Sample UMH207 Understanding Mental Health Assignment

UMH207 Understanding Mental Health Assignment Sample

Task Summary

In this 1800-word Report, respond to the challenges and issues in the case scenario. You are asked to research and find studies/research/journal articles/government and international health agency reports relating to the case study. These peer-reviewed articles will help you support your line of reasoning.

In this report, you will describe key points in relation to legal and ethical factors and the mental health act. You will also discuss your role as a mental health nurse in this case scenario and consider how you would respond to the client in a practical situation.

Finally, you will critically evaluate the importance of the “therapeutic relationship” in a male client with chronic schizophrenia, who is currently admitted involuntarily under a community treatment order in an acute mental health ward.

Instructions

1) Read the case study provided via Assessment 3 area of the subject.
2) Address the following questions in your Report.

• Discuss how and why the mental health act applies to the case scenario.

• Summarise and Identify specific examples of legal and ethical issues in relation to the patient’s rights.

• Compare the concepts of mental health, mental illness and mental disorder. Determine which category the patient in the case scenario fits. Accurately identify the main symptoms of schizophrenia as outlined in the case.

• As the registered nurse looking after the patient, explain how do you advocate for his rights as a mental health consumer?

• Identify and illustrate the main symptoms of schizophrenia as outlined in the case (this can be done in table form)

• Determine a medication that may be clinically indicated for the patient in the case scenario. Provide a rationale for why it is indicated.

• Evaluate and explain three (3) techniques you would use to develop trust, rapport and begin a therapeutic relationship with the patient when first admitted to the hospital.

• Express how you would explain the need to give the patient a depot anti-psychotic medication.

• Given the patient’s mental state at this time, identify one (1) technique you would use to ensure your personal safety (during the explanation about the depot medication outlined above).

Writing Guidelines

• Be formal and objective in your writing.

• Be analytical and demonstrate critical thinking.

• Keep to the set word limit.

• Answer all questions in your report.

• Use in-text references to support your ideas.

• Use information from academic texts and credible sources only.

• Format in-text references and the reference list according to APA 6th ed. referencing style.

• Proofread your work to check that each paragraph links to the previous or the thesis and that it is easy to read.

• Check your spelling, grammar and punctuation.

• Use a size 12 font (Times New Roman, Calibri or Arial).

• Include a footer with your name, student number and page numbers.

• Include a cover page with your name, student number, subject name, title of assessment, learning facilitator’s name and the final word count (not including referencing).

Case Scenario

“Jason” is a 32-year-old male living in housing commission in Western Sydney. He was diagnosed with schizophrenia when he was 19 years old. At that time, he was living with his parents and he increasingly experienced auditory hallucinations with voices telling him to burn his parent’s house down. Fortunately, these voices reduced when Jason started taking an antipsychotic medication.

Jason has been unemployed since he was 19 years old, and has been taking his medication every day since.

Six months ago, Jason moved out of his parent’s home and entered a shared apartment with 3 other males in the local housing commission. Jason stated he felt “fine” and decided to stop taking his antipsychotic medication.

Over the next 2 weeks, his mental state quickly deteriorated, with auditory hallucinations “louder than ever”. He became paranoid that his flatmates were poisoning his food and he believed a tracking device had been inserted under his skin and that he was being “tracked with a satellite by the CIA”.

His paranoia was so intense that he did not leave his bedroom for 3 days before the ambulance arrived.

Jason was scheduled under the Mental Health Act and admitted to the local acute mental health ward as an involuntary consumer..

You are the student nurse looking after Jason on the ward. He appears agitated, moving around erratically and is not making eye contact with you. He swears occasionally and appears frustrated at being “locked up inside the hospital”.

Jason is refusing to take his oral antipsychotic medication tablets. The doctor has charted an intramuscular “depot” antipsychotic medication, which you have been asked to give to Jason. After assessing Jason’s mental state, you agree that the depot is clinically indicated and is in Jason’s best interest, even though he has not agreed to take the medication.

After a discussion with a senior nurse and the psychiatrist, the team makes the decision that Jason should receive a depot antipsychotic medication against his will.
One week after having the depot, Jason’s mental state is stabilising and he is now agreeing to take oral anti-psychotic tablets. However, he still feels “very tired” and would sleep the whole day if he could. He is still unsure if the psychotic symptoms he recently experienced were real or not, but he is “thinking a lot about it”.

His psychiatrist reviewed Jason and he is hoping to transfer to the sub-acute mental health ward soon, and be discharged home soon as he feels “uncomfortable” in the hospital and “can’t wait to go home”.

Solution

Introduction

Schizophrenia can easily be identified as a severe mental disorder that manifests in an abnormal interpretation of reality. Several studies have been conducted to establish the genetic linkage between the diseases, with little success, therefore, presently, the condition is attempted to be treated through clinical intervention strategies (ncbi.nlm.nih.gov, 2022). The present report is based on the case scenario of Jason, who is suffering from severe auditory hallucination, after the withdrawal from antipsychotic medications. The report addresses the mental health act applicable in the scenario, building knowledge over the difference in mental health, disorder, and illness, advocating for the patient's rights. The main schizophrenia symptoms have been outlined, along with the appropriate rationale for medication. The report also sheds light on the relationship development with the patient ensuring their personal safety for assignment help.

Application of Mental Health Act in the case scenario

Jason has been administered under the “Mental Health Act” within a local health ward specializing in acute mental health. In this situation, the Mental Health Act is the most appropriate legal aspect for the improvement of the patient. As per the Act, mental health practitioners and psychiatrists are encouraged to develop a strong relationship with the patient, which is critically needed in the present situation, as the patient is unable to trust (health.vic.gov.au, 2022). Moreover, as the Act has provisions for compulsory and voluntary treatment, makes it even more preferable in the situation, where Jason’s auditory hallucinations deteriorated leading to paranoia, and requiring compulsory intervention.

Legal and Ethical Issues Pertaining To Patient Rights

The legal rights of a patient, who has sought care within the Australian Health System, are ensured by the “Australian Charter of Healthcare Rights”, which ensures communication, respect, safety, privacy, participation, and comment of the patent (healthdirect.gov.au, 2022). According to Sperling (2021, p.25), patients bear the right to refuse medication. On the contrary, Jason has been seen to refuse medication, which has made the schizophrenia condition worsen. An additional legal right issue that emerges is the access to care facilities that are equipped to handle such critical cases, as Jason has been struggling financially owing to unemployment. The medications being forced upon the patient raises an ethical issue of patient rights (Rhodes, 2019, p.3). Taking into consideration the ethical issues, the privacy of the patient is needed to be ensured and the patient is needed to be treated with respect.

Schizophrenia Symptoms and Contrast of Mental Health, Mental Illness, and Mental Disorder

Mental health is inclusive of psychological, emotional, and social well-being. Mental health bears the potential to heavily influence the nature in which we act, feel, think, handle stress, relate to others and make choices (Happell et al., 2018, p.12). In contrast, mental illness pertains to the health conditions that bring about changes in individual behaviour, thinking, or emotions behind them. According to Zumstein & Riese (2020, p.15), the occurrence of mental illness is closely associated with problems and distress, preventing the ability to perform adequately in family, social, or work environments. According to the World Health Organization, a mental disorder is characterized by clinically significant disturbances in one's emotional regulation, behaviour, and cognition (who.int, 2022). These are associated with impairment and or distress in important areas of functioning. The case study of patient Jason and the details, therefore, provided align with the concept of mental disorder. Moreover in support of the mental disorder and linking it with schizophrenia Müller (2018) has opined that, the disorder results in a combination of delusion, hallucination, and disordered thinking, that impairs daily activities. Symptoms of schizophrenia that have been outlined in the case study are auditory hallucination and paranoia.

Advocacy of Mental Health Toward The Patient

Jason had been suffering from schizophrenia when his age was only 19. Due to his auditory hallucinations, he has been treated with antipsychotic medications. Though Jason has taken antipsychotic medicines for a long time and after stopping the medication, symptoms became aggravated he has been considered and hospitalized under Mental Health Act. The Mental health Act of Australia encourages mental health practitioners and psychiatrists to create a strong relationship with patients applying services of mental health and to give them support and information to make an informed choice about their care (Health.vic.gov.au,2022). In the case of Jason, it has been observed by the student nurse that Jason disagreed to take medications. Therefore, the student nurse has discussed with the psychiatrist and senior nurses and made the decision to provide a “depot antipsychotic drug” for Jason. It has been observed that in this case, mental health practitioners have made the decision for the patient related to taking medications. As per the opinion of Livingston (2020, p. 12), in Australia, mental health patients have the right to access support, assessment, treatment, care, services, and rehabilitation for wellbeing and recovery with the same equality as others. Jason is a mental health consumer here because he is taking services from the mental health hospital. As a nurse, the student can advocate a facilitate communication with all other healthcare members relevant to the preferences of the patient. Based on the research by Bégin et al., (2020, p. 40), it is the role of a nurse to integrate patient-oriented goals into the treatment plan and give objective guidance. Here, after observing aggravated schizophrenia symptoms the nurse has discussed with other team members and advocated the care for Jason. Reid et al., (2018, p. 1210) have stated that to promote advocacy for the mental health consumer a nurse must inform the total team, exhibit appropriate nursing care, give assistance with social problems, and teach patients about their personal advocacy. Therefore, the student nurse who is taking care of Jason has already started advocacy for the right of Jason as a mental health patient.

Identification and Illustration of Schizophrenia Symptoms (Case Scenario)

Critical analysis of the case of schizophrenia patient Jason it has been observed that different symptoms of this disease have occurred in Jason. The problem started when he lives with his parents in Western Sydney and became aggravated after moving to a shared apartment and topping medications. According to Menon (2019, p. 133), schizophrenia is a chronic disorder of the brain that appears with active symptoms like hallucinations, lack of motivation, issues with talking, delusions, disorganized speech, and others. In the case of Jason, during his 19 years of age, he suffered from auditory hallucinations, in which a voice continuously told him to burn the house of his parents. After feeling fine, six months ago, Jason stopped taking medicines and his situation became deteriorated. In the second phase, again auditory hallucination symptoms of schizophrenia have started. In this situation, Jason became paranoid that flatmates are going to poison his food. In addition to this, he has started believing that a tracking device has been inserted under his skin and that he has been tracked by CIA satellites. Moreover, not making eye contact, frustration, agitation, erratic movement, and tiredness are some other schizophrenic symptoms of Jason [Refers to appendix].
Medication and rationale

It has been obtained from the case study that, antipsychotic medicines have been taken for Jason from the start of the symptoms. Since the 19 years old, he has been taking this medication every day. Recently, to treat his deteriorated situation, the psychiatrist of a local “acute mental health ward” has prescribed “intramuscular depot antipsychotic medication”. Based on the research by Haight et al., (2019, p. 780), depot injection is a slow-release configuration of medication. The injection applies a liquid that emits the antipsychotic medication slowly and provides a long-lasting effect. Other authors have stated that depot antipsychotic medication is beneficial for schizophrenia because it overpowers the issues of covert non-compliance (Ling et al., 2019, p. 60). Therefore, depot injection is suitable for Jason in his aggravated situation.

Identified Three Techniques for Developing Trust, Therapeutic Relations, and Rapport

With respect to the case study when Jason was admitted to the local acute mental health ward under the Mental health Act of Australia, the doctor started to give intramuscular “depot” antipsychotic medication. However, Jason did not agree to take the medications rather he refused due to a poor therapeutic relationship. In this condition, three techniques can be used by the mental health ward staff to develop trust rapport with the patient for starting a therapeutic relationship. These are,

1. Accepting: It is really important to acknowledge what the patient tends to say and ensure that they have listened carefully. It is found that acceptance is the best thing to make eye contact and understand patients (van Belle et al., 2020, p.2). Patients like Jason who feels that their doctors and nurse are listening to them are more likely to become receptive to care

2. Encouraging descriptions of the perception: Sutanto (2021, p.14) opined that for patients who tend to experience hallucinations like Jason, it might be useful to ask about them nonjudgmentally. It helps patients to understand that doctors and nurses will not judge them and they can cast their perceptions in an effective manner. This results in developing better trust between patients and doctors.

3. Expressing empathy: When Jason was first admitted to the hospital he refused to take depot anti-psychotic medication. However, the doctors are required to empathize with the patients without being so emotionally overwhelmed. The doctors and nurses are required to manage their emotions so that the issues of the patients might not affect them emotionally. The goal of the mental ward staff should be related to overcoming the issue that the patient is going through. This can help them to make an objective decision during suggestions for the patient. This is how the therapeutic relationship between the doctor and patient can be built.

Explanation of The Need To Give Antipsychotic Medication

It has been found from the case study that Jason was in a bad condition when he was admitted to the mental health ward. This is because he did not leave his bedroom for 3 days and he stopped taking his anti-psychotic medications for days and held poor auditory hallucinations. His mental state was so poor and motivation for treatment was lacking in Jaso with heavier psychotic disorders like schizophrenia. This is why a patient might be less willing to take antipsychotic medications for engaging in treatment activities. As argued by Galderisi et al., (2021, p.12), as a negative symptom of schizophrenia disorder, lack of motivation to take the medication is known to be a common issue and difficult for patients as well as clinicians to recognize. The depot antipsychotic medication was in the best interest of Jason in order to raise the benefits of the treatment. This is considered to be easier to observe and holds long-lasting impacts. However, it also decreases the rates of relapse compared to oral medications. This is why it was required to give the patient a depot anti-psychotic medication.

Technique for Personal Safety

One technique to ensure the safety of the patient with respect to giving him the depot medication as discussed above includes,

1. Z-track method: This method of administrating the IM injection to give the depot anti-psychotic medication is effective (Gee et al., 2018, p.6). Since it aims to prevent the medication from being tracked via the subcutaneous tissue and swaling the medication in the area of muscle. This results in reducing any irritation from the medication. Using this method, the skin can be pulled in a lateral way from the site of infection prior to the injection, and then the medication can be injected. Followed by this the needle is removed and the skin can be released.

Conclusion

It can be concluded that Jason was suffering from schizophrenia issue. However, taking the antipsychotic medication regularly tended to reduce the impact of schizophrenia. On the other hand, when Jason managed to move out of his parent's house, it is seen that he tended to stop taking his antipsychotic medications. With respect to this situation, the impacts of schizophrenia were greater such as louder auditory hallucinations. However, concerning the condition of Jason, he was admitted to an acute local mental health award. It was the proper legal movement to improve the condition of the patient. Although, Jason refused to take the medication in the mental health ward and he was facing financial issues due to unemployment. Despite his unwillingness, the doctors gave him the medication. However, this situation could be improved by developing proper therapeutic relationships between doctors and patients by considering the three techniques discussed above.

References