Cna256 | Health | The Assessment Answer

In order to arrive at an accurate diagnosis, a more extensive, specialized and systematic diagnosis method is needed to be used. DSM 5 or the Diagnostic and Statistical Manual of Mental Disorders is the 5tth revised edition introduced in the year or 2013 by the American psychiatric association (American Psychiatric Association, 2013). This acts as a comprehensive and systematic diagnostic tool that helps in the critical taxonomical diagnosis of the psychiatric disorders that the patient is experiencing. There are 19 different diagnostic criteria for diagnosis and each if the criteria has a very systematic and taxonomical pathway which helps the mental health professional arrive at the exact mental illness is a systematic step by step procedure. In this case, Chung had been detached from his family and culture, had an extremely stressful professional life, an ill wife and new born daughter that he does not get to spend time with, and all of these factors have given rise to persistent chronic depression. However, along with that, he also had frequent panic attacks and was suffering from palpitation, chest pain, and breathlessness which is significant symptom of severe anxiety. Along with that, he had also been experiencing frequent panic attacks fearing death due to heart attack. Therefore, as per the DSM 5 criteria the patient is suffering from panic disorder under the section of anxiety disorders that stemmed from the chronic depression (American Psychiatric Association, 2013).

2. The cause of the mental health disorders have been very difficult to determine due to the complex developmental trajectory of these diseases. However, consistent research on the pathways of implementation of change in the mental illness symptoms has given rise to a varied range of different models and frameworks that can help in understanding the developmental trajectory of the mental health disorders. The stress vulnerability model is one such model which aids in discovering how the psychological disorders develop and how different factors interact in developing the disorder (Zannas & West, 2014). There are five different elements that are present in the stress vulnerability model, including alcohol and substance abuse, medication use, social support, stress and its coping and meaningful activities. All these elements have a significant impact on the biological vulnerability of the patient, while addressing tem can reduce the psychotic symptoms that the patient is suffering with, the lack of the same can induce varied degree of stress and can give rise to various psychotic disorders in the patient (Townsend & Morgan, 2017).

In case of Chung, the patient had various external and internal factors that acted like a stressor in his life aggravating or facilitating the psychological distress. Firstly, occupational or job related issues is the first factor that induced a considerable amount of stress in his life. Exploring further, the patient had been working as a doctor in the emergency department of the hospital. Bragard, Dupuis and Fleet (2015), have discussed that the emergency department health care staff generally have to suffer from a considerable trauma and burnout which again is a very crucial stress on the mental health and wellbeing status of the patient. Along with that, Chung had also been investigated for a medication error he committed, which might have had a considerable impact on the coping skills and stress enduring capacity of the patient. Along with that, he had to do long shifts as well due to the financial burden on him for his wife’s illness post birth of his daughter and to care for the new born, by working 20-24 hours straight without sleep. This had also been a considerable impact on the mental state of the patient.

The second factor that contributed to the stress that the patient had been feeling has been the lack of any social support. Chung had no connection with his culture and family for close to five years to a point where most important events of his life like his wedding and the birth of his daughter was spent without his family members. Hence, the lack of any connection with his own family and culture had been a considerable impact on his ability to cope with the stressors in his life. Along with that, his wife also had been ill since the birth of his daughter and he did not have enough time to connect with his daughter either which also aggravated his lack of social support and facilitated the chronic depression and anxiety that the patient had been suffering with (Uchino, Bowen & Kent, 2015).

3. Mental health can be defined as the overall state of psychological, emotional and social health and wellbeing of an individual. On the other hand, mental illness can be defined as the diseased condition that develops mild to severe impact on the psychosocial or emotional wellbeing of the patient by directing or indirectly altering and causing distortions in the thought and behavior which results in a massive inability to cope with demands of life. As mentioned by Drake and Whitley (2014), the journey from mental illness to adequate mental health can be considered as the journey of recovery for the mental patient. Now recovery for mental illness includes more than just addressing the different symptoms of the mental disorder, rather the recovery process of a mental illness is associated with addressing the emotional, psychological and socio-cultural aspects of the mental illness. Hence, it can be concluded that the recovery is needed to b oriented towards a more holistic approach to caring, so that the overall health and wellbeing of the patient can be addressed.

The mental health recovery model can be an excellent framework that can be used to implement holistic care approaches for the patient (Storm & Edwards, 2013). The recovery model for mental health disorders is associated with a holistic patient centered approach to the mental health care. This model is based on two guiding principles of mental health care, one focusing on encouragement for the patients for recovery and entertaining a patient directed approach to recovery. Similarly, the mental health recovery principles for the practice by the Health.gov.au, (2018) illustrates 6 individual principles for the mental health recovery for the patient. These principles include uniqueness of the patient, real choices, attitudes and rights, dignity and respect, partnership and communication, and evaluating recovery. These principles guide the mental health professional as a recovery oriented framework to implement a holistic approach to the recovery. Among the various principles that have been illustrated by the government health document, three very important aspect of recovery model which also bears intricate link to the condition of Chung is respect, empowerment and hope. The principle 4 states safeguarding the dignity and respect of the patient is crucial for accelerating recovery of the mental patients. Having a therapeutic relationship with mutual respect for the patient, his beliefs and culture will facilitate a sense of empowerment and being valued. Empowerment is a crucial element of the care being provided to a mental patient (Ruotsalainen et al., 2015).

The inability to control their life is a significant contributor to the hopelessness and lack of self-worth. Providing the power of decision making or valuing the choice or beliefs while planning and implementing care will empower Chung and aid in the process of recovery. Lastly, hope is another crucial element of care delivery which allows the patient to have a positive and optimistic view on life and helps accelerate recovery. The third principle of the framework, ‘attitudes and rights’ also guides that instilling hope in a mental patient can accelerate recovery and improve the co-operation or eagerness in the patient to gain recovery. Engaging Chung in community engagement activities and involving his family and friends in the recovery oriented care planning will allow Chung to regain hope and attain optimistic expectations from life. Entertaining therapeutic traditional or culturally safe treatment measures that are in accordance to his Chinese roots can also facilitate recovery for him (Hungerford et al., 2018).

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Bragard, I., Dupuis, G., & Fleet, R. (2015). Quality of work life, burnout, and stress in emergency department physicians: a qualitative review. European Journal of Emergency Medicine, 22(4), 227-234.

Cumming, T. B., Churilov, L., Lindén, T., & Bernhardt, J. (2013). Montreal Cognitive Assessment and Mini–Mental State Examination are both valid cognitive tools in stroke. Acta Neurologica Scandinavica, 128(2), 122-129.

Drake, R. E., & Whitley, R. (2014). Recovery and severe mental illness: description and analysis. The Canadian Journal of Psychiatry, 59(5), 236-242.

Hungerford, C., Hodgson, D., Bostwick, R., Clancy, R., Murphy, G.  (2018). Mental health care (Third edition). John Wiley & Sons, Milton, Qld

Kidd, S., Kenny, A., & McKinstry, C. (2015). The meaning of recovery in a regional mental health service: an action research study. Journal of Advanced Nursing, 71(1), 181-192.

Principles of recovery oriented mental health practice. (2018). Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/content/CFA833CB8C1AA178CA257BF0001E7520/$File/servpri.pdf

Ruotsalainen, J. H., Verbeek, J. H., Mariné, A., & Serra, C. (2015). Preventing occupational stress in healthcare workers. Cochrane Database Syst Rev, 4.

Storm, M., & Edwards, A. (2013). Models of user involvement in the mental health context: intentions and implementation challenges. Psychiatric Quarterly, 84(3), 313-327.

Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.

Uchino, B. N., Bowen, K., & Kent, R. (2015). Social support and mental health. In Encyclopedia of Mental Health: Second Edition (pp. 189-195). Elsevier Inc..

Zannas, A. S., & West, A. E. (2014). Epigenetics and the regulation of stress vulnerability and resilience. Neuroscience, 264, 157-170