401013 Promoting Mental Health And Wellbeing 1

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? 

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.