Mental Health Case Study



One way of defining vulnerability is too susceptible to something bad or harmful. This can either be in the form of a disease or infection. For example, people living in war torn countries where basic infrastructure has been destroyed are most likely to contract diseases like malaria. Similarly, aged people above 60 or 70 years are more vulnerable or susceptible to develop different kind of harmful diseases like cardiovascular diseases and other problems related to nervous system like dementia or Alzheimer.
A second definition of vulnerability is to be capable of being either physically or emotionally wounded. For example, a child born with mental handicap can be devastated by the unceasing jeers and taunts of children at school that bully him.
Vulnerability Case Study of Mental Health
Patient Case Overview
A 51-year old make began to embezzle at work. He started listing vague and mysterious expenses in his travel reimbursement form, which actually turned out to be purchases of pornographic material from the internet. When questioned about his work, he said that he was using the corporate for all his transactions so that his wife does not find out about his sexual activity. Furthermore, other female employees in the office also complained about the nature of comments that he made about their physique and the uneasy and uncomfortable way he started at them.
Due to his deteriorating status at work, he was forced to leave the job. However, he did not show any intent towards finding a new job. His attitude with his family was no different as well. He would watch television for hours without talking to his wife or children; he would stuff food into his mouth, often choking at dinner table. He started gaining weight up to 15lbs and his language became too inflammatory. Moreover, his family history revealed that his first cousin had died from Lou Gehrig’s disease.
He became profoundly apathetic and indifferent to everything that he had either done at home or at office. Such attitude of the patient makes him vulnerable not only towards himself, but also to people around him. He is completely indifferent about the ways in which his attitude is affecting him in changing his mental behavior and approach towards business and family. Also, since he is completely apathetic to all such things, he can be an easy victim towards getting affected by other people because of his inappropriate behavior.
Planned Intervention
Preliminary neurological examination revealed pathologically brisk snout and jaw jerks. Subtle atrophy and weakness were evident in arms and legs, whereas, plantar response was flexor. Further psychological evaluation for examining the cognitive functioning of the patient was done by means of mini mental state examination or MMSE, clinical interview and mental status evaluation by the nursing staff to examine the condition of the patient and submit their initial reports regarding patient’s condition. The score of patient was 15 out of a possible 30 in the MMSE.


Furthermore, the person lacked the ability to converse in a logical and coherent manner and his responses to most questions asked were inappropriate and illogical. For instance, when questioned about the gravity of the situation he was in he said that he was very optimistic stating that he would be very rich and will be a real estate mogul if he wanted (Stein, 2015). Upon initial intervention it seemed that the patient suffered from major cognitive dysfunction and senile dementia. Moreover, the individual with this level of impairment would not be in a likely position to function independently. As a result, it was advised to the family of the patient to seek guidance and help from an Alzheimer facility for custodial care.
Strategies
Definitions of Strategy in Healthcare
The term ‘strategy’ can be defined in multiple ways when applied in the situation of healthcare. Firstly, one definition of strategy can be in the form of applying ‘unique set of activities’ that a healthcare organization needs to or does not need to apply in their working practices. All healthcare organizations have a certain process and set of standard operating procedures that they adhere to when operating and treating. It is basically the strategy and its subsequent application and implementation in the organizational framework that determines certain practices as permissible and prohibits others.
Another definition of strategy can be in regards to the ‘value to customers’ that has been delivered by a certain strategy and process applied in a healthcare organization. At the end of the day, the assessment of any strategy is determined by the magnitude of value it was able to deliver to the customers or in this case patients that are admitted in a healthcare center. If any strategy is unable to add value or convenience in the life of a person who is already in a state of pain and stress, it directly implies that the strategy being followed needs to be rectified and restructured (Jain, 2010).
Strategies used on Patient
There were couples of strategies employed in regards to improving the condition of the patient ranging from medicinal to non-medicinal strategies. Firstly, the nursing team assigned to take care of the patient started off with Level 1 of the ‘Neurotransmitters Therapy’ dosing. The changes in his condition were observed after dose was injected in her bloodstream. The time allocated to observe any possible changes in the condition of the patient after initial injection of dosage was one week. During this testing time span, other strategies were also employed at non-medicinal end to help in improving the condition of the patient.
This was done by planning out set of activities especially the ones that the patient was fond of before his condition began to degenerate. By carefully going through the case study of the patient it was observed that the patient used to spend most of his time at home either reading or watching television. Moreover, when in office he would spend his time reading articles related to current affairs and global politics apart from doing the routine work assigned to him. This provided nursing team with a good and clear idea regarding the activities that they could carry out with the patient in order to make him feel as relaxed as possible during the time he is in the hospital and under observation.
Magazines such as Economist, Newsweek and Time were provided to nurses so that the patient could read them and enjoy as well. Also, books related to global politics were also provided to the patient. However, it was observed that even with all these strategies the ultimate motive and objective of improving the condition of the patient was not achieved and after the end of the first week, patient did not show much change in condition. The team of doctors and nurses unanimously decided to increase the dosage previously provided to the patient by giving him ‘Neurotransmitter Therapy’ with level 2 dosage and repeat the same activities by including new ones as well. The new activity included calling those relatives to the hospital on regular or daily basis to whom the patient is specifically attached and emotionally close to. These people will first be provided with a high level overview regarding the overall condition of the patient and the kind of communication that they need to engage with the patient. Also, they were specifically instructed to recall and tell the patient about the memorable times of enjoyment and fun that they had spent together.
Also, they should also talk about the things he use to talk about the advice he use to give them regarding life and other relevant things that can help them in recalling those times. Furthermore, when talking to him, they must be specific about dates, month and year. The adoption and implementation of this strategy proved to be extremely successful. In just another two weeks’ time, the patient showed considerable improvement in his condition. He was able to converse and communicate in a logical and coherent manner, he was able to remember his date of birth, name of relatives that use to visit him as well his direct relation with him.
Moreover, he was also regretful regarding his previous behavior that almost placed his life as well as the life of his family at risk. Apart from this, he was able to recall some preliminary details regarding his office and colleagues which made him sad as his attitude towards female coworkers of his office was downright offensive and he was courageous enough to acknowledge that. On a medical front, the patient had an episode of several days of extremely foul smelling stools for what seemed to be no specific reason. It was most likely that his body was discharging petrochemicals and aromatic hydrocarbons that had been stored in his body making it toxic. With the help of the neurotransmitter dosage and cysteine/selenium formula provided to the patient helped in clearing his liver through the intestinal tract improving his condition considerably.
Observing that the condition of the patient showed substantial improvement, the family of the patient decided to take him home. However, before discharging him a set of conditions and guidelines were provided to family members regarding the steps that need to be followed when taking care of the patient apart from hospital.
These guidelines were incorporated as a strategy adopted and applied from the Mental Health Care Act 1983 in which Section 2 highlights the conditions and medical pre-requisites that need to be fulfilled before admitting the patient in a psychiatric healthcare facility. Furthermore, the team of doctors assigned to take care of the patient must visit the patient five times in a week, and one of the doctors must have specialist experience of working with patients suffering from mental disorder.
Multi Agency/Inter Profession
The term ‘multi-agency’ can be defined as the collaboration of different service providers for fulfilling a particular objective. With the cooperation and input of different service providers the hassle and hurdles in fulfilling a task can be alleviated.
Another definition of ‘multi-agency’ is about providing seamless response to individuals with multiple and complex needs. This could either be a part of a multidisciplinary team or the team can be hired on ad hoc basis. The core objective of different stakeholders involved in the formation of a multi-agency team is to fulfill the desired objective .
Working with Different Agencies and Professionals
Over different phases of time, there has been the opportunity of working with different agencies and professionals from multi agencies. These multi agencies provided services related to mental health disorders and guidance regarding the initial treatment that needs to be provided to patients who have suffered a stroke and have been admitted in the hospital.
The role of multi agencies comes in really handy and useful especially at critical moments of time when the patient requires immediate and timely help and the respective healthcare professional of the hospital is not present. It is in these circumstances when consultation and help from multi agencies in healthcare specializing in mental health disorders become really helpful. Furthermore, another major advantage of working with multi agencies is that it allows the person to develop relations and effective networking with specialists from different segments and specializations of healthcare industry. With the help of these contacts established with multi agency people an individual can easily work in diverse segments and can fit himself that seems to fascinate him the most.
Policies and Procedures Relating to Multi Agency Working
Over the passage of time, different policies and working procedures have been formulated that encourage the collaboration of healthcare centers and institutes with multi agencies in the field of healthcare. Some of these include:
·         Multi agency collaboration with healthcare institutes and centers help in the effective streamlining of national strategies such as personalization aimed to enhance and strengthen links across different frontiers of health and social care. Hence, all cooperation in all aspects must be provided by all stakeholders. 
·         The multi-agency involved in taking care of operations related to healthcare must show the ways in which they have undertaken different responsibilities that were assigned to them and the ways in which they were able to effectively intervene and coordinate in the entire scenario
·         Barriers related to confidentiality can be overcome to ensure transparent collaboration between all stakeholders
Mental health case study: nursing articles research

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