Analysing The Mental Health Status Of The Client And Identifying Related Factors

Mental State Examination and DSM V in relation to client’s mental health status

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.

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.

Identifying two contributing factors using the stress-vulnerability model

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).

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.

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