1. PSYC6825 Introduction To Mental Health
Answer:
Introduction
Person-centred care approach is considered to have deep roots in clinical practice and
historically have been a major segment of both Western and Eastern medicine approach.
Person-centred practice approaches have been provided a significant profile in the previous
60 years and presume specific importance as of now along with the proceedings towards
personalised medications (Stuart, 2017). NSW, 2021, consider this approach as it takes into
account every person’s age, life experience, culture, gender, language, heritage, beliefs as
well as identity. Person-centred approach is based on strength of patient, where clients are
acknowledged as the health professionals in their life specifically focuses on their ability,
and any assistance they require on it. International support is there for person-centred
clinical approaches by the side of World Health Organization (WHO). Person-centred care
has significant importance in psychiatric setting. For example, mental health sectors has
adopted an approach known as biopsychological approach is inherently person-centred.
The main reason for adapting this approach is mainly due to having association of
biopsychological determinants of an individual with both development and progression of
mental health disorders (Stuart, 2017). However, despite its’ importance in psychiatric
setting, psychiatry has a prolonged history of being criticised specifically due to its’ focus on
classifications of disorders that are currently seen as dehumanising individuals and
marking them as deviant while significantly avoiding major aspects of some subjective
experiences of ethnicity, culture, trauma and political oppression. According to current
evidences, even today, in many segments of the world individuals with psychological health
illnesses are poorly resourced in comparison with physical health services.
The main objective of this study is to discuss the importance of person centred care and
recovery oriented practice in individuals with psychiatric individuals.
Case Study
Mr. X is a 67 years old retired individual who is currently experiencing clinical symptoms of
clinical depression including isolation from society and peers, confusion, and disorientation.
He has been diagnosed with some chronic illnesses such as diabetes and hypertension three
2. years before. He currently lives with his wife as he had lost his son four years before
following a car accident. Since that period, Mr. Y has shifted his place to a new community
and currently lives in a rental place. He has been consulted with a general practitioner as
was experiencing the clinical symptoms of the condition. Mr. Y was recommended with
both pharmacological and non-pharmacological interventions including anti-depressant
drugs as well as yoga and cognitive behavioural approach as all the stated interventions are
considered evidence-based and have significant impact in ensuring gradual recovery and
wellbeing of the individuals. However, due to his reluctant behaviour, he had denied to
follow the recommended therapeutic for the patient. However, as currently, he is
experiencing clinical deterioration, wife of Mr. Y has become very worried thinking of Mr.
Y’s health status and wellbeing. Mr. Y is currently eliciting aggressiveness and societal
withdrawal associated symptoms; therefore, Mr. Y has been presented to a mental health
centre where physicians have performed a thorough physiological and psychological
assessment in order to investigate current health status of the individual and identify
biopsychological, sociocultural, environmental and behavioural determinants that may be
associated with the current health status of the patient. In the next section of this study, the
author is going to discuss person centred care and recovery oriented practice considering
the current situation of the patient.
Gordon’s health assessment pattern was followed in order to assess current health
determinants and health status of the patient due to having generalizability and validity of
the method in psychiatric setting and following the findings from the Gordon’s health
assessment report, it was found that Mr. Y had complications associated with behavioural
factors (e.g., Mr. Y has followed a sedentary lifestyle for a longer time that is known to
increase both physiological and psychological health complication and risk for individuals
having chronic health issues), emotional and psychological trauma following demise of son
of him, social isolation and no direct relationship with neighbours and relatives that
significantly increases risk of development and progression of depression and anxiety and
associated complications (Gengo E Silva Butcher & Jones, 2021). As per current
understanding, physician has recommended cognitive behavioural therapy (CBT) for the
patient as it is known to improve psychological health status of patient suffering from
clinical depression and associated complications and anti-depressant medications (Gautam
et al., 2020). Now, it is the role and responsibility of mental health nurse in order to ensure
effective follow up of evidence-based practice and person-centred care for the patient.
Interventions
Considering the principle of person-centred care, it is essential to engage and/or involve the
patient in therapeutic approach. As a mental health care nurse, I have followed effective
communication strategy with both patient and his family members in order to increase his
engagement in both pharmacological and non-pharmacological therapeutic approach for
the patient. In this specific aspect, I have used both active verbal and non-verbal
communication to draw attention of the patient and to collect effective information from
3. him for administering recommended interventions in order to ensure gradual recovery and
wellbeing of the patient (Vogel, Meyer & Harendza, 2018). All interventions I have followed
were based on current evidences ranging from administration of cognitive-behavioural
therapy, Ad-Din Cognitive psychological counselling on the depression, self-concept and
resilience of the patient (Thase et al., 2018). While conducting an initial assessment and
interview I have found that the patient has tendency to self-harm and suicidal tendency.
Considered this findings, I have consulted with physician and administered intervention
like pharmacological interventions such as citalopram and cognitive behavioural therapy as
recommended above.
According to current evidence, recovery oriented practice is considered and/or understood
in the framework as encapsulating psychological health care that significantly maximises
self-management and self-determination of psychological health practice and wellbeing and
incorporates person-first, person-centred and evidence-based and strength-based
intervention, rehabilitation and assistance to patients with mental health illnesses in order
to ensure quick recovery and wellbeing of individuals (Gammon et al., 2018). Following the
said guideline, I also have followed a strength-based approach in order to highlight on the
strength of the patient in order to mitigate further progression of depression in Mr. X. For
example, he has a previous habit in gardening and making animations. However, following
the progression of current condition, he is experiencing withdrawal from the stated habits
of the patient. Knowing about the creative habits of the patient, I tried to focus on the above
mentioned particulars; therefore, they can further enhance engagement and attachment of
the patient for the said hobbies. I have provided the patient with pictures of several
animated characters and said him to colour those images as per his wishes and to identify
the characters as per his knowledge. He has followed the instruction gently and it helped in
facilitating gradual recovery of the patient that was reflected through the gradual
improvement in cognitive score of the patient (Cuijpers et al., 2019). Apart from that, I have
also involved the patient in group counselling intervention where a total of ten different
patients of depression were involved in the process of psychological counselling and it also
helped in the process of gradual recovery of the patient. I also focused on self-management
of depression in the patient that requires having sufficient knowledge on disease
development and progression. In this specific aspect, I have tried to engage wife of Mr Y’s
wife in the process of treatment too and it has been elicited that partnership and/or
collaboration in care has shown significant positive impact in facilitating recovery and
wellbeing of the patient (Cuijpers et al., 2019). Both yoga and physical activities are known
to have positive influence on psychological health of patients suffering from depression and
other mental health complications (Bridges & Sharma, 2017). Due to that specific reason, I
have also focused on recovery oriented approach and evidence-based care strategy in order
to involve the patient in healthy active lifestyle strategy that would further improve his
inclination and perception of both physiological and psychological health. As it has already
been mentioned before, that Mr. Y is known to follow a sedentary lifestyle, considering its’
negative impact on psychological health and progression of depression, I as a mental health
nurse has preferred to focus on this specific intervention and it significantly helped in
4. ensuring quick recovery of the patient and I have recorded the log score of the mental
health status of the patient as it helps in evaluating gradual improvement of the patient.
Last but not the least, considering the principle of strength-oriented practice, I also focused
on health promotion programme focusing on community demographics of the patient and
other biopsyhcological and behavioural determinants that enhance risk of development and
progression of clinical depression (e.g., social isolation, poor attachment with relatives and
neighbours, getting withdrawal from all belongings). I promoted community activities and
social engagement and it helped in facilitating improvement in psychological health status
of the patient.
Discharge Education
Mr. Y was admitted in primary healthcare for four days for initial assessment and evaluation
of care-plan and intervention. In between this time as said above, mental health nurse
professional was responsible for his current symptoms of clinical depression and as well as
physician for developing plan considering current physiological status of the patient.
However, after gradual recovery, in time of discharge Mr. Y needs to be provided with
effective discharge plan and further recommendation.
Hand-out is given to Mr. Y’s wife on self-management of depression with effective
pharmacological and non-pharmacological approach.
Education is provided to the wife of Mr. Y on strength-based approach and to engage him in
creative activities and creative discussion and/or conversation.
Environment plays a major role on elevation in symptoms associated with mental health
disorder. Therefore, the room environment needs to be calm and organized. No sharp
elements are to be present in the room and Mr. Y’s wife needs to be careful about whether
he is eliciting any aggressive or suicidal symptoms or not.
In case of sustainable support, Beyond Blue is there in Australia who work for depressed or
anxious people. Therefore, Mr. Y’s wife is provided with sufficient details and
recommendation to communicate further with My Aged Care service and Beyond Blue in
order to get rid of complications.
SHINE community services is there in Australia that specifically work for seniors and meet
some essential requirements (e.g., foods, health and social activities). Recommendation has
also been given to the patient to further communicate with the NGO.
Lastly, Mr. Y needs to stay adhere to all the non-pharmacological and pharmacological
interventions ranging from physical activities, healthy nutrition, yoga to pharmacological
interventions. In case of any difficulties, Mr. Y can also ask for residential nurse practitioner
who would promote person-centred care in residential care considering the requirements
of client.
Conclusion
Therefore, considering all the above mentioned facts and information, it can be stated that
person-centred care and recovery-oriented practice are very important in clinical practice
5. for assisting a patient with mental health disorder. In this study the case study of Mr. Y has
been discussed who is suffering from clinical depression and in this study, I as a mental
health practitioner, have reflected on my care-experiences and practical skills that have
been shown to be beneficial for the patient in ensuring both health and social wellbeing.
Reference
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