CASE STUDY. 2. : CASE STUDY. 1. Case Study: Mental Heal

Running head: CASE STUDY 1
Case Study: Mental Health Nursing
Name
Institutional Affiliation

CASE STUDY 2
Case Study: Mental Health Nursing
In this paper I focused on a mental health nursing in unique scenarios that I have
experienced in my clinical practice. In this case, I describe my encounter with an immigrant
woman who had undergone various cultural practices including gender based violence and
female genital mutilation (FGM). The purpose is to describe the rehabilitation and recovery
process of the woman with a focus on nursing roles and interventions I undertook. The
sections included in the study include a presentation of the case, the process of engagement
and relationship building, identification of specific needs/problems and strengths,
application of principles of rehabilitation and recovery, the interventions implemented on
the patient and the assessment tools/rating scales used.
A Case History
I was on morning shift when a 23-year-old Somali woman comes to the hospital
accompanied by an elderly woman. She complained of sleeplessness, and attention deficit.
The elderly woman who was identified as her friend stated that she had been having
inconsistent thoughts, was easily irritated, had lost interest in activities such as knitting,
which she was previously engaged in and she often seemed anxious. The young woman was
unwilling to share finer details regarding her condition, but insisted she had not been
sleeping adequately. The friend asserted that she had been spending much time alone and
was often scared by noises and motions.
I requested the friend to leave the room. Upon leaving, the woman explained that she
had been in Australia for the last 6 months. She left Somalia through a refugee program to
seek asylum in Australia. She has one child who she got from a forced marriage in her
teenage years. She also underwent female circumcision which was a traumatizing experience
at the age of 12 years, before being forcefully married off to an older man. She went on to
narrate that since the birth of her first child, she had been experiencing severe pain in her

CASE STUDY 3
genitalia, which was a major challenge in her marriage. She suffered domestic violence and
severe beating from her husband. The memories of the horrific FGM experience and severe
violence inflicted on her kept haunting her. She could not share the experiences with fellow
Somali women due to influences of stigma, cultural viewpoints and fear of victimization.
Following her case history, she is diagnosed with posttraumatic stress disorder (PTSD).
The Process of Engagement and Relationship Building
In my interaction with the patient, I observed that the effectiveness of healthcare
engagements and relationships was influenced by the cultural, environmental and individual
factors of the patient. Cultural factors were a major barrier to effective engagement and
relationship building among victims of FGM. The woman still perceived FGM to be a
justifiable and appropriate procedure due to her cultural orientation. Klein, Helzner,
Shayowitz, Kohlhoff, and Smith-Norowitz (2018) explained that female circumcision
involves the manipulation or alteration of external genitalia for women and girls. In
developing countries, it is often regarded as a societal norm is a requirement for families to
be accepted in the community. In the cultural perspective, FGM is upheld due to the
perceptions that it is preserves fertility, improves chastity among girls, and enhances sexual
pleasure for men and promoted hygiene. Failure to undergo FGM is regarded as bringing
shame to the family (Klein et al., 2018).
I also realised that the woman had suffered stigma from the community regarding
reporting of FGM incidences was another barrier to effective interactions. Knipscheer et al.
(2015) explained that circumcised immigrant women are at risk of emotional instability,
PTSD, depression and anxiety. Specifically, the victims of FGM in the Somali community
often fear reporting the incidences due to different cultural perceptions and taboos that make
them ashamed to discuss their problems and feel a sense of stigma. Further, they my fear

CASE STUDY 4
sharing their stories as it may be a reminder of the pain and trauma they experienced during
the mutilation (Knipscheer et al., 2015).
Societal factors also played a critical role in determining the nature of clinical
interactions. Speaking openly about trauma is an essential part of healing and recovery.
However, it is only applicable in a culture that recognizes the trauma and the psychological
consequences it causes on the individuals (Knipscheer et al., 2015). Unfortunately, in the
Somali community where the woman comes from, it is difficult to discuss the traumatic
consequences of FGM within their culture as most of the fellow women view the event less
negatively as compared to women from other cultures. Further, most Somali women are
Muslims who regard FGM as a cultural right referring to the Islamic teachers which regard
sunna (female circumcision) as acceptable).
Additionally, I realised the financial challenges of the woman that prevented her
from seeking health services. According to Suphanchaimat, Kantamaturapoj, Putthasri, and
Prakongsai (2015), there are various challenges that influence the attitudes, practices and
perceptions of healthcare providers in the delivery of healthcare services to immigrants.
Some essential factors include inadequate institutional capacity as a result of resource of
time constraints, fear resulting for perceived racism, and their legal status. Therefore, it is
essential for healthcare practitioners to ignore discussions regarding the legal status of
immigrants to enhance professionalism and functionality of the clinical practice.
Due to the cultural orientation of the patient, it was challenging to establish
therapeutic interactions. The patient approached the interactions cautiously in fear of ridicule
by fellow women. Additional, the woman did not perceive FGM as a cause of psychological
problems as she still regarded it highly due to the cultural orientation.
Identification of Specific Needs/Problems and Strengths