Discuss about the Mental Health Case Scenario.
Mental disorder is one of the most common illnesses that affect people in Australia. Mental illnesses cause socio-psychological changes that alter the behavior, emotion and moods of individuals suffering from mental illnesses. Nonetheless, mental illness can be addressed if measures are taken to examine the patient to ascertain the conditions before diagnosing and providing management and treatment interventions. This paper presents an in-depth analysis of mental illnesses in Australia. It alludes to a case scenario of a 24-year old Derby-based Fred Robinson to analyze the applications of Mental Health Act 2014 in the assessment, management, and treatment of serious mental illnesses.
Fred has a serious mental problem that requires an attentive care at the Approved Hospital. A medical examination carried on him revealed that he has psychological and social challenges that require redress. In the first place, the patient is so violent. He demonstrated his aggression when he refused to be interrogated by the police officers and went ahead to shout at them and attempted to punch them (Bradley, Townsend & Eburn, 2015). This is a clear proof that Fred is so violent and can be dangerous to the health care providers, carers and himself.
When it comes to social challenges, Fred has been observed to be detached from the rest of the society. Apart from hearing imaginary voices, Fred has been displaying a series of antisocial behaviors such as isolation, over-activity, restlessness, and muttering at himself. These are serious issues that need an attention of a psychiatrist because if left unchecked, can be so disastrous to Fred’s life and that of others around him (Kidd, Kenny & McKinstry, 2015). Psychiatric intervention is necessary because it will help the patient to manage his condition and regain his normal mental health. Fred therefore deserved an individualized patient-centered quality psychiatric care because it will not help him, but guarantee the safety of other people that might be victimized by his mental illness.
The Mental Health Act which was enacted in the year 2014 is a legislation that reformed mental health in Australia by acknowledging the contribution of the mentally-ill patients and putting them at the center of the care, recovery and treatment process. As a patient diagnosed with a mental illness, Fred deserves a quality mental health care. To do so, the healthcare providers are mandated to apply the principles of the Mental Health Act 2014 (Curry, 2016). There are several clauses of the act that suit Fred’s conditions. These are discussed herein:
As clearly stipulated in the Mental Health Act 2014, a patient with mental illness should be involved in the decision-making process. The law requires that the practitioner should not engage in any form of treatment, procedure or interventions without seeking the opinion of the patient. A mentally-ill patient, just like any other patient has a right to be notified of their medical conditions and be actively involved in the making decisions regarding the medical interventions to undergo (Palmer, Chondros, Piper, Callander, Weavell, Godbee & Furler, 2015). This legislation is relevant in Fred’s case. The practitioners should not make any decision without seeking for his opinion. His consent or that of his carers should be gotten by the health care providers.
The other clause that applies in Fred’s case is the one that advocates for the need of delivering quality care for the best interest of the patient. When this legislation is applied, the practitioners should do everything within their capacity to help the patient to improve his conditions so as to eventually regain a full recovery (Harvey, 2015). Therefore, the practitioners should adopt the best alternative when handling the patient. For example, even if it might be necessary to restrain him, minimal force should be used to do so.
Moreover, Fred’s care should be guided by the clause which emphasizes the need of examining the patient at an authorized hospital. The referral of Fred’s case to the authorized hospital was done as per the law. The police officers were right to take Fred to the facility to be given the necessary medical care. So, health care providers at the authorized hospital should not hesitate to receive Fred and accord him the necessary mental care services (Mechanic & Olfson, 2016). Lastly, the practitioners should apply a clause that advocates for the respect of individual rights. Although Fred is in a poor state of mental health, no one should take advantage of his condition to infringe on his rights. Apart from dully informing him on all the proposed treatments to be given to him, the patient should be given a quality care that can ensure his safety at all times.
The Mental State Examination (MSE) refers to an organized way of carrying out an observation, examination and documentation of the behaviors, thoughts and motions of an individual. MSE is a very important tool in the field of psychiatry. It can play a very significant role in guiding the mental health professionals in examining the patients with mental illness. As a mentally-ill patient, Fred requires to have a MSE performed for him (Burckhardt, Manicavasagar, Batterham & Hadzi-Pavlovic, 2016). To do so, the practitioner needs to use a combination of indirect and direct techniques to gather enough information on the patient’s social and biographical data based on direct observations made on psychological tests as well as his symptoms.
As already hinted, the use of MSE cannot be ruled out when serving Fred because it will play an integral role in determining the severity of his mental conditions. His MSE should therefore be captured in a standard format as outlined below:
MSE is essential for Fred because it can help the service providers to acquire reliable information on his behavior, perception, speech, mood, mind, attitude, appearance, judgment, affect, insight, and thought process. This information, if added to the available historical and biographical data from the patient’s psychiatric history, can enable the practitioner to organize for a coherent treatment for Fred. Therefore, before providing any form of treatment to the patient, the practitioner should allocate enough time for MSE (Rosenbaum, Tiedemann, Stanton, Parker, Waterreus, Curtis & Ward, 2015). The examination is crucial because without it, the practitioner cannot get information to rely on while making a choice on the right kind of intervention to give to the patient. It should also be noted that the patient can be diagnosed based on the results of the MSE or through a performance of an appropriate diagnosis test on the patient.
From the results of his MSE, Fred has a serious mental problem. This means that he deserves to be admitted at the authorized hospital because it is the most suitable facility in which he will get the necessary mental health care (Bartlem, Bowman, Bailey, Freund, Wye, Lecathelinais & Wiggers, 2015). However, his admission at the facility will not be a walk in the park because of the myriad of challenges faced as a result of the presence of the patient at the hospital. In other words, Fred is a potential risk because he will pose the following challenges to his health care providers:
Violence: A keener look at the MSE reveals that Fred is an aggressive patient who cannot be easily handled by the health care providers. The way in which he treated the police officers who handed him to the facility shows that he is too violent and cause bodily harm to anyone around him. If he almost punched a scary police officer, what would he do to his unarmed health care providers? Unless due care if taken to restrain him, Fred can attack and injure anyone he comes across (Kidd, Kenny & McKinstry, 2015).
Anger: After the assessment, it was observed that Fred is hot tempered. As a result of his mental illness, Fred has become emotional and gets annoyed so fast. Meaning, he can be easily irritated and be forced to revenge on anyone whom he feels is responsible for his anger (Ogloff, Talevski, Lemphers, Wood & Simmons, 2015). It is not an easy task to handle such an emotional patient because one never knows the potential dangers waiting. This is also an important risk that should be considered when handling the patient.
Defiance: Another risk associated with Fred is that he is a defiant patient who does not heed advice and cannot follow medication instructions given to him. Meaning, he can not comply with the directions given by the health care providers. This is quite unfortunate because it will make it difficult for the health care providers to effectively serve him as they ought to.
Since Fred a potential risk at the facility, its employees and himself, it is incumbent upon the service providers to come up with appropriate management plan for him. This paper thus recommends the following management strategies for Fred:
De-escalation: This is a management strategy in which one makes a good use f verbal and non-verbal communication to handle a patient. Here, one uses a polite language that can personally appeal to the patient to consider cooperating (Brayley, Alston & Rogers, 2015). De-escalation is suitable for dealing with the problem of anger. It does not fuel anger, but prepares the patent to cool down as required.
Restraint: Here, measures are taken to deliberately immobilize the patient and prevent him from getting access to other patients, health care providers or his carers who might be harmed by him. While it is important to note that restart strategy is recommend for violent patients, it should be acknowledged that it can be done manually or mechanically using equipments like restraining belts or hand cuffs (Kidd, Kenny & McKinstry, 2015).
Pro re Nata (p.r.n.): This refers to the use of medications. Medications can be suggested for Fred because they can help in facilitating the redress of his violent acts. Therefore, to do so, the health care provide should choose the most appropriate medicine to use for him.
Conclusion
Indeed, the Mental Health Act 2014 is a noble legislation that does a good job in promoting the delivery of quality mental health care services to all Australians. Since its enactment, the legislation has been playing a significant role in advocating for the rights of the patients with mental illness. For a mentally-ill patient like Fred, the act can be a relief because it helps in laying out a clear framework on how he should be treated. When he was referred to the authorized hospital, Fred was given an opportunity to get mental care regardless of how violent he was. This is a clear proof that a properly conducted MSE is key to a proper identification of the patient’s conditions and management and treatment interventions for a patient with mental illness.
References
Bartlem, K. M., Bowman, J. A., Bailey, J. M., Freund, M., Wye, P. M., Lecathelinais, C., … & Wiggers, J. H. (2015). Chronic disease health risk behaviours amongst people with a mental illness. Australian and New Zealand journal of psychiatry, 0004867415569798.
Bradley, E. J., Townsend, R., & Eburn, M. (2015). Paramedics and ACT mental health legislation. Australasian Journal of Paramedicine, 12(4).
Brayley, J., Alston, A., & Rogers, K. (2015). Legal criteria for involuntary mental health admission: clinician performance in recording grounds for decision. The Medical journal of Australia, 203(8), 334-334.
Burckhardt, R., Manicavasagar, V., Batterham, P. J., & Hadzi-Pavlovic, D. (2016). A randomized controlled trial of strong minds: a school-based mental health program combining acceptance and commitment therapy and positive psychology. Journal of school psychology, 57, 41-52.
Curry, P. (2016). The mental health act 2014 and the right to refuse psychiatric treatment. Brief, 43(5), 8.
Harvey, I. (2015). A person-centred approach to mental health care in NSW. LSJ: Law Society of NSW Journal, 2(9), 90.
Kidd, S., Kenny, A., & McKinstry, C. (2015). The meaning of recovery in a regional mental health service: an action research study. Journal of advanced nursing, 71(1), 181-192.
Kidd, S., Kenny, A., & McKinstry, C. (2015). The meaning of recovery in a regional mental health service: an action research study. Journal of advanced nursing, 71(1), 181-192.
Mechanic, D., & Olfson, M. (2016). The relevance of the Affordable Care Act for improving mental health care. Annual review of clinical psychology, 12, 515-542.
Ogloff, J. R., Talevski, D., Lemphers, A., Wood, M., & Simmons, M. (2015). Co-occurring mental illness, substance use disorders, and antisocial personality disorder among clients of forensic mental health services. Psychiatric rehabilitation journal, 38(1), 16.
Palmer, V. J., Chondros, P., Piper, D., Callander, R., Weavell, W., Godbee, K., … & Furler, J.(2015). The CORE study protocol: a stepped wedge cluster randomised controlled trial to test a co-design technique to optimise psychosocial recovery outcomes for people affected by mental illness in the community mental health setting. BMJ open, 5(3),e006688.
Rosenbaum, S., Tiedemann, A., Stanton, R., Parker, A., Waterreus, A., Curtis, J., & Ward, P. B. (2015). Implementing evidence-based physical activity interventions for people with mental illness: an Australian perspective. Australasian Psychiatry, 1039856215590252.
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