Case Study: Chung’s Mental Health And Nursing Interventions

Background Information

A high priority and urgent mental health risk area that faces Chung is suicide. Prolonged depression can lead to suicidal thoughts. Chung experiences pressure at work and feels that he is neglecting his daughter and wife.  He has a perception of the mental health condition as self-induced and believes that there is no treatment that can help. He views suicide as his escape route.

Suicidal thoughts have crossed his mind for the last week and he is conscious of high lethality prescriptions that he can take above their dosages to put his life to an end. The hospital is therefore risky place for him to be because he can access lethal medication which he will use to end his life. An effective intervention is advising Chung to stay at home for some days. This lessens access to suicidal means (Zalsman et al., 2016).

Chung feels that treatment may not help him and due to this it can be difficult to convince him to see a therapist. The nurse can apply the talk therapy first before Chung sees a specialist. This will help him ‘face and master his own emotions’ (Bowers, 2012).The nurse should ‘talk in a supportive and non-judgemental way’ to Chung (American Psychological Association, 2018).Talking about how we feel makes us view things differently.

Prolonged stressful life experiences can lead to the development of mental health disorders unhealthy (American Psychiatric Association, 2013).  According to Silvaa, Loureiro and Cardoso (2016), anxiety and depression are examples of mental disorders. They further explain that mental wellbeing is influenced by the individual attributes, the socioeconomic circumstances and the environment. Chung is depressed due to his stressful daily environment at home and work. He works for long hours thus has difficulties balancing his family and career life. Legg (2017) mentions the symptoms of depression as hopelessness, loss of interest, changes in appetite and weight, increased fatigue, sleep problems and anxiety. Some symptoms of anxiety are restlessness, rapid heart rate and breathing (Legg, 2017).

Chung has been sleepless for the past six weeks but still works at night and could go for over 20 hours without sleep. He has a feeling that the condition is self-inflicted and believes there is no cure; a sign of hopelessness (Pollard, 2018). He has lost five kilograms of weight during the past month, due to reduced appetite and missing meals. Chung states his desire to end his life.

Cognitive behavioural therapy administered by a specialist is necessary for Chung in form of psychoeducation. This will help him to change his thoughts of hopelessness to positive ones (Martin, 2018).

Nurses are required to maintain professional relationships with patients whom they deal with to ensure better patient outcome (NMBA, 2015). At times, nurses are emotionally affected by the patient’s health status (Koinis et al., 2015).The nurse assigned to care for Chung‘s wife should avoid emotional ties when dealing with the family.

Mentally ill patients have the right to confidentiality (NMBA, 2018).The nurse dealing with Chung should be confidential. Any information shared by Chung during CBT should not be disclosed.

The nurse should not be overly involved with Chung‘s case since her main duty is to care for his wife (NMBA, 2018).

References:

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5®). Washington, D.C.: American Psychiatric Publishing.

American Psychological Association (2018). How to help in an emotional crisis. (2018). https://www.apa.org. Retrieved 1 October 2018, from https://www.apa.org/helpcenter/emotional-crisis.aspx

 Koinis, A., Giannou, V., Drantaki, V., Angelaina, S., Stratou, E., & Saridi, M. (2015). The impact of healthcare workers job environment on their mental-emotional health. Coping strategies: The case of a local general hospital. Health Psychology Research, 3(1). doi:10.4081/hpr.2015.1984

Legg, T. J. (2017, June 27). Recognizing Depression Symptoms: 9 Warning Signs. (2018). Healthline. Retrieved 1 October 2018, from https://www.healthline.com/health/depression/recognizing-symptoms

 Martin, B. (2018, April 04). In-Depth: Cognitive Behavioural Therapy. Retrieved on 28^th September 2018 from https://psychcentral.com/lib/in-depth-cognitive-behavioral-therapy/

Pollard, C. (2018). Fundamentals of the psychiatric mental health status examination (pp. 36-42). [S.l.]: Canadian Scholars Pr.

Professional standards. (2018, March 1). Retrieved October 2, 2018, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

Silvaa, M., Loureiro, A., & Cardoso, G. (2016). Social determinants of mental health: A review of the evidence    . The European Journal of Psychiatry,30. Retrieved on 28^th September 2018 from content://com.sec.android.app.sbrowser/readinglist/0927124102.mhtml.

Zalsman, G., Hawton, K., Wasserman, D., Heeringen, K. V., Arensman, E., Sarchiapone, M., . . . Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. The Lancet Psychiatry,3(7), 646-659. doi:10.1016/s2215-0366(16)30030-x