Mental Disorder and Mental Capacity - Case Study Example

Mental Disorder and Mental Capa A Person with Learning Disability Mental Disorder and Mental Capa A Person with LearningDisability Introduction Mental health refers to emotional and cognitive wellbeing i.e. how we feel, think and behave. Therefore, mental health can be used to mean an absence of mental disorder. Mental disorder, also known as mental illness is commonly misunderstood by many people. However, according to Alexander and Link (2003), it is human nature to fear anything that we do not understand; thus, mental disorder is surrounded by a lot of stigmas. This also applies to mental capacity, which refers to the degree of memory and understanding of a person to differentiate between right from wrong i.e. mental ability (Thornicroft and Szmukler, 2001). For this reason, statutory legislation regarding mental health such as the Mental Health Act 1983 and the Mental Capacity Act 2005 have been set in order to protect individuals with mental disorder and mental capacity respectively. Therefore, this paper will critically analyze the models of mental disorder and mental capacity, the Mental Capacity Act 2005, Mental Health Act 1983, as well as the related code of Practices. Also, it will include the practice and policy context of working with people with mental disorder and who lack mental capacity, their diagnoses and how these issues relate to the case study. Background information Forty eight year old Sarah has a moderate learning disability and limited communication skill. She is in a community home, where she has lived happily for 15 years. Recently, the care team in the home considered about her behaviour, which appears to be extremely ‘obsessional’. For instance, she spends up to an hour folding her clothes in her wardrobe, and she closes doors exceedingly slowly, and if she is interrupted, she becomes terribly upset. The staff referred Sarah to the psychiatrist within the local community learning disability team. Sarah attended an outpatient appointment, accompanied by her key worker. The psychiatrist suggested that as Sarah has been previously diagnosed with autism; thus, it is necessary for her to have routine behavior, which would account for her activities. The care givers responsible for Sarah took her room; 2 months later, they referred Sarah once more to the team as her behaviors had increased in frequency and duration. The previous psychiatrist had since left the service, and Sarah was seen by another doctor, her opinion was different, and she diagnosed her with obsessional, compulsive disorder (OCD). She was then prescribed the appropriate medication (normally, an anti-depressant) and asked to return in 6 weeks. By the time, of the next appointment, Sarah’s behaviors had totally disappeared, and the prescribed medication was the only intervention required. Models of Mental Disorder In order to understand all the factors that have an impact on a mental disorder and how they interact in each case, it is necessary to form a model that explains the cause, as well as predicts the best treatment for the disorder (Falconer, 2007). For instance, the biological model of mental disorder contains different theories in which one state that mental disorder differs from physical illness that is caused by physical factors and requires physical treatments. Additionally, other biological models state that mental disorder is caused by genetic factors, chemicals mainly the neurotransmitter, or by hormonal imbalances in the body. For this reason, the most appropriate biological intervention involves treatment with drugs that aim at reversing the chemical imbalance. Thus, according to this model, Sara’s condition could have been caused mainly by genetic factors or other causes such as agents that cause birth defects and childhood immunizations (World Health Organization, 2005). Another model of mental disorder is the social model, which consists of two theories. The first theory is known as the theory of Labeling, which states that most behaviors that are disliked by the society are considered as symptoms of a psychiatrist illness (Institute of Medicine, 2001). This causes a person to think that they have a mental disorder and lose their social status such as jobs. Thus, based on this theory, use of medication is not essential since the problem of mental disorder is defined by what the society considers as normal behavior. The second theory as speculated by Kessler et al. (2005) states that social situations can lead to mental disorders. For example, social situations such as poverty can lead situations that a person cannot control; thus, cause anxiety. Also, this theory does not require the use of medication because the main cause of the problem is the situation that a person was placed in by the society. Thus, Sarah may have been labeled autistic due to her obsessive behavior that the society classified as abnormal. Moreover, the medical model focuses mainly on certain areas mostly those that have substantial consensus among humans as to what constitutes a problem, which reflects various situations involving absolute cause-effect relationships (Gilbody, 2004). Other mental disorder models include psychological models, behavioral and psychodynamic approaches and the Bio-social models that consider environmental factors, as well as the individual stress tolerance levels. Mental Disorder and Diagnosis According to Institute of Medicine (2001), one in four people experience an episode of mental disorder during their lifetime, but the treatment varies and still remains wide between the need for and receipt of the necessary services. In Europe, mental disorder accounts for about 20 percent of the total disability burden, but get much lower proportions of the total health expenditure, which is usually below five percent (World Mental Health Survey Consortium, 2004). Moreover, Falconer (2007) argues that women are more prone to mental illness due to their role in the society than men, who the distractions provided by work opportunities since they are always away from home for work. Thus, legislation regarding people’s mental health has been set as intervention measures in order to ensure that they receive the appropriate treatment. For instance, the Medical Health Act (MHA) 1983, which was amended, in 2007 sets the rules of working with people with mental disorder, and it is normally used when patients are a risk to other people and themselves. When diagnosing people with mental disorder, there are various steps that should be followed. First the psychiatrist should obtain the full history of the patient, as well as all the relevant facts of the condition presented. Thus, a detailed and general medical examination focusing on the symptoms and signs should be carried out (World Health Organization, 2005). Moreover, it is recommended that the psychiatrist performs a neurological examination in order to obtain a clear understanding of the wellbeing of the patient’s brain, nerves, muscles and mental function. Department of Health (2003) states that neurological examination is a tool that physicians use to identify psychiatric and structural abnormality. However, the first psychiatrist who examined Sarah did not conduct a thorough neurological examination on her. Thus, he failed to identify the correct psychiatric and structural abnormality associate with Sarah’s condition of being obsessional. As stated above, the psychiatrist suggested that as Sarah had been previously diagnosed with autism and that is why she exhibited her behavior, which accounted for her activities, but 2 months later, her behaviours had increased. Nevertheless, the second doctor was able to identify Sarah’s condition after identifying the symptoms and signs associated with Obsessive Compulsive Disorder (OCD). OCD is a mental disorder that is associated with compulsive behavior and obsessive thoughts just like Sarah was experienced. The best way to deal with OCD is to seek treatment because if left untreated, its symptoms get worse and can last for up to 30 years. Treatment can reduce the severity of OCD although complete treatment is highly achievable. Normally, psychotherapy called cognitive, behavioural therapy is the best treatment for OCD, and can be combined with antidepressants, to achieve success (Commission of the European Communities, 2004). Mental Capacity Mental capacity refers to the degree of memory and understanding of a person to differentiate between right from wrong i.e. mental ability (Gilbody, 2004). This is stated under the Mental Capacity Act 2005 legislation, which is the quite significant to individuals who lack mental capacity. There are various reasons why a person may experience a lack of mental capacity such as stroke, dementia, a mental health problem, a learning disability, and substance abuse, among others. MCA enables people to make their own decisions, protect people who lack capacity, and ensure that they participate highly in all decisions that are made on their behalf. Additionally, the MCA allows people to plan ahead for future in case they cannot make their own decisions later in life. According to Fryers, Melzer and Jenkins (2003), the MCA requires a lot of support from the practical guidance, as well as the code of Practice, which gives examples to the best practitioners and cares. Moreover, it introduces the principle of that an act done has to benefit the patient, which includes both formal and informal interventions (Bebbington, 1990). However, the first psychiatrist made a decision that was not in her best interest. This is probably because Sarah was unable to make her own decision regarding her condition since she had a moderate learning disability, as well as limited communication skills. Thus, her capacity could not be determined due to her inability to communicate well with the psychiatrist. Conclusion Disability Rights Commission (2006) argues that mental disorder is highly influenced by both biological and social factors. For this reason, the biological and social models of mental illness have shown to be significant for some people. Moreover, the medical model focuses mainly on certain areas, which reflects various situations involving absolute cause-effect relationships (Atkinson, Garner and Gilmour, 2004). Therefore, legislation regarding people’s mental health has been set as intervention measures in order to ensure that people receive the appropriate treatment. For example, the Mental Health Act (MHA) 1983, which was amended, in 2007 sets the rules of working with people with mental disorder, and it is normally used when patients are a risk to other people and themselves. The Mental Capacity 2005 as stated earlier protects people who lack capacity and helps them to make decisions, and allows people to plan ahead for future in case they are unable to make decisions later in life. Bibliography Alexander, L.A. & Link, B.G. (2003). The impact of contact on stigmatizing attitudes towards people with mental illness, Journal of Mental Health, 12(3): 271–90. Atkinson, J.M., Garner, M.C. and Gilmour, W.H (2004). 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