Acute mental illness is a condition that affects the person’s thinking, behavior, emotions and feeling. There are many people who have a mental illness but they don’t want to talk about it. They are treatable easily if the symptoms can be identified early and the patient cooperates with the doctor or the psychiatrist. In this case a teen who is depressed up to that level that she tried to end up her life is interrogated by a psychiatrist. The mental health assessment of the patient is done by using a biopsychosocial approach.
Part 1
Mental health assessment of patients includes an interview, physical examinations, and certain medical tests. Mental health assessment is used to assess the emotional and social wellbeing of the patients. It is designed to diagnose the conditions of a patient’s mental health such as depression, anxiety, suicidal thoughts and psychotic illness (Delaney, et al., 2018). In this case, the patient is admitted to acute care as she tried to end up her life by eating an overdose of certain medicines (Case study. 2014). The doctor refers the patient to a psychiatrist to get an assessment of her mental health. The psychiatrist interviewed the patient personally using a person-to-person collaborative approach and found that patient was in depression for the last few months. The patient told the psychiatrist that the reason for her depression was the people who send her bad messages and misusing her pictures on social media. During the assessment, it was found that the physical health of the patient was good, but her psychosocial health was not good. The patient’s past medical and non-medical history clearly confirmed that she suffered from anxiety over the past few months. The patient is easily affected by the actions of other people and is highly vulnerable to the conditions like self-harming, loneliness, exclusion from participation in societal functions, lack of educational opportunities, sadness and hopelessness, sleeping and eating disorder etc. The patient is only 17 years old pursuing her bachelor of arts. She is good at creative writing as she told to the psychiatrist. She is interested in writing poems, story but from the past few months, she stop writing anything and excluded herself from the social environment. Her family story shows that both her parents are working and his younger brother is in school. On the day when she attempted suicide, there was no body at home, she was alone. The patient doesn’t want to continue her studies as she was hurt by the people in the real and the virtual world. During the assessment her needs, preferences and abilities were identified.
Along with nursing care and support, the contribution of psychiatrist helps in the assessment and treatment of the patient (Evans, et al., 2019). During the interview and observation of the patient her symptoms and signs of conditions and her verbal and non-verbal communication, her medical history and social history were considered. The patient’s future plan and her thinking over the current situation of her life were asked. It was diagnosed that the patient didn’t get the right environment and care from her family, she remains alone so she used to find friends on social media and there also negative things happened. The patient got bad messages and abusing from the people on social media that took her to that point. The patient history explains why most of the time the patient remains in low mood and tired. It was very important to build a rapport with the patient sensitively (Foster, et al., 2019). Daily conversation, psychotherapist sessions and assistance with the patient’s personal care was done. Regular observation to monitor self-neglect for the risk assessment was done. Cognitive stimulation is implied by talking and allowing the patient to discuss her feelings and thoughts and recreational activities like problem solving activities were introduced for encouragement and enhancement of quality of life.
Part 2
Formulation of the problem is very important in the clinical practice and can be defined as a thorough explanation of the diagnosis in detail (Happell, et al., 2018). It will include a classification of the disorder as well as a list of the medical, constitutional, and psychogenic elements that have contributed to its emergence (McGuire, et al., 2021). It will also include a brief strategy for additional research and therapy. The formulation and engagement can be done by using these five Ps discussed here.
Presenting History- In this assessment, the patient is suffering from depression that took her to the level of committing suicide. There are many symptoms of mental illness like tiredness, loneliness, exclusion from the society, insomniac, improper diet, lack of communication with peer group, loss of interest in the things which the patient like to do earlier. In this case, the patient was interested in creative writing but now finds no interest in writing.
Predisposing factors- The patient’s history reveals that there is lack of communication between her and her family, both her parents work and her brothers remains busy in their own life. This made the patient attracted to social media to find friends but there also she faced abuse. People called her ugly and bullied her that made her depressed and self-neglected. The patient loses interest in the things which once was loved by her. Also, the eating and sleeping habit of the patient was affected.
Precipitating factors- This is the area which triggered the presenting problem and its effects (Jones, & Beauvais, 2022). The patient shares that her friends and people on social media text her bad messages, misusing her pictures and provoked her to commit suicide. The patient was upset, tired and started hating her. The patient tried to harm her many times before also. Here the psychiatrist may use strategies that are based on reality to address choices and the effects.
Perpetuating factors – It includes the areas that continue the presenting problem. The patient shared that she feels tired, not interested in any social function. Her life was going to the university and coming back to the home. The time which the patient spends on social media trigger the problem. The patient feels neglected, demoralized and insulted.
Protective factors – This area focuses on the resources that help the patient to prevent the thoughts that come in the mind while facing abuse on social media (McDonald, 2018). These five Ps help in formulation of the problems. The psychiatrist collaborates with patient and provides steps to combating the symptoms and enables the patient in gaining his morale.
The whole assessment was recovery oriented (Martínez?Martínez, et al., 2019). Every patient is different and so as their problem. The patient was diagnosed with the acute mental illness (depression). After the assessment, the reason that causes the depression is identified by the psychiatrist. The goal and aims of the patient were revealed. The patient needs attention and care from the family and friends but when the patient didn’t get these from her parents and her peer group, she was attracted to the social media to fight the loneliness. She starts searching care and attention in the virtual world. But there also the patient finds failure.
After assessment the problem was identified that the patient need support from the parents. So, a counseling session was organized with the patient’s parents and friends which aims at providing social and emotional support to the patient.
Conclusion
In this case, it is described how a patient of 17 years of age is suffering from depression and tried to self-harm her. During the assessment various reasons behind the act was identified. Mental health illness is common among people, it may be depression, anxiety, suicidal thoughts etc. This can be assessed by interviewing and observing the patient and formulating the problem as done in this case to find out the problem. So, during the assessment the history of patient and her family was known by asking many questions related to the life of patient. Various medical tests were performed. After diagnosing the patient, proper medical and social care was provided to the patient.
References
Delaney, K. R., Naegle, M. A., Valentine, N. M., Antai-Otong, D., Groh, C. J., & Brennaman, L. (2018). The effective use of psychiatric mental health nurses in integrated care: Policy implications for increasing quality and access to care. The journal of behavioral health services & research, 45(2), 300-309.
Evans, K., Nizette, D., O’Brien, A., & Johnson, K. (Eds.). (2019). Psychiatric and mental health nursing in the UK. Elsevier Health Sciences.
Foster, K., Roche, M., Delgado, C., Cuzzillo, C., Giandinoto, J. A., & Furness, T. (2019). Resilience and mental health nursing: An integrative review of international literature. International journal of mental health nursing, 28(1), 71-85.
Happell, B., Platania-Phung, C., Bocking, J., Scholz, B., Horgan, A., Manning, F., … & Biering, P. (2018). Nursing students’ attitudes towards people diagnosed with mental illness and mental health nursing: an international project from Europe and Australia. Issues in mental health nursing, 39(10), 829-839.
Jones, J. S., & Beauvais, A. M. (2022). Psychiatric mental health nursing: An interpersonal approach. Jones & Bartlett Learning.
Martínez?Martínez, C., Sánchez?Martínez, V., Sales?Orts, R., Dinca, A., Richart?Martínez, M., & Ramos?Pichardo, J. D. (2019). Effectiveness of direct contact intervention with people with mental illness to reduce stigma in nursing students. International journal of mental health nursing, 28(3), 735-743.
McDonald, K. (2018). Social support and mental health in LGBTQ adolescents: a review of the literature. Issues in mental health nursing, 39(1), 16-29.
McGuire, A. B., Kukla, M., Rollins, A. L., Garabrant, J., Henry, N., Eliacin, J., … & Salyers, M. P. (2021). Recovery-oriented acute inpatient mental health care: Operationalization and measurement. Psychiatric Rehabilitation Journal.
Roach, A. (2018). Supportive peer relationships and mental health in adolescence: An integrative review. Issues in mental health nursing, 39(9), 723-737.
Case study. 2014. [Online] Available through: https://www.youtube.com/watch?v=WdC3nhxA66U.
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