HLST259 Mental Health Nursing


You are to write a care study (essay). This can be based on either one of the scenarios provided or you may select a patient(s) of interest from your practice experience and relevant to your field of practice.  The essay will draw upon relevant theoretical concepts supporting the shared decision making process in the assessment planning and interventions to meet the patient’s / client’s needs. You will include a critical review of the patient’s complex needs using a bio-psychosocial perspective and demonstrate how effective shared decision making may prevent deterioration/crisis, enhance coping and/or recovery or contribute to good end of life care. You will consider the nurse’s role where dependency levels change and where there needs to be care escalation, referring to the use of appropriate assessment skills to identify risk.  In evaluating the planning and delivery of nursing care (including therapeutic interventions) you will need to discriminate between the research evidence available to support the care proposed. A systematic approach in assessment and care delivery must be evident with reference to national and /or professional guidelines to support shared decisions.

Service user:

James is 28 years old and has a diagnosis of Bipolar Affective Disorder.

Present Situation:

James has been placed on a Section 136 and is in the local mental health unit place of safety. Police had been called to the local park at approx. 4pm by members of the public expressing concerns that a man was upsetting children who were using the paddling pool. On arrival police found James lying down near the paddling pool, waving his arms, shouting and screaming. James was only wearing long shorts, and was noticeably sunburnt.  James recognised one of the police officers from a previous encounter and reluctantly talked to the officers.  The police were concerned for James’ wellbeing and felt he warranted further assessment therefore placed him on Section 136.  On route to the mental health unit James continued to shout and made several attempts to leave the police van whilst the vehicle was in motion, claiming he was invincible.

Psychiatric History:

James has an 8 year history of Bipolar Disorder I. He has had numerous admissions, the majority under the Mental Health Act when he has been extremely manic, grandiose and behaviours such as excessive spending, leaving the house naked, painting the outside of the flat in the early hours of the morning.  James has been under the care of the CMHT Recovery team for the last 3 years since his last admission.  James has a history of non-compliance with medication usually as a result of psychosocial stressors.

Personal and social history:

James is the eldest of 3 boys. His youngest brother, aged 20, has a diagnosis of Asperger’s. His middle brother is married, has a 6 year old daughter, and lives locally. James sees his brothers regularly and dotes on his niece.  James’s father is 52 and also lives locally. James’ mother died of breast cancer 8 years ago. James has Sunday lunch with his father every week.

James finished school with 3 A Levels and had begun studying Medicine when he first became ill. Unfortunately, James was not able to return to university and complete his studies.  James has been looking for work and has been offered temporary unskilled work, James feels frustrated by not having a career.

Medical History:

Appendectomy at 8 years old

James does not smoke or drink alcohol.


Lithium 600mg BD


At the Mental Health Unit James is assessed by the duty psychiatrist and senior nurse. James is noticeably calmer in the mental health unit compared to the police van. He makes no attempts to leave and is very happy to see a doctor he recognises.

During the assessment James insists he has taken his lithium and states his prescription is due next week. In the property bag provided by the police there is a medication box with 10x 600mg capsules remaining, multiple receipts and a credit card in a travelcard wallet, and a mobile phone, which James immediately retrieves when he sees it.

James is noticeably sunburnt and complains of a headache. He reports to have had persistent headaches for the last month. He does drink the water offered to him and requests more. James refuses for his temperature to be taken but agrees for his BP and pulse to be done.

Pulse: 80bpm   BP: 145/85

As the assessment progresses James becomes more irritable, frustrated by the questions and wants to leave. He maintains the only problem he has is the persistent headaches.  He makes several attempts to call his brother on his mobile but only gets the answer machine. James is overheard leaving a message saying “they are at it again”, “the police are colluding with the Drs again”, “why are they doing this to me, don’t they know who I am”.

Get a 10 % discount on an order above $ 100
Use the following coupon code :
Open chat
Hello, you can now chat with our live agent via WhatsApp +1 (347) 428-6774
Our professional nursing writers will work on your paper from scratch.
We guarantee a plagiarism-free custom-written nursing paper.