Developing Mental Health Scenario for Kathy - Assignment Example

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Mental Health Case Analysis Table of Contents Introduction …...................................................................................................3 Public Health and Mental Health as a Tool to the Issues......................................4 Diagnosis of Kathy's Problems.............................................................................7 History …..................................................................................................7 Symptoms..................................................................................................8 Signs..........................................................................................................8 Formulation of Intervention Strategy....................................................................9 Implementation and Interprofessional Elements of the Treatment.......................10 Evaluation and Monitoring of Solutions...............................................................11 Conclusion............................................................................................................12 References.............................................................................................................13 Appendix 1............................................................................................................15 Introduction This paper is based on a mental health scenario involving a patient, Kathy. In the scenario, it is apparent that Kathy is going through a mental health crises that has caused her to resort to the following circumstances: 1. Disruptions in her family life 2. Disruptions in her work life 3. Emotional problems 4. Alcohol abuse 5. Social isolationism. These issues culminated after a series of incidents that occurred to her. She recently lost her mother and prior to her passing, she could not reconcile her differences with her. Due to this, she died without them making any substantial peace. This led to a serious depression which has created the effects listed in 1 to 5 above. This research attempts to diagnose Kathy's problems and prescribe a solution to it based on the framework of public health and mental health. In doing this, the following objectives will be addressed: 1. A critical review of literature relating to public health and mental health relevant to the issues at hand. 2. A discussion on how to diagnose and assess Kathy's problem based on the principles of mental and public health. 3. Formulation of a strategy to help Kathy to overcome her challenges. 4. Evaluation of the strategy and the interprofessional elements involved in solving Kathy's problems. Public Health and Mental Health as a Tool to the Issues The definition of the scope of mental health is not very simple (Simpson, 2009 p3). This is because mental health is something that comes as an abstract form of medical conditions. Its scope spans from behavioural disorders to mental functions as well as other emotional conditions (Tengland, 2001 p1). Due to this, it typically involves the work of numerous health professionals and has always been a kind of 'joint' discipline with numerous players. The responsibility for mental health and in a public health context revolves around psychologists, physicians/nurses/hospital staff and sociologists. Sociologists might be interested in the effect of a mental health situation on the wider society. The case under review, it is apparent that the mental health challenges of Kathy is affecting not only her as an individual, but her immediate family: her children, husband and her work as well as the wider society. As such, mental health is an issue that concerns sociologists and they have an interest in studying it to identify its scope and effect in order to provide the best framework to contain it. Psychologists have the technical responsibility of dealing with mental health cases. They have to tools and resources necessary to diagnose and deal with the mental related cases. Additionally, doctors often deal with complications related to mental health disorders. In spite of the difficulty in defining mental health as a discipline, the problems and challenges of mental health is more widespread than most people think. According to the Department of Health website, one in four adults experience mental illness at some point in their lives. This means that the occurrence of mental health is more pronounced than most people thought. Additionally, the DOH website indicates that at every point in time, one in six people have some mental disorders that they need to deal with. This means that between 12% and 20% of people have to battle with mental health problems at every point in time in the United Kingdom. This ranges from depression to other forms of mental challenges that comes in various degrees of severity. The scope of nursing cuts across all these professions. As such, the role of nurses in mental health situations and cases are important and crucial. In defining the duties of mental health nurses, Barry and Jenkins (2007) state that there is the need for three main components of mental health solutions in medical facilities. They include: 1. Programme development based on underpinning theories, research into the principles of efficacy and needs assessment. This refers to a situation where medical and research institutions will develop conscious efforts for maintaining mental health units where research will be conducted into new elements of mental health. This will also include the acquisition of more knowledge into situations that will improve the body of knowledge and systems that exist in mental health. 2. Focus on programme planning, implementation and evaluation. This involves the creation of specific interventions and systems that will provide practical solutions in medical outlets to people who need them. This ensures that efficient mental health units are running in medical facilities with practical solutions to cases that people suffer. 3. Address a range of protective and risk functions. Under this third function, mental health facilities need to use a proactive system to create awareness for the identification of risks and the creation of preventive systems and tools to ensure that mental health cases are dealt with before they get out of hand and become serious issues. In the case of Kathy, there is the need for theories and concepts of mental health to be applied to diagnose her problem and formulate an intervention strategy. As such, she will be better off if she goes to a health facility that has a programme based on underpinning theories of the principles of mental health. Also, a good facility will have to design a programme for her based on the symptoms she has exhibited. This will be based on diagnosis and the formulation of an intervention strategy as well as the implementation of the strategy. Once she is placed on such a programme, she will have to be given the appropriate medication and medical requirements. As she fulfils them, she will be monitored by the mental health facility that took charge of her case. Additionally, when she is treated to a satisfactory level, she will be given other preventive treatments that will identify risks and give room for the early treatment of symptoms that may occur in the future. Depression rates third in mental health cases (Shia, 2009). Nine out of ten depression cases are treated in primary care. This means that nurses are important in treating such cases. Community health nurses therefore need to tackle the issues relating to depression as and when they arise. In the UK, depression affects between 5% and 10% of individuals of all ages, races and cultures (Ballenger et al, 2001). Depression is quite common in the daily lives of people. However it gets acute with distressing life events like job loss, work-related stress, relationship problems, bereavement, pregnancy, childbirth and bullying (Shia, 2009). Shia identifies that there are two main types of depression which are major depressions (which could be mild, moderate or severe) and Dysthymia which is chronic depression that affect people over a long period of time (2009). Depression leads to persistent low moods, loss of pleasure and enjoyment. It leaves the victims feeling sad or tearful. The treatment options include psychotherapy and pharmocological treatments which involve medicine and antidepressants (Blankson, 2007). Diagnosis of Kathy's Problems “The Greek term 'diagnosis' means 'distinguishing' or 'discerning'” (Morrison, 2007 p4). This means that before any intervention can take place, there is the need for a conscious effort to understand the root cause of Kathy's problem. This will lead us to find solutions to her problems and act in a more responsible manner. In diagnosis in mental health care, the trauma situation needs to be examined closely to identify important information about the patient (Palmo et al, 2006 p265). In doing this, there is the need to examine the symptoms, signs and history of the patient (Morrison, 2007). History In the case of Kathy, it can be identified that she had a very normal life in what is more or less an ideal setting for a woman. However, the death of her parents [particularly the recent passing of her mother] seem to have been the root of the traumatic experiences that led to chronic depression. However, prior to the death of her mother, she seem to have had a few issues with her that she could not resolve. This irreconcilable difference seem to have played a role in the depression as there might have been some level of guilt in her actions. Symptoms She is in a period of despair. She seem to have issues integrating to the society and with her immediate family. This indicate that she has a serious emotional situation after the traumatic experience she went through. These mental health challenges make it difficult for her to make any proper progress in her work life. Signs There are apparent signs that make it difficult for her to overcome her differences with her nuclear family, society and work. This is indicated by her despair, sadness, failure to brush her teeth, alcohol abuse as a form of escapism, and her inability to go to work. In order to identify the actual extent of this history, symptoms and signs, it is necessary that she fills out a Patient Health Questionnaire (PHQ – 9) to identify her situation and status so that proper assessment can be made. A version has been created in Appendix 1 below. After filling those questionnaires, there is the need to ensure that each of the data is processed in the following format as prescribed by Jakopac and Patel (2009). 1. Assessment data: The nurse will have to examine the objective and subjective elements of everything that is presented in the PHQ form in conjunction with the history of Kathy. 2. Evidence-based intervention: The nurse will have to draw a framework of interventions based on the information provided in the questionnaire and her history. 3. Rationales: Every intervention should be rationalized and matched with the information given in the assessment data. 4. Patient perspective must be incorporated through a further discussion between the patient and nurse. Objective 4 can be carried out by requesting for information about the prior episodes of the patient's life before the trauma occurred (Sadock et al, 2007). This should include soliciting for information about the patient's cultural beliefs, and what the problems were. In this case, It will be useful to ask about Kathy's relationship with her mother and father. This will give important information about the root cause of the problem that led to her breakdown. Also, information about her cultural and religious belief can be important in deciding the level of guilt that she burdened herself with. This can enable her to get solutions to her problems. After this is done, the assessor will be in the position to identify two main things (Sadock, 2007): 1. Why the breakdown started 2. What were the chief problems Formulation of Intervention Strategy Crises are different from long-term cases in mental health (James, 2008). This is because crises are from one-off events that lead to major issues in the mental health of a patient. On the other hand, long-term incidents include cases that have longstanding histories that get complicated from time to time. As such, it is ideal that the intervention plan focuses on the immediate traumatizing component of the patient's life. The plan should focus on the immediate needs of the patient. In this case, the intervention strategy will be one that will define the main cause of the problem of Kathy. This should include a critical evaluation of the link between Kathy and her mother's death as well as her cultural and social beliefs. This can give way to some important clues that can help to define the cause of her problem. After that, there should be a way of ensuring Kathy's safety. In other words, the questions relating to suicide and other tendencies that could cause her to harm herself or remain opened to harm should be examined critically. If she needs to be admitted at the medical facility, that should occur if her life is in danger. There should be constant and relevant support that will be provided for her. This can be done through psychotherapy or pharmacological prescriptions that will ease her pain through the traumatizing period or where the crises get worse. This should be done after a critical analysis of the facts and an assessment of alternative options. Once these vital steps are completed, the professional team involved in this case should work together to formulate a plan that will ensure the holistic treatment of Kathy at this vital point in time. This should be done in cognisance with her family and work needs (Truglio-Londrigan and Leweson, 2011) to ensure that she recovers fully and resumes normal life fairly easily. Another approach presented by Segal et al (2010) should be one that will eliminate stressors and modify her physical and social environment. However this approach is quite limited because Kathy's case is very serious and she has broken down totally. However, this could be integrated into the recovery plan after she regains some level of normalcy. Implementation and Interprofessional Elements of the Treatment Clearly, this case is one that involves a lot of several personnel who might need to work together to attain optimum results. Ideally, I foresee that there are three main experts that will be needed to get this case solved fully. First of all, there is the need for a psychologist to be involved. This is because the psychologist can best administer the PHQ and do the relevant analysis. Also, a psychologist will be best in providing the important feedback and psychotherapy structure for Kathy to regain her past life fully. Secondly, a physician will be needed in the administering of relevant drugs. This is because the doctor will know the right dosage for antidepressants and other drugs that she will need to take without getting complications. As such, her case history would need to be forwarded to a doctor to examine her and prescribe the right dosage of drugs for her. Thirdly, in a very ideal medical setting, there would be the need for the psychologist to consult a social worker. The social worker can conduct further investigations and provide important explanations of the root cause of the problem. This can be done by examining the social and religious belief system that Kathy subscribes to. Through this, her case can be understood better. Also, the sociologist can help in Kathy's reintegration into society after suffering this setback. Evaluation and Monitoring of Solutions Once a required pathway for her treatment is attained, she must be evaluated regularly. The psychologist in charge of her case will have to examine her from time to time and ask about her progress. In this process, there might be the need for new questionnaires to track her progress and other important requirements (Blazer, 1998). This will provide information about whether things are working well or not. In case things are not right, there could be an alteration of her treatment so that she can be integrated fully into the society and get her past life back. Conclusion Kathy's case requires a high degree of structured care in a medical facility or system. As such, there is the need for careful diagnosis of her case through an appropriate Patient Health Questionnaire. This should be complemented with important information about her background and an enquiry into her past life. With such information an intervention strategy could be formulated which will give her an opportunity to regain her past life. The case will require interprofessional collaboration between a psychologist, medical doctor and sociologist. This will enable her case to be diagnosed well and allow for the proper combination of psychotherapy and pharmacological dosage. Kathy's case needs to be examined regularly so that improvements and changes can be made to the initial treatment system employed. References Ballenger, J. C, Davidson, J. R. T. and Lecrubier, T (2001) “Conscious Statement in Transcultural Issues in Depression and Anxiety from International Consensus Group or Depression and Anxiety” J. Clin Psych. 62 (Suppl. 13) 47 – 53 Barry, M and Jenkins R. (2007) Implementing Mental Health Promotion London: Elsevier Blankson, M. (2007) Depression and Mental Health New York: Dickson Science Publishing. Blazer, D. (1998) Emotional Problems in Later Life: Intervention Strategies for Professional Caregivers 2nd Edition New York: Springer. Department of Health (2011) Mental Health [Online] Available at http://www.dh.gov.uk/health/category/policy-areas/social-care/mental-health/ Accessed: 6th June, 2012. James, R. K. (2008) Crises Intervention Strategies Mason, OH: Cengage Jakopac, K. A, and Patel, S. (2009) Psychiatric Mental Health Case Studies and Care Plans Surrey: Jones and Bartlett Publishing. Merrell, K. W. (2008) Helping Students Overcome Depression and Anxiety: A Practical Guide. London: Guilford Press. Morrison, J. R. (2007) Diagnosis Made Easier: Principles and Techniques for Mental Health Clinicians London: Guilford Press. Palmo, A. J., Weilal, W. J. and Borsos, D. (2006) Foundations of Mental Health Counselling Charles C. Thomas Publishers Sadock, B. J., Kaplan, H. I and Sadock, V. A. (2007) Kaplan and Sadock's Synopsis of Psychiatry Amsterdam: Lippincott Williams & Wilkins Publishing. Segal, D. L, Qualls, S. H. and Smyer M. A. (2010) Ageing and Mental Health Hoboken, NJ: John Wiley & Sons. Shia, N. (2009) “The Role of Community Nurses in the Management of Depression” Nurse Prescribing Vol 7 Number 12. Simpson, J (2009) Mental Health and Allied Sciences Hoboken, NJ: John Wiley and Sons.s Tengland, P. A. (2001) Mental Health A Philosophical Analysis London Springer. Truglio-Londrigan, M and Leweson, S (2011) Public Health Nursing: Practicing Population- based Care Surrey: Jones & Bartlett Publishing. Appendix 1 Personal Health Questionnaire (PHQ – 9) Dear Kathy, We will be very grateful if you could take a short time to fill out the questionnaire below. This questionnaire is meant to keep track of your emotional and mental position in the last two months. This will be a very important tool for the assessment and diagnosis of your situation so that we can work together to provide a lasting solution to your current situation. Please tick the section that is applicable Question Not At All Several Days More than half of the time Nearly Everyday Has your interest and pleasure in doing things diminished? Do you feel down and hopeless? Are you able to sleep as you used to? Has there been changes in your eating habits? Do you sometimes feel tired, weak and drained? Do you feel guilty in any way? Do you feel suicidal? Do you feel anxiety? Do you get nightmares and bad dreams when you sleep? Do you feel or hear things that are similar to hallucinations and visions Read More