295-315.
Turecki, G., & Brent, D. A. (2016). Suicide and suicidal behavior. The Lancet, 387(10024), 1227-1239.
van Spijker, B. A., Calear, A. L., Batterham, P. J., Mackinnon, A. J., Gosling, J. A., Kerkhof, A. J., … & Christensen, H. (2015). Reducing suicidal thoughts in the Australian general population through web-based self-help: study protocol for a randomized controlled trial. Trials, 16(1), 62.

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401013 Promoting Mental Health And Wellbeing

401013 Promoting Mental Health And Wellbeing

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401013 Promoting Mental Health And Wellbeing

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401013 Promoting Mental Health And Wellbeing

0 Download8 Pages / 1,992 Words

Course Code: 401013
University: Western Sydney University

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

Country: Australia

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.

Question 2

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.

Question 3

Question 3 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.

Recommended use of words – 125 words for recovery model / theory and 125 words for each of the principles – respect, empowerment and hope.

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 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:

MSE helps caregivers to observe and describe the psychological functioning of the patient at a given time (Rollinger, Berres, Ehrensperger, & Monsch, 2015). The first component of the examination is the appearance of the patient. Mr. Chung’s posture indicates that he has clinical depression. He is slumped in his chair and has rounded shoulders.
The patient also stares at the floor for long periods of time. Behavior is another component of MSE. Chung has limited eye-to-eye contact with the health care specialist. The patient is less attentive to the questions as the interviewer has to repeat questions before getting an answer from him. Another aspect that indicates depression is the speech of Mr. Chung. His speech is slowed and purposeful.
The patient has a tearful and flat mood which has existed for six weeks. His unpleasant mood is due to the condition of his child and wife. The child’s (Charlette) birth was through a cesarean section due to complications at birth. Harriette (Mr. Chung’s wife) developed an infection due to operation at birth. The process left her with a lot of pain. The patient also has a sad and restrictive affect. The contents of his thoughts are also unpleasant as he has suicidal thoughts. Chung has been having suicidal thoughts for the last week. The patient is also delusional and thinks that he is the cause of his child and wife’s condition. He also blames himself for the drug error at the accident and emergency department.
MSD-V
Depression is also called the depressive order and makes the patient have a feeling of isolation, despair, and sadness for extended periods. Mr. Chung has clinical depression due to the symptoms of the disease that are evident in him. A depressed individual has a sad mood for days, weeks, or even months (Fried, & Nesse, 2015). The patient has had a tearful and flat mood for six weeks. The low mood is due to the long working hours; hence, he finds little time for his new daughter. The shift and the high pressure from the accident and emergency department are also responsible for the sad mood. Anxiety is another symptom of clinical depression. The patient has been anxious for the past two months due to the condition of the wife and child.
Depression makes a victim to lose weight due to loss of appetite or failure to take regular meals (Simmons et al., 2016). The case study indicates that Chung has lost five kilograms of weight due to reduced appetite and missing meals. Insomnia is also prevalent in patients with depressive disorder. Insomnia is the inability to fall asleep or to remain asleep (Manber et al., 2014). Chung has been experiencing sleeplessness which began as insomnia. However, he has also been experiencing early morning waking at 3 AM. Patients also feel worthless and guilty on a daily basis. Chung feels guilty due to the medical error and the conditions of the child and wife. Patients also have recurrent death thoughts. Chung has been having suicidal thoughts for the last week.
Question Two
Stress Vulnerability Model (S.V.M)
The vulnerability is the susceptibility of an individual towards a mental disorder (Calvete, Orue, & Hankin, 2015). The primary determinants of vulnerability are experiences during early life and genetics. Factors that affect susceptibility include the use of alcohol and medications. Challenges that an individual faces during a lifetime form the basis of stress. Persons with proper coping skills overcome stress easily than those without the skills. Individuals also need social support to counter stressful experiences. Therefore, the significant components of the SVM are biological Vulnerability, stress, and protective factors. The model assists caregivers to understand Mr. Chung’s condition and suggest a long-lasting solution to the problems.
Biological Vulnerability refers to the tendency or biological susceptibility t a mental disorder (Nixon et al., 2014). The susceptibility differs from one individual to the other. The intensity of depression and its symptoms also vary depending on the levels of a person’s sensitivity. Genetic factors are the first determinants of biological vulnerability. Persons who are from families with a history of depression have high chances of getting the mental disorder. However, the case study does not indicate the medical history of the patient. Biological factors also influence an individual’s vulnerability to depression. The elements are like a viral infection when an individual is at a young age. 
Drug abuse and alcoholism increase vulnerability to stress and anxiety. However, the case study does not indicate whether Chung is an alcoholic or otherwise. Alcoholism increases the severity of depression symptoms. Depressed individuals have high sensitivity to little amounts of drugs and alcohol (Duman, Aghajanian, Sanacora, & Krystal, 2016). Stressful working environments increase the severity of depression symptoms. The long working hours at the hospital are stressful as Chung has limited time for his family. The drug-error at the accident and emergency department also worsened the symptoms of clinical depression. The shifts and going to school to earn a promotion further limit Chung’s time for his family.
Stress is any activity or occurrence that challenges an individual. The stressed individual requires urgent adaptation to deal with the condition (Yun et al., 2016). Severe stressful circumstances in the life of Chung involve long working hours at the hospital. The error in the medical administration that made the eight-year-old patient very sick is also a stressful event. Chung administered the medication intravenously instead of intra-dermal administration. The wife’s pain due to an infection during birth is also stressful. Chung also finds little time and space with his new daughter due to the nature of his job.
Protective factors decrease an individual’s stress and biological vulnerability. Medication is essential factors in dealing with depression (Williams et al., 2014). Relevant drugs reduce the severity of the symptoms of the conditions. Appropriate medication also prevents the reoccurrence of symptoms such as suicidal thoughts. Proper coping skills of relatives and the patients also help to reduce the impacts of medical disorders. The parents of Harriette should allow Chung to spend time with his daughter after work. The hospital management should reduce the working hours and ensure that staff members spend quality time with their families. Therefore, stress and biological vulnerability are essential components of SVM.
Question Three
Mental Health Recovery Model
The model explores factors that enable an individual to recover from a mental disorder such as depression. Recovery involves hope, empowerment, and respect for the victim of depression (Slade et al., 2014). An efficient recovery process reduces the symptoms of depression and also ends minor signs. The patient, family, stakeholders, and the government have the responsibility of supporting the patients with medical disorders. Chung should remain hopeful that his situation is not permanent. The wife and her parents should encourage the patient by making him believe that he can recover from the condition. The government should empower patients by building specialized mental health facilities. The treatment of depression should be cheap and affordable. Family members should respect the decisions of Chung despite his psychological status.
Hope is a belief that all is well despite a long list of challenges. The family members should help Chung to find hope of recovery from the mental disease. The health stakeholders should nurture the newly-found optimism by visiting the patient and acting as a source of encouragement. Chung should be optimistic and believe that he can recover from the clinical depression. The symptoms of the disease are many and severe in manifestation. Therefore, Chung should be ready to tolerate the setbacks and uncertainties due to the condition. Hope can begin at a given point or start and develop slowly. Hope should exist despite the general failure and disappointment due to the symptoms (Chen, Koller, Krupa, & Stuart, 2016). Every stakeholder has the responsibility of ensuring that mental health patients remain hopeful in life.
Empowerment is the second component of the recovery model. Empowerment involves the development of a positive healing culture in patients (Shahdadi, Rahdar, Mansouri, & Abdollahimohammad, 2018). The hospital administration should offer a competitive salary to enable Chung to treat his depressive condition. The government should build specialized mental health centers in every part of Australia. The health facilities should offer affordable treatment to psychological disorder patients. The parents of Harriette should support Chung by ensuring that he spends time with the daughter after work. Empowerment decreases the mental and social impacts of depression. Individual care practices and proper medication enable the patient to have a speedy recovery from mental disorders. The wife should ensure that Chung takes the appropriate drugs to reduce the symptoms of the disease.
Respect is another component of the recovery model. The physicians should respect the decisions of the patients despite their mental conditions (Barth et al., 2016). Caregivers should explain the various remedies of depression to Mr. Chung and allow him to make an informed decision. Self-respect is also an essential path to recovery from mental diseases. Mr. Chung should take the depression drugs according to the caregiver’s prescription.
Drugs and alcohol are substances that increase the severity of depression symptoms. Chung should avoid the addictive substances to hasten the process of recovery. The hospital administration should respect Chung by asking him about his preferred working hours. The health facility should then obey the decision of the patient. Allowing Chung to spend time with his daughter is another component of respect. 
References
Barth, J., Munder, T., Gerger, H., Nüesch, E., Trelle, S., Znoj, H., … & Cuijpers, P. (2016). Comparative efficacy of seven psychotherapeutic interventions for patients with depression: a network meta-analysis. Focus, 14(2), 229-243.
Calvete, E., Orue, I., & Hankin, B. L. (2015). A longitudinal test of the vulnerability-stress model with early maladaptive schemas for depressive and social anxiety symptoms in adolescents. Journal of Psychopathology and Behavioral Assessment, 37(1), 85-99.
Chen, S. P., Koller, M., Krupa, T., & Stuart, H. (2016). Contact in the classroom: Developing a program model for youth mental health contact-based anti-stigma education. Community mental health journal, 52(3), 281-293.
Duman, R. S., Aghajanian, G. K., Sanacora, G., & Krystal, J. H. (2016). Synaptic plasticity and depression: new insights from stress and rapid-acting antidepressants. Nature medicine, 22(3), 238.
Fried, E. I., & Nesse, R. M. (2015). Depression is not a consistent syndrome: an investigation of unique symptom patterns in the STAR* D study. Journal of affective disorders, 172, 96-102.
Manber, R., Bernert, R. A., Suh, S., Nowakowski, S., Siebern, A. T., & Ong, J. C. (2014). CBT for insomnia in patients with high and low depressive symptom severity: adherence and clinical outcomes. Focus, 12(1), 90-98.
Nixon, N. L., Liddle, P. F., Nixon, E., Worwood, G., Liotti, M., & Palaniyappan, L. (2014). Biological vulnerability to depression: linked structural and functional brain network findings. The British Journal of Psychiatry, 204(4), 283-289.
Rollinger, H. K., Berres, M., Ehrensperger, M. M., & Monsch, A. U. (2015). Transformation formulae between scores of the mini-mental status examination (MMSE) and the Montreal cognitive assessment (MoCA). Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 11(7), P574.
Shahdadi, H., Rahdar, Z., Mansouri, A., & Abdollahimohammad, A. (2018). The effect of family-centered empowerment model on the level of death anxiety and depression in hemodialysis patients. Revista Publicando, 5(16), 470-482.
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.
Simmons, W. K., Burrows, K., Avery, J. A., Kerr, K. L., Bodurka, J., Savage, C. R., & Drevets, W. C. (2016). Depression-related increases and decreases in appetite: dissociable patterns of unusual activity in reward and interoceptive neurocircuitry. American Journal of Psychiatry, 173(4), 418-428.
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.
Yun, S., Donovan, M. H., Ross, M. N., Richardson, D. R., Reister, R., Farnbauch, L. A., … & Eisch, A. J. (2016). Stress-induced anxiety-and depressive-like phenotype associated with a transient reduction in neurogenesis in adult nestin-CreERT2/diphtheria toxin fragment A transgenic mice. PLoS One, 11(1), e0147256.

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401013 Promoting Mental Health And Wellbeing

401013 Promoting Mental Health And Wellbeing

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401013 Promoting Mental Health And Wellbeing

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401013 Promoting Mental Health And Wellbeing

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Questions:
1.Using relevant literature critically discuss the mental health status of the client in the case study. Your work should make reference to two (2) components of the Mental State Examination (MSE) related explicitly to the case study and the DSM V.
 
2.ritically discuss two (2) factors which have contributed to the development of the client’s current mental health status. You should demonstrate your knowledge of the Stress Vulnerability Model. Your work should clearly identify the contributing factors; make reference to the case study and relevant literature.
 
3.Empowerment and hope are three (3) positive aspects of mental health recovery. Using relevant literature and the case study, critically discuss how these three (3) principles could positively contribute to the client’s journey of recovery. You should demonstrate your knowledge of recovery orientated mental health theory and practice. 
Answers:

1.Mental State Examination (MSE) is an important assessment in psychiatric practice which provides a structured way of describing psychological functioning of a patient at a given time frame. Considering the case study of Chung, domains of speech, mood and affect are explicitly relevant that provides a comprehensive description of his mental state and allows accurate formulation and diagnosis for treatment (Mitchell, 2013). The speech of the patient is observed based on paralinguistic features like rhythm, loudness, pitch, rate, quantity and latency. His speech was slow and purposeful (Taylor, 2013). There were repetitions of questions and it was difficult to get information from him. Most of the time, Chung was non-responsive when the nurse inquired about his health. Speech is also associated with mood and affect. Chung’s affect is sad and restrictive and he was quiet, slow and flat in mood and tearful. According to the case study, Chung’s mood is described anxious as apparent through his non-verbal behaviour. There is blunted or flat affect that may be associated with any sort of heightened or dramatic effect showing anxiety. During the assessment, the patient had restricted affect where he was totally un-reactive and not with the flow of the conversation. A bland lack of concern in response to the conversation was observed in Chung.
According to the American Psychiatric Association, DSM V, anxiety disorders shares its features with anxiety and fear. Anxiety is anticipatory and in the given case study, Chung is anxious in response to a perceived threat where he is experiencing thoughts of a heart attack in the future. The signs and symptoms experienced by Chung meet the DSM-5 Diagnostic Codes of 300.01 Panic Disorder. The primary features that define panic disorder experienced by Chung are inappropriate worries or fear about future, unexpected and persistent panic attacks as he might get a heart attack (American Psychiatric Association, 2013). Various changes take place in the body due to panic attacks like trembling, dizziness, sweating and increased heart rate that is also witnessed in Chung. Physical and cognitive symptoms also accompany in panic attacks that is enough to recognize panic attacks and diagnose panic disorder of a certain expected nature. In the case study, Chung persistently worried about his recurrent physical symptoms and intense fear that he might get a heart attack in the future and die. He has been experiencing chest pains, palpitations and breathlessness, sleeplessness particularly initial insomnia and early wakening. Panic Disorder Diagnostic Criteria: 300.01 (F41.0) outlines the unexpected panic attacks when there is an abrupt increase of intense discomfort or fear reaching peak within a short period of time. This abrupt surge occurs from anxious or calm state where symptoms like sweating, shaking, pounding heart, and feeling of choking, discomfort or chest pain, fear of dying or losing control occur and also manifested in Chung (Edition & American Psychiatric Association, 2013). Therefore, the symptoms manifested by Chung in the given case study fulfil the criteria outlined in anxiety disorders, panic disorder 300.01 (F41.0).
2.The Stress-Vulnerability Model explains that there are three critical factors that are responsible for the development and progression of a psychiatric disorder over the course of time. The interaction between stress, biological vulnerability and protective factors contribute to a psychiatric condition. Stress has a great impact on the vulnerability that can trigger the onset of a disorder or worsen it. Stress is thought to be caused in response to life situations that make it difficult for an individual to change or adapt to the situation (Russo, 2015). If an individual is unable to adapt to the stress, mental issue or psychiatric symptoms may develop or progress in response to the stressors. The examples include tense relationships, life events and lack of productive life activities that are witnessed in the given case study (Butcher, Mineka & Hooley, 2013). Chung is a doctor working in Accident and Emergency (A&E) department at a busy, inner city hospital migrated from China to Australia. Two years back he was under investigation due to wrong route medication error and was placed on practice supervision for a year. He always remained tired and stressed out due to overnight calls and that resulted in the medication error. On his wedding day, his parents were not present and the ceremony lacked reference to Chinese culture made him emotionally weak due to lack of family support. Moreover, he was unable to participate in the wedding planning due to his long working hours.
As described by the model, life event, birth of a child is a psychosocial stressor also contributes to stress and can trigger psychiatric symptoms. Chung and his wife, Harriett has a three week old baby girl, Charlotte and during delivery, his wife had an infection that resulted in pain, dressings and difficulty in mobility. Due to Chung’s long working hours and hectic schedule, he is unable to take care of his wife and baby depicting tensed and detached relationships. He is stressed due to long working hours and high pressure environment at A&D acting as an occupational stressor. Altogether, the three stressors, wife’s health, Charlotte’s birth and lack of productive and useful activity made him anxious and he is experiencing chest pains, palpitations breathlessness. He is also experiencing feelings of hopelessness and helplessness and wanted to die. He is feeling worthless, unproductive and failure in his medical role and letting his family down as he lacks healthy coping skills with the present situation that is progressing towards a psychiatric condition (Brewin, 2013). He is attacked with suicidal thoughts, blaming him for the situation and is panicked that he might get a heart attack and die.
The current situation of Chung is explicitly explained through the stress-vulnerability model where the environmental stressors are contributing to psychiatric disorder experienced by him. This stressful situation is challenging for him as the situation demands good adaption and family support that is lacking in the current scenario. The lack of Chung’s involvement in meaningful life-in activities such as parenting and medical work is sources of stress that is contributing to his psychiatric condition. Therefore, lack of coping skills, social support, involvement in meaningful activities are the contributing factors to Chung’s stress and course of psychiatric condition, panic disorder.
3.Positive mental health recovery is not only being free from mental illness, but also allows an individual to enjoy pleasures of life, believe oneself and have the ability to cope with the daily life challenges while working productively and enjoy socializing (Slade et al., 2014). Recovery model of mental health is an approach to emphasize and support an individual’s potential towards the process of recovery. This is helpful in providing a new purpose and meaning in an individual’s life so that one evolves beyond their mental illness condition (Chronister, Chou & Liao, 2013). Recovery oriented mental health practice has three important positive aspects that comprises of hope, respect and empowerment that facilitates recovery and impart positive sense in oneself. Dignity and respect are important for Chung as there should be honest and respectful interactions. The recovery process should involve respect and sensitivity being courteous in every aspect (Davidson, 2016). A mental health professional should appreciate and accept the Chinese culture, beliefs and values of Chung so that he feels valued and respected crucial to recovery.  The uniqueness of the individual should be recognized and there should be inclusion of one’s health beliefs so that the one has opportunities for choices and live a satisfying, meaningful and purposeful life (Storm & Edwards, 2013). As a mental health professional, it is important to accept that recovery outcomes are unique and personal and beyond physical health focusing on quality of life and social inclusion.
As depicted in the case study, Chung is experiencing feelings of helplessness and hopelessness being a failure in medical role and personal life, therefore empowerment is important for his recovery process. He should be empowered so that he recognizes his capabilities and potential in engaging in meaningful activities. He should be empowered and supported in making his own choices about how he want to lead his life and make real choices in living a creative and productive life (Jacob, 2015). He should be supported building on his strengths and empower him referring to level of influence, choice and exercise control over events in his life. Empowerment would help Chung to overcome his state of powerlessness and gain control of his own life. Gradually, he would be able to define his ambitions and needs and focus on the development of his resources and capacities that support him. His family can support him in the recovery process by establishing healthy social network with him, promoting cohesion and empowering him through period of vulnerability and difficult transition (Priebe et al., 2014). This empowerment is also intended to help him adopt autonomy and self-determination and gain self-esteem and hope in his life. Empathetic communication can help to instil hope in Chung about his future and capability to live a purposeful and meaningful life (Gilburt et al., 2013). Healthcare professionals should acknowledge that every individual is a master in his or her life and work in realistic and positive ways so that one realizes their own goals, hopes and aspirations in life.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Brewin, C. R. (2013). Cognitive Foundations of Clinical Psychology (Psychology Revivals). Psychology Press.
Butcher, J. N., Mineka, S., & Hooley, J. M. (2013). Abnormal psychology. ^ eNew York New York: Pearson.
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.
Davidson, L. (2016). The recovery movement: Implications for mental health care and enabling people to participate fully in life. Health Affairs, 35(6), 1091-1097.
Edition, F., & American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Arlington: American Psychiatric Publishing.
Gilburt, H., Slade, M., Bird, V., Oduola, S., & Craig, T. K. (2013). Promoting recovery-oriented practice in mental health services: a quasi-experimental mixed-methods study. BMC psychiatry, 13(1), 167.
Jacob, K. S. (2015). Recovery model of mental illness: A complementary approach to psychiatric care. Indian journal of psychological medicine, 37(2), 117.
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.
Priebe, S., Omer, S., Giacco, D., & Slade, M. (2014). Resource-oriented therapeutic models in psychiatry: conceptual review. The British Journal of Psychiatry, 204(4), 256-261.
Russo, M. (2015). Work–home enrichment and health: An analysis of the mediating role of persistence in goal striving and vulnerability to stress. The International Journal of Human Resource Management, 26(19), 2486-2502.
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.
Storm, M., & Edwards, A. (2013). Models of user involvement in the mental health context: intentions and implementation challenges. Psychiatric Quarterly, 84(3), 313-327.
Taylor, M. A. (2013). The neuropsychiatric mental status examination. Elsevier.

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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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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

401013 Promoting Mental Health And Wellbeing

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401013 Promoting Mental Health And Wellbeing

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401013 Promoting Mental Health And Wellbeing

0 Download9 Pages / 2,070 Words

Course Code: 401013
University: Western Sydney University

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

Country: Australia

Question: 
1 Using relevant literature critically discuss the mental health status of the client in the case study. Your work should make reference to two (2) components of the Mental State Examination (MSE) related explicitly to the case study and the DSM V.
 
2 Critically discuss two (2) factors which have contributed to the development of the client’s current mental health status. You should demonstrate your knowledge of the Stress Vulnerability Model. Your work should clearly identify the contributing factors; make reference to the case study and relevant literature. 
 
3 Respect, empowerment and hope are three (3) positive aspects of mental health recovery. Using relevant literature and the case study, critically discuss how these three (3) principles could positively contribute to the client’s journey of recovery. You should demonstrate your knowledge of recovery orientated mental health theory and practice. 
Answer: 

1. Mental health most commonly encompasses the psychological, emotional and social wellbeing and creates an effect on the way by which an individual feels, things, or acts. Thus, mental state examination (MSE) helps in the determination of how a person can handle stress and makes necessary changes, and is essential at every stage of life, beginning from childhood and adolescence, till old age (Jacobi et al., 2014). In other words, the MSE has been identified as an essential assessment that needs to be conducted in psychiatric practice, in order to gain a deeper understanding of the underlying psychological functioning of a client, suffering from an abnormal mental state (Gibbons, Thorsteinsson & Loi, 2015). An analysis of the case study of Chung provides evidence for the fact that his mood, affect and speech are primarily affected, which in turn help in diagnosing his presenting complaints, and formulating an accurate treatment plan. Speech of a patient is most often assessed by making an observation of the spontaneous speech that the person can make, and with the use of certain structured tests that are designed with the aim of assessing specific language functions.
While observing the spontaneous speech of a patient, most often the paralinguistic features of the person such as rhythm, intonation, prosody, phonation, speech, articulation, and loudness, are taken into account (Kraus, Adler & Chen, 2013). In the case study, it was observed that the speech of the patient was purposeful and slow, and there were several repetitions of question, owing to the fact that it was becoming extremely difficult to retrieve proper information from Chung. While mood refers to certain emotional experiences that are prevalent over a persistent time, affect is used to explain the immediate emotional expressions, both of which are intricately associated with speech (Ekkekakis, 2013). Furthermore, he also appeared non-responsive upon enquiry of his health, besides displaying a flat and tearful mood. The case study also suggests that his nonverbal behaviour were related to presence of anxiety.
Although occasional anxiety is a normal part of human life, anxiety disorders are often classified as a group of mental illness that are primarily characterized by significant emotions of fear and apprehensions about future events (Melton et al., 2017). These feelings are most often manifested in terms of physical symptoms such as, shakiness and fast heart. An analysis of the signs that are reported by Chung indicates the presence of panic disorder. This condition is primarily characterized by unexpected and recurrent panic that can be referred to as sudden surges of discomfort, which in turn can get heightened significantly within few minutes. This has been diagnosed in accordance to the DSM-V diagnostic criteria for panic disorder 300.01 (F41.0), according to which an individual experiences recurrent panic attacks during a time when there is abnormal sweating,  quickened heart beat, palpitations, shaking, and/or trembling (American Psychiatric Association, 2013). Furthermore, feelings of choking, abdominal pain or nausea, dizziness, numbness, and de-realization are some of the other criteria that lead to a mental disturbance (Carleton et al., 2014). Therefore it can be suggested that Chung is suffering from panic disorder and meets the criteria outline in the diagnostic guidelines.
2. Vulnerability refers to the common susceptibility of a person to mental illness and this often determined by the early life experiences, and genetic constitution. Moreover, the use of medications, substance abuse, and alcoholism also play an important role in determining this vulnerability. On the other hand, stress refers to certain challenges that a person faces and is generally affected by social support, participation in meaningful activities and presence of coping strategies (McEwen & Morrison, 2013). Some individuals are biologically vulnerable to a range of psychiatric disorders such as, schizophrenia, anxiety disorder, bipolar disorder, or major depression. Greater the vulnerability of an individual to a certain disorder, the earlier is the likelihood of the person to develop the disease and more is its severity. Environmental stress have been found to create a negative impact and make a person more likely to suffer from biological vulnerabilities, thereby worsening the symptoms and resulting in relapses of a disorder. Stressful events most often include loss of a loved one, experience of victimization, or unemployment (Admon, Milad & Hendler, 2013). The tremendous work pressure that Chung faced while working in the Emergency Department and the subsequent medication error that threatened the life of a patient contributed to stress in his life and made him more vulnerable to suffer from the disorder. Social support is another way that reduces the negative impacts of stress on vulnerability and usually comes from establishment of meaningful and close relationship with others. Owing to the fact that Chung was separated from his parents and failed to maintain a healthy relationship with them acted as barriers in solving challenging problems and supporting him in pursuing meaningful life goals. Both of these elements of the stress vulnerability model contributed to the onset of panic disorder. Support from his family members would have facilitated a willing and open discussion in association with resolving personal understanding, and/or disagreements, thereby illuminating conflicting areas that lead to stress in the situation (Kleiman & Liu, 2013).
Some of the major contributing factors in this case scenario is his strained relationship with family members and an absence of any word daily life activities. The fact that, Chung was placed under investigation due to a medication error, and was supervised for a year, besides absence of his parents in the wedding ceremony, creating a negative impact on his life. Birth of his daughter can be considered as another psychosocial stressor that invariably resulted in an elevation of the panic symptoms. The child birth resulted in an infection in his wife that created pain, needed dressing and resulted in impairment in mobility. In addition, his long working hours, a major form of occupational stressor, also resulted in his failure to take proper care of a child and wife, thereby demonstrating a detached relationship with them. Lack of purposeful involvement in essential life areas such as, parenting is a significant contributor to stress (Butcher, Mineka & Hooley, 2013). All of these aforementioned factors made him miserable, worthless and unproductive in taking care of his family and life, thereby aggravating the mental condition. This in turn, directly resulted in a disruption in his thought process, and led to the development of suicidal and hostile thoughts, thereby threatening his life and wellbeing.
3. From the perspectives of people suffering from mental illness, recovery refers to retaining and gaining hope, engagement in life activities, social identity, and personal autonomy, gaining an understanding of one’s disabilities and abilities, and creating a positive sense of self-worth. The recovery oriented approach to mental illnesses elaborates on supporting the potential of the affected person for recovery, which is viewed in the form of a personal journey, in place of pre-determined outcomes (Slade et al., 2014). This recovery most often involves development of hope, social inclusion, and empowerment, presence of strong supportive relationship, a secure base, and proper coping skills. Hence, recovery oriented practice views mental illness symptoms in the form of a continuum of the rules and norms, rather than some form of aberration. Research evidences often emphasize on the fact that the journey of an individual to their recovery from mental illness is a personal process, and is intricately associated with the society and community, in which the person resides (Moran et al., 2013). Nurturing and finding hope are one of the key prerequisites to recovery, and include not just a mental attitude that reflects the belief regarding a favourable and desirable outcome, but also demonstrates a willingness to sail through the setbacks and uncertainty. Hope is indispensable to the discovery of Chung and his earnest expectation of returning to normal life. Evidences have illustrated on the fact that all people suffering from mental illness have the capability of recovering from the condition through absolute will power, therefore establishing hope as a major support to the person in the recovery journey (Sklar et al., 2013). Promoting a positive culture that will assist Chung in his healing process is another essential recovery approach. Self-determination and empowerment are imperative in reducing the psychological and social effects of stress. Therefore, confidence needs to be developed in Chung for assisting him in taking assertive decision making. This can also be achieved by accomplishing social inclusion, where his immediate family members will be consulted and advised on the ways by which they can support him in the coping process. Several research studies have highlighted on the disempowering behaviour and attitude that exists in the society, towards people suffering from mental illnesses (Corrigan, Druss & Perlick, 2014). Hence, efforts must be taken to prevent all forms of discrimination and bring about a positive change by reducing the prevalent stigma.
Adopting a empowering and positive attitude will also facilitate the recovery process. This can be directly achieved by engaging in an empathetic verbal and nonverbal communication with the client, in order to help him realise the ways by which he can lead a meaningful and purposeful life. Dignity and respect are also crucial in this context, since they involve sensitivity towards the values, culture and beliefs of the individual (Chambers et al., 2014). Gaining a thorough understanding of the Chinese culture and traditions that are deep-seated in Chung would also help in challenging all forms of stigma and discrimination that exist in the broader community. Addressing his mental health needs, in relation to his cultural preferences and demands, will help in establishment of a sense of belonging to the society, and help him fight with the environmental stressors.
References:
Admon, R., Milad, M. R., & Hendler, T. (2013). A causal model of post-traumatic stress disorder: disentangling predisposed from acquired neural abnormalities. Trends in cognitive sciences, 17(7), 337-347.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Butcher, J. N., Mineka, S., & Hooley, J. M. (2013). Abnormal psychology. ^ eNew York New York: Pearson.
Carleton, R. N., Duranceau, S., Freeston, M. H., Boelen, P. A., McCabe, R. E., & Antony, M. M. (2014). “But it might be a heart attack”: Intolerance of uncertainty and panic disorder symptoms. Journal of anxiety disorders, 28(5), 463-470.
Chambers, M., Gallagher, A., Borschmann, R., Gillard, S., Turner, K., & Kantaris, X. (2014). The experiences of detained mental health service users: issues of dignity in care. BMC medical ethics, 15(1), 50.
Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest, 15(2), 37-70.
Ekkekakis, P. (2013). The measurement of affect, mood, and emotion: A guide for health-behavioral research. Cambridge University Press.
Gibbons, R. J., Thorsteinsson, E. B., & Loi, N. M. (2015). Beliefs and attitudes towards mental illness: an examination of the sex differences in mental health literacy in a community sample. PeerJ, 3, e1004.
Jacobi, F., Höfler, M., Siegert, J., Mack, S., Gerschler, A., Scholl, L., … & Gaebel, W. (2014). Twelve?month prevalence, comorbidity and correlates of mental disorders in Germany: the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1?MH). International journal of methods in psychiatric research, 23(3), 304-319.
Kleiman, E. M., & Liu, R. T. (2013). Social support as a protective factor in suicide: Findings from two nationally representative samples. Journal of affective disorders, 150(2), 540-545.
Kraus, M. W., Adler, N., & Chen, T. W. D. (2013). Is the association of subjective SES and self-rated health confounded by negative mood? An experimental approach. Health Psychology, 32(2), 138.
McEwen, B. S., & Morrison, J. H. (2013). The brain on stress: vulnerability and plasticity of the prefrontal cortex over the life course. Neuron, 79(1), 16-29.
Melton, G. B., Petrila, J., Poythress, N. G., Slobogin, C., Otto, R. K., Mossman, D., & Condie, L. O. (2017). Psychological evaluations for the courts: A handbook for mental health professionals and lawyers. Guilford Publications.
Moran, G. S., Russinova, Z., Gidugu, V., & Gagne, C. (2013). Challenges experienced by paid peer providers in mental health recovery: a qualitative study. Community Mental Health Journal, 49(3), 281-291.
Sklar, M., Groessl, E. J., O’Connell, M., Davidson, L., & Aarons, G. A. (2013). Instruments for measuring mental health recovery: a systematic review. Clinical psychology review, 33(8), 1082-1095.
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.

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401013 Promoting Mental Health And Wellbeing

401013 Promoting Mental Health And Wellbeing

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401013 Promoting Mental Health And Wellbeing

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401013 Promoting Mental Health And Wellbeing

0 Download11 Pages / 2,633 Words

Course Code: 401013
University: Western Sydney University

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

Country: Australia

Questions
1. Depression and suicide are significant areas of concern in Australia.
a) Investigate and outline the incidence of both depression and suicide in Australia. Ensure you address depression and suicide separately.
b) 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. (for example: a particular age; social; employment or cultural group) Ensure your answer demonstrates why these groups are thought to be at risk.
Using current literature and one of the scenarios A or B which you have been provided, answer the following questions:
 
2. Critically discuss 2 factors that may have contributed to the development of the client’s mental health concemsand 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 risk 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 relevant literature.(Note: the interventions should be something that you as a nurse / midwife would undertake directly with your client A referral to another service or health provider is notconsidered a suitable intervention for your work).
 
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 on relevant literature. (Note: the interventions should be something twe:lit/ate Wind( as a nurse / midwife would undertake directly with your client A referral to another service or o to Settings to ac G health provider is notconsidered a suitable intervention for your work). 
Scenario 
You are working as a nurse in an Accident and Emergency department. Jonathon was brought in by ambulance after his father found him semi-conscious at home. Medical examination revealed Jonathon consumed an overdose of over the counter medications. He is now alert and engaging with you. During your discussions with Jonathon, you obtain the following information.
 
Jonathon is a 19 year old man. He lives with his father Dennis, and younger sister, Maria, who is 16 years old. During your discussions with Jonathon, he reported he had a very positive relationship with his father. However. Jonathon has felt more distance from his father since his mum died eleven months ago. His mum was diagnosed with breast cancer 12 months before she died. Since her death, Jonathon reported his dad has been working extra hours to fund family bills. His dad leaves the house at 6-30am and doesn’t return until 7-30pm most week days. His dad also works at least one weekend day. Jonathon is undertaking an electrical training course at the Technical and Further Education (TAFE) institution He is expected to be at work four days a week and at TAFE one day a week. He reports he hasn’t submitted his last two assessments for TAFE, as he has been feeling very tired, with noticeably lower energy for three to four months. Jonathon has called in sick to his work place at least one day a week during the past month. He is becoming increasingly anxious that he may be asked to leave his training course due to non-submission of his assessments and reduced attendance at work. Jonathon has been in a relationship with Leah, a 20 year old female, for one year. They met while both studying at TAFE. Jonathan states that Leah has been distressed during the last month, she feels Jonathon has become increasingly emotionally distant. He admitted that has cancelled their prearranged dates and has not been answering her phone calls.
 
On the night of the overdose, Jonathon and Leah met in the local pub. They had an argument about the status of the relationship. Jonathon had walked home, calling into the bottle shop for some additional beers. He consumed at least six bottles of extra strength beer while at home alone. He reports he became increasingly distressed and agitated at home. He took an impulsive overdose of medications which were in the kitchen cupboard with the aim to kill himself. He is unsure of both the actual medications and the quantity of tablets which he consumed. He states he has been experiencing ruminating thoughts of suicide since his mum died. He thought about going to work early in the morning, to use the electrical equipment to kill himself. The first anniversary of his mum’s death is approaching and he was thinking about suicide on the same date. He misses her terribly. He hasn’t felt able to chat to his dad about his mum as his dad has been busy working. He feels he has let his mum down because he hasn’t been able to cope with her death. He feels like a failure because of reduced attendance at work and non-submission of his assessments. He’s felt over whelmed for the past month, since his girlfriend has been talking about finishing their relationship. At the current time, he states he wants to die.
Answers

1. Depression and suicide are significant areas of concern in Australia.

a. Surveys conducted in the Australian context reveal that common mental disorder is likely to afflict 1 out of 5 persons that account for 20% of the population. Investigation o adult population aged 16-85 years showed that 6% of the population is under the threat of getting affected by depression like affective disorder. Further major depressive disorders are found to be among the common mental disorders prevalent in case of children and adolescents aged 4-17 years with an incidence rate of 3% that showed an increase from 2.1% to 3.2%. The data depicts that depression serves as a crucial driver of both disability and morbidity in the population in addition to further accentuating the chances of occurrence of physical ailment as a co-morbid disorder (Mhsa.aihw.gov.au, 2017).

Report furnished for the year 2015 revealed suicide as the 13th leading cause of death in Australia that further showed an increased preponderance when compared with past data. For the year 2015, 12.6 deaths per 100,000 persons were reported as standardized death rate for suicide. Data further suggested that percentage of collective suicide deaths in Australia for the year 2015 was 73.2% evident in case of the most populous states of Victoria, New South Wales and Queensland. Deeper probe on the matter showed that for people belonging to the age bracket of 15-24 years and for those aged 25-34 years, suicide amounted to 33.9% and 27.7% respectively. As part of the recorded death rates due to intentional self-harm, leading cause of death in people aged 15-44 years as well as in children between 5-17 years of age was attributed to suicide while among those belonging to the age group of 45-54 years it was identified as the second vital cause of death. Males were recognized to be potentially more vulnerable to face deaths due to intentional self harm in comparison to the females, approximately three times greater than that for females (Abs.gov.au, 2017).

b. Extensive research carried out with respect to the prevalence of depression among the Australians brought to the forefront the state of extremely risky community of Aboriginals and Torres Strait Islanders who owing to their linguistically and culturally diverse background are under the threat of encountering depressive symptoms. Studies conducted on this community have revealed that impact of trauma in this vulnerable population at young age predisposes them to face the difficulties because of depression in later life. Moreover, social and emotional wellbeing have been found to be limited by factors such as social exclusion, racism and social inequality. Excessive stress due to discriminating attitude in terms of provision of healthcare and other resources also predispose them to experience depressive symptoms. Placement in public housing coupled with other factors pertaining to poor rating of both own as well as child’s health, difficult financial condition and single status also posed threat to this specific community to suffer from post natal depression and other mental health disorders (Parker & Milroy, 2014).
Assessments for risk of suicide among the Australians suggest that the young adults who encompass a bulk of the population are under the threat of getting affected by suicidal incidences. The risk of suicide in the vulnerable youth population has been evaluated in study through assessment of the impact of involuntary job loss on suicide and attempted suicide in the young adults. Findings of the study after careful analysis and adjustments made with respect to variables such as socio-economic status, marital status and diagnosis entailing an affective or anxiety disorder highlighted important issues. It displayed that involuntary job loss that lead to unemployment accounted for increased odds of suicide or attempted suicide in the concerned population of young adults belonging to the age group of 18-34 years (Milner et al., 2014).
Scenario A
2. The case scenario depicted that the client’s mental health condition and risks might have originated from a plethora of factors that are intimately associated with one another. It has been stated that Jonathan, a 19 years old youth has tried to end his life following consumption of overdose of over the counter medications. However, the causes of such actions have been found to be deep-rooted on detailed discussions with the client. In this connection, two factors may be recognized as crucial determinants that might have lead to the condition. Firstly, death of his mother 11 months ago has exerted a major influence in his life as he was unable to cope up with this unexpected loss and has expressed of missing her terribly. Relevant literature revealed that unexpected death of loved one is related to elevated risk for onset of mental health disorder in the concerned individual (Keyes et al., 2014). Jonathan has been found to experience this and inability to cope up with the sudden loss predisposed him to suffer from depression like mental health disorder that finally culminated in his attempt to suicide. Further emotional detachment from his father in the period following his mother’s death, also influenced his behavior considerably as he was not in a position to share his feelings because of paucity of time on the part of his father because of active engagements to work even on a day in the weekend. Personal crisis in relationships and mental turmoil also thwarted him thereby increasing chances of encountering depressive symptoms. He could not vent out his anger, emotions and neither was ready to share his concerns with his loved ones and family. Distance with his father apart from sudden loss of his mother might have created a void that was not immediately repairable thereby leading to adverse outcomes in mental health. Research has shown that supportive relationships with family have the potential to mitigate and prevent development of depression and anxiety particularly in the vulnerable population of youth thereby increasing their resiliency to combat mental health issues (Reivich et al., 2013). Dearth of this paternal guidance and emotional support following mother’s death in case of Jonathan might have resulted in the onset of depressive symptoms that ultimately lead to the causation of suicidal tendency.

3. The situation relevant to Jonathan as represented in the case study exhibits threats of certain risks that might thwart the existence of the individual. It has been stated in course of the case study that Jonathan suffered a major setback following the premature death of his mother that further reflected in his performance at workplace. Consecutive detachment with his father due to his heavy work schedule also put him under stress. Reduced attendance in workplace in addition to non-submission of allotted assignments for the electrical training course at the Technical and Further Education (TAFE) institution further de-motivated him and increased his propensity to suffer from depressive symptoms and other mental health issues. Therefore, in order to combat the risk factors associated with his condition compliance to certain ethical principles is indispensable. Interventions applied in this case must resort to the fundamental bioethics principles such as beneficence and non-malfeasance. The healthcare professionals by means of conforming to the virtue of beneficence must take actions in the best interest of the client. The practitioner must stringently follow ethical considerations so that the best available practice is followed in order to mitigate issues relevant to the client for harboring positive outcomes. Welfare of the affected person must be emphasized in the process (Beauchamp, 2016). Moreover, it has been recommended as part of the bioethical principles that efforts must be undertaken so that no harm is caused to the patient on account of following the principle of non-malfeasance. Infliction of minimum or no harm should be directed through healthcare service delivery and informed choice decisions thereby ameliorating chances of intentional harm to the patient. Thus, conformity with this virtue will ensure optimum outcomes for the client (Tepper, 2017). Both these virtues are to be maintained and attended to for Jonathan by the nurses and practitioners so that optimum care may be directed to the patient with sufficient scopes for improvement with reduced risk for adverse results.

Treatment modalities with respect to the case as seen in case of Jonathan must be addressed properly. Provision of adequate care and treatment must be ensured for the mentally ill patient Jonathan in compliance with the existing Mental Health Act 2007 thereby facilitating the recovery process. Other provision of community care facilities alongside appropriate hospital care facilities must be rendered effectively. Access to proper care must be done in alliance with protection of the civil rights of the person. Moreover, decision making processes must include the participation of the persons who are responsible for caring for the client so that the recovery is accelerated and positive benefits may be procured from such engagements. Prior to administering medications or any other invasive methods for assessment of his clinical condition, necessary consent and approval must be sought from his family members. These people will be responsible for taking decision on his behalf because of his non-allegiance and diminished state of mind. Informed consent rather than verbal approval must be encouraged to document the family members’ willingness and passage of rights to continue with the therapeutic interventions meant for Jonathan in a legally acceptable manner (Legislation.nsw.gov.au, 2017). For Jonathan, his near family comprising of his father and sister must be allowed to take part in decision making to foster improved care. Therefore, careful attention to these aspects of the Act relevant to the areas of risk will ensure optimum care and treatment for the concerned client in the case study.

4. Jonathan in accordance with the proceedings of the case study showed high degree of risk to commit suicide and inflict self-harm. Thus, in order to abate this high-risk behavior of attempt to suicide, the nurses may resort to suitable intervention strategies. As a psychiatric nurse, it is crucial to cater to development and maintenance of a collaborative, therapeutic relationship with the client might offer help to the distressed patient who is susceptible to resort to suicidal tendency. Appropriate recording and documentation in determining the priority of care through clinical reasoning, support and judgment will enable in abiding by the standards of care to render safety and evidence based practice in managing the patient situation. Evidence based interventions to combat suicidal tendencies through nursing focus will thus elicit good responses (Hadlaczky et al., 2014). Once the client will accept the therapeutic association with the psychiatric nurse, it will be easier to gain the therapeutic benefits out of the applied interventions. Further, counseling of the family members for the sake of restricting the unauthorized access to potent lethal prescription medications might be an effective intervention for the client. For Jonathan, his father may be informed about his present condition and made aware about the potential risk factors that thwart his mental state due to predisposition to suicidal tendency. Recruitment of family members will harbor positive outcomes for Jonathan as he will spend most of his time with them and therefore assessing change in his immediate behaviors will be easier for them. As per the National practice standards for the mental health workforce 2013, Standard 2 states working with people, families and caregivers through adoption of recovery-focused techniques (Health.gov.au, 2017). This may be applicable in this particular case indicating positive outcomes. Hence, evidence based nursing interventions in addition to incorporation of family members may thus be indicative of reliving the suicidal burden in the concerned person, Jonathan.

5. The mental health need or problem that may be recognized in course of the case study is that of depression. Interventions that cater to mitigation of this problem must acknowledge the acceptance and awareness pertaining to self-promoting positive concept of self through identification of strengths and prudent objectives that are indicative of recovery from depression. Encouragement must be given for the client to verbalize his feelings, worries and resentments through open-ended questions and thorough discussions. Exhibition of empathy for the client will enable him to open up and share his concerns that will further aid in the recovery process and in combating the depressive symptoms. Moral support and appraisal of his strength will boost up the confidence and morale of the patient thereby aiding in quicker recovery. Depression being a legitimate illness must not be ignored and adequate attention and prompt intervention through support and encouragement must be given so that the affected person seeks necessary medical assistance to successfully combat the situation. Timely referral to psychiatrist will ensure that the patient is receiving the most suitable therapy to do away with the depressive symptom (Fortinash & Worret, 2014). Further, behavioral modifications through cognitive behavioral therapy (CBT) that serves as a noble approach in the form of psychotherapy to combat the negative patterns of perception regarding self and paraphernalia for treating depression like mood disorders. Risks for self-directed violence, impaired social interaction, disturbed perceptions, and low self-esteem may be effectively addressed by CBT approach whereby psychological needs and promotion of health and wellness may be further promoted. Adaptive responses are sharpened through CBT is capable of triggering emotional arousal and subsequent processing (Greenberg, 2017). Jonathan is likely to be benefited by this approach ad improved symptoms may be reflected in his personal relationship status as well as improvement in his workplace behavior and attitude. Further thoughts of suicidal tendencies may be effectively mitigated by catering to the depressive symptoms that may further lead to adverse outcomes in the client. Unwanted behavior patterns might be well tackled through employment of this CBT nursing intervention. Thus, timely referral to psychiatrist through insight and prudence apart from adopting the CBT approach may be considered as the relevant interventions in this case.
References
Abs.gov.au. (2017). 3303.0 – Causes of Death, Australia, 2015. Abs.gov.au. Retrieved 3 August 2017, from https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0~2015~Main%20Features~Intentional%20self-harm:%20key%20characteristics~8
Beauchamp, T. L. (2016). Principlism in Bioethics. In Bioethical Decision Making and Argumentation (pp. 1-16). Springer International Publishing.
Fortinash, K. M., & Worret, P. A. H. (2014). Psychiatric Mental Health Nursing-E-Book. Elsevier Health Sciences.
Greenberg, L. S. (2017). Emotion-focused therapy of depression. Person-Centered & Experiential Psychotherapies, 1-12.
Hadlaczky, G., Hökby, S., Mkrtchian, A., Carli, V., & Wasserman, D. (2014). Mental Health First Aid is an effective public health intervention for improving knowledge, attitudes, and behaviour: A meta-analysis. International Review of Psychiatry, 26(4), 467-475.
Health.gov.au. (2017). National practice standards for the mental health workforce 2013. Health.gov.au. Retrieved 3 August 2017, from https://www.health.gov.au/internet/main/publishing.nsf/content/5D7909E82304E6D2CA257C430004E877/$File/wkstd13.pdf
Keyes, K. M., Pratt, C., Galea, S., McLaughlin, K. A., Koenen, K. C., & Shear, M. K. (2014). The burden of loss: unexpected death of a loved one and psychiatric disorders across the life course in a national study. American Journal of Psychiatry, 171(8), 864-871.
Legislation.nsw.gov.au. (2017). Mental Health Act 2007 No 8. Legislation.nsw.gov.au. Retrieved 3 August 2017, from https://www.legislation.nsw.gov.au/acts/2007-8.pdf
Mhsa.aihw.gov.au. (2017). Prevalence, impact and burden. Mhsa.aihw.gov.au. Retrieved 3 August 2017, from https://mhsa.aihw.gov.au/background/prevalance/
Milner, A., Page, A., Morrell, S., Hobbs, C., Carter, G., Dudley, M., … & Taylor, R. (2014). The effects of involuntary job loss on suicide and suicide attempts among young adults: Evidence from a matched case–control study. Australian & New Zealand Journal of Psychiatry, 48(4), 333-340.
Parker, R., & Milroy, H. (2014). Aboriginal and Torres Strait Islander mental health: an overview. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice, 2, 25-38.
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 US.
Tepper, J. E. (2017). Ethics in Clinical Care. International Journal of Radiation Oncology Biology Physics.

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