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Mental Health Assignment

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Mental Health Assignment

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Question :
Disuss about the Mental Helth Care?
Answer :

Mental status examination (MSE) is an assessment tool used in the determining the psychological and mental functioning of an individual by utilizing such aspects as appearance, behaviour, speech, though content and process, perception, cognition and insight among other aspects.
Thought form or thought process is the vivid description of the manner in which the ideas or thoughts of a patient are interconnected. It is majorly concerned on how the client’s ideas are linked, but not the ideas themselves. Additionally, it describes the patient’s thought amount and its rate of flow. The client can only verbalize this aspect of thought or inferred from the speech. Under normal circumstances, the thought process is described as logical and linear, tight, goal-directed and coherent. When this normalcy is destabilized due to a myriad of mental illness or substance abuse, a thought form disorder is said to exist. An example of these disorders includes; clang associations and flight of ideas due to mania and thought blocking and derailment which mostly comes as a result of schizophrenia (Morrison 2015).
Thought content, on the other hand, is the description of the patient’s ideas. In a broad perspective, it can be described as thought nature. This also encompasses the theme that dominates the patient’s thought and perceptual disturbance (Bauman 2015).
From the case study, it’s evident that Annabes has lots of thought disturbance. Suspicious and distrustful thoughts are conspicuously displayed. She is preoccupied with thoughts that the staffs are using the cubicle as bait to trap her. She also keeps distance and avoids physical contact. Her thoughts are logical and goal directed but not explicitly coherent as she is muttering and giggling to herself to some extent. Moreover, delusional thoughts are evident. First and foremost, there is a somatic delusion. She believes that something has gotten into her veins. Also, there is an element of persecutory thoughts. She believes everyone and the planet are falling and that ‘someone’ is conspiring to hurt them including the children. Some conditions cause delusions but in this particular care the following has been given prominence; drug abuse, bipolar disorders, schizophrenia and psychosis (Nelson, Kloos & Ornels 2014).
Perception can be defined as any sensory experience. It entails becoming familiar with both internal and external stimuli and making a meaningful order and interpretation of those particular stimuli. The abnormality of this domain results in perceptual disturbances. Hallucinations and illusions are the most common of these disturbances. Hallucinations are unreal perceptions without stimuli. They are categorized depending on the senses where they are experienced. Auditory (hearing voices), taste (gustatory) ,touch (tactile),smell (olfactory) and sight (visual).Auditory hallucination is the most common and is mainly witnessed in psychotic disorders such as mania and schizophrenia. The least forms of hallucinations are mainly typical in medical illness and substance abuse. However, illusions are merely the misinterpretation of true stimuli e.g. rustling papers as voices (Keogh 2014).
Annabelle was experiencing some hallucinations. To start with, there is an auditory hallucination. She surprised that the interviewer is not hearing what ‘they’ are saying.”Can’t you listen to what they are saying?” also, we are seeing her shouting ‘them ‘down during the interview. “Shut up, shut up, and shut up!!!!!!”Furthermore, it is apparent from the case that Annabelle is experiencing visual hallucinations. We are occasionally seeing her tensely staring at the ceiling. Although she doesn’t describe it herself, her incessant act of staring at the ceiling and sometimes become agitated confirms this. Last but not least, she is experiencing a tactile hallucination. She is lamenting that ‘it’ has gotten to her veins and that ‘they’ are under her skin.”You know it’s in my veins”.”They are everywhere.Everywhere under my skin”. Critical analysis of the case also indicates there is an element of command hallucination. This is where false stimuli direct the patient to execute something which is hurtful in most cases (Hogan, Przbylowicz &Vacek). This is demonstrated where she is asking for forgiveness as result of ‘hurting’ the children.
Mood is described as the emotional experience of an individual over an extended period. It can also be described as a prolonged inner feeling of an individual. It’s totally a subjective experience, and thus it is commonly inferred from the client. Moreover, mood tends to remain constant. When it is being described, the exact words of the patient are normally used. It can be described as down, depressed, sad, anxious, angry, irritable or fearful. (Ester 2014)
On the other hand, affect can be defined as the outward expression of the patient’s emotional state. It usually fluctuates as individual thoughts changes. This is what can be observed about an individual’s emotional state. Typically, both mood and affect must show congruency. However, this phenomenon is different in situations where one has a mental disorder. Affect can be described as labile, angry, anxious or depressed. (Morrison 2014)
As per the information was given by her mother, Annabelle has had a sad and angry mood. The mother reports that she spends time in her room alone and she doesn’t want to talk to anybody. She also reports that some days early she had shouted at her father. It is also depicted at the ED when she intensely stares at staff. She also has an anxious mood. She is pacing up, and the ED and she are unable to sit still.
The intensity of her affect is restricted in the sense that there is moderation in the intensity and range in which feelings are displayed. The patient is capable of regulating the manner in which she displays her emotion. She can stop shouting at her father and return to her room. The range of her affect is broad. This is a normal affect that is variable with facial expression, voice tone, etc.For example, when she is smiling at staff she expresses a happy affect and vice versa (Hale, Yudofsky & Roberts)
She is 22 years old, and she appears the stated age. She exhibits a poor personal hygiene. It’s evident that she is dressed in a dirty jeans and T-shirt. Her hair is inappropriately dyed blue and pink, unkempt and matted. Moreover, her grooming is inappropriate. For instance, she is barefooted which is unusual for her.
On the other hand, the patient has a poorly built body frame and posture. It’s evident that the patient is malnourished. According to the narration from her mother, the patient has lost significant weight over a short period. This is attributed to her not eating even up to two days.Behaviour
The patient is tense and hyperactive. She is pacing about the corridor of the ED while wringing her hands continuously. She is also unable to sit still, and this is a typical symptom of a manic episode. The patient has a labile facial expression. It kept on mutating from happy, sad and angry to depressed. At one point she is smiling at the interviewer only to stare angrily at him the next minute. The patient hardly maintained an eye contact that was intermittent.She was distracted by both visual and auditory hallucinations as she kept on staring at the ceiling. She was uninterested and uncooperative to the interview process. This is illustrated by her failure to maintain an eye contact throughout the exercise, frequent interruptions and inability to follow instruction. The patient also exhibits some evasive and suspicious behavior. When she is led into her cubicle by one of the staff, she hesitates only to enter after persuasions from her mother. She thinks that they have conspired against her and that the cubicle is used as a trap
In relation to MSE, some of the aforementioned aspects of her appearance and behaviour are abnormal. For instance, her poor personal hygiene and inappropriate grooming are atypical. Additionally, the patient’s inability to stay calm and cooperate with the interviewer are inconsistent with normal MSE and these are some of the features of mania (Ester 2014).
Armitage, A 2015, Advanced practice nursing guide to the neurological exam, Springer Publishing Company, New York.
Estes, M, E, Z 2014, Health Assessment & Physical examination, Thomson Delmar Learning, Clifton Park.
Hales, R, E, Yudofsky, S, C & Roberts, L, W 2014, The American Psychiatric Publishing Textbook of Psychiatry, American Psychiatric Publishing, Washington, D.C.
Hogan, M, A, Przybylowicz, T, & Vacek, J 2013, Mental health nursing, Pearson, Boston.
Keogh, J, E 2014, Psychiatric and mental health nursing Demystified, McGraw-Hill Education/Medica, New York.
Morrison, J, R 2014, Diagnosis made easier: principles and techniques for mental health clinicians, New York: Thales.
Yudofsky, S, C & Roberts, L, W 2014, The American Psychiatric Publishing textbook of psychiatry, The Guilford Press, New York
Nelson, G, B, Kloos, B & Ornelas, J 2014, Community psychology and community mental health: towards transformative change, Elsevier. Philadelphia.
Bauman, S & Rivers, I 2015, Mental health in the digital age, Palgrave Macmillan,
Houndmills, Basingstoke, Hampshire; New York.

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