Mental Health Case Study (Doc)

CASE STUDY

TABLE OF CONTENTS
CASE STUDY 1..............................................................................................................................1
HONOS RESULT........................................................................................................................2
REFERENCES................................................................................................................................1

CASE STUDY 1
This is based on the case study of Ben, who is single and is 25 years old living as an
inpatient at Mental Health Unit. He was an engineering student and started experiencing
psychosis when he was 22 years in the final year. His conditions are getting triggered in the most
uncertain ways and has impacted both his personal and professional lives adversely.
Overview on Family background: He has been brought by his parents, Peter and Janet and
recently, his mother has developed Type 2 diabetes. He has a sibling named Estelle and share
strong bonds with the entire family. He was a B grade student and his long term plans were
completing his degree and settled down in a stable job. Moreover, his focus was to travel and
ultimately settled down by starting a family of his own.
 He was diagnosed with psychotic symptoms and admitted for 4 weeks due to
deteriorating conditions.
 Ben found it difficult to take his oral medication which in turn affect the stress levels in
higher extent.
 He had been treated with First Onset Psychosis Team and received good recovery.
 He experienced a relapse when holidaying with his family in abroad location and led him
to get admitted at the Public Adult Inpatient Unit.
 Ben gained 4 kilograms and his appetite has been increased with large meals and snacks
as the side dishes.
 His present status is of feeling constant hopelessness and worthlessness with variable
mood swings of sadness and anxiety.
 Ben is in constant stressed and paved the path of disorganized thoughts and actions as
well in context to is living conditions.
 He has been experiencing difficulty in sleep but never encountered any middle night or
early morning awakening.
 He is currently hallucinating about the paranoid ideation in terms of constant watching,
following and talking with him from some other invisible elements.
 Ben has been called by several names like 'freak','odd ball' etc. and has been under the
notion that he has been investigated and under constant monitoring of his subordinates.
 Ben has been experiencing poor handling of doing daily chores and tend to forget taking
medication. This also aids in poor health in context to both physical and psychological.
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 He also feels suicidal tendency, however he never attempted it but wished that this
constant struggle comes to an end.
HONOS RESULT
Domain Results
Hallucinations or
delusions
0 1 2 3 4
Activities of daily living 0 1 2 3 4
Problems with occupation
and activities
0 1 2 3 4
Consumers
Priority
Identified
Goals/Issues
Consumer's
strengths to
address these
issues
Consumer
and Nursing
Interventions
Person/s
Responsible
Time frame
Ben has been
in constant
despair feeling
in which
psychotic
reflexes has
been felt by
him on regular
duration.
Consumer's
Priority: #1
Issue 1:
Feeling of
sadness and
worthlessness
with onset of
suicidal
tendency in
Ben which
forced him to
get admitted
as an inpatient.
He has also
shown lack of
confidence in
pursuing
Strength 1: -
After
contemplating
on his overall
progress, it is
found that he
had no clue
about his
hallucinations
since he
believed that it
is occurring in
the real life,
however he
wants to get
Intervention
1:
Collaboration
between Ben
and nurse
must be
initiated for
proper
adoption of
therapeutic
interventions
in order to
attain the
goals (Guo,
Responsibilit
y 1:
-Case
Manager, who
is reviewing
his case since
nine months
and has keen
observatory
details. It
might be
useful for him
to take the
interventions
on time and
Time frame
1:
He has been
an inpatient
and must
follow the
medication
properly, thus
it is important
for him to
adjust it with
self discipline
on daily basis
2

future
prospects.
Goal 1:
To minimise
the psychotic
hallucinations
through proper
channels via
adopting
medical
medications
for better
recovery
HONOS
Score: 4
recovered at
faster modes.
-For this, he
must ot remain
in constant
preoccupation
of such
negative
emotions and
should follow
nursing
interventions
religiously.
-Ben never
had any
medical issues
or allergies,
however at 17,
he met with
accident and
underwent
surgery. This
was the only
time when he
received
medical
treatment until
22, yet he is
determined to
2015).
-There is need
to have proper
monitoring
systems to
understand the
progression
levels
under the
professional
advice.
-Additionally,
he might be
helping Ben in
more
collaborative
manner due to
the proximity
levels.
-Moreover, the
focus is to
make him
understand the
real time
issues and stop
thinking about
the voices and
people he sees
or interacts
with.
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end all this
negativity by
staying
positive and
follow the
symptoms of
schizophrenia
to adopt
strategic
planning
-He is goal
oriented and
has sense of
responsibility
since he is the
older child of
his parents.
Ben has
encountered
that there is
onset of
anxious
desperation to
bring some
changes but
miserably
failing. His
Issue 2:
Ben is unable
to concentrate
on doing the
daily activities
due to feeling
of
helplessness.
He is
demotivated
and is highly
Strength 2:
-He is hard
working and
immediately
started
working after
his first
incident of this
relapse to earn
money. Thus,
he is aware of
Intervention
2:
-It is also
required to
build
effective
communicatio
n in terms of
reaching Ben's
capacity,
ability and
Responsibilit
y 2:
-His parents
also play
important part
in his recovery
plan. They are
the foremost
contact who
might make
him feel
Time frame
2:
- He must
engage in
constructive
activities to
minimise the
psychotic
emotions' and
must be
monitored
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focus has been
withdrawn and
lead to
impaired
concentration
Consumer's
Priority: #2
uncertain
about his
future. This
diagnosis is in
danger zone
and needs to
be looked into
for better
recovery of
Ben.
Goal 2:
To make him
engage with
daily activities
to bring back
into the real
world through
consistency
and
persistence
HONOS
Score: 3
the conditions'
and closely
taking help
from his
parents and
the case
manager to
become
normal again
-He is creative
and logical
person who
never believed
in ideological
concepts.
Furthermore,
he believed in
earning on the
basis of merit
and
knowledge
and needs the
interventions
to be followed.
However, he
sometimes
become
forgetful.
-Ben is
interested into
resourcefulnes
s and provide
assistance for
his recovery
(Wilson &
et.al., 2016).
-Sense of hope
must be
inculcated
which is
aimed at
'doing for' Ben
and laid the
foundation of
establishing
balance
between
nursing
intervention
and the
personal
objective of
Ben through
reliable and
open
communicatio
n
comfortable in
his skin and
flaws as well.
-They might
plan the daily
activities and
monitor the
overall
progress to
understand the
development.
-He had
suicidal
tendencies and
must never be
promoted to
follow and for
this, the
parents must
have one to
one interactive
sessions with
him about his
life and daily
feelings to
make him
come out of
this delusional
world.
under weekly
report
-He must join
focus groups
and share his
fears and inner
emotions to
give more
clarity and
fluidity to the
parents
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reading and
watching TV
but struggling
due to
prevalent
symptoms of
such
psychological
tendencies and
wants to stay
motivated
Ben is unable
to pursue his
engineering
and carry with
doing work.
He lost the
eagerness to
continue his
life of feeling
scared all the
times. It is
shown that he
has a feeling
of helplessness
and
worthlessness.
Consumer's
Priority: #3
Issue 3:
The residual
paranoia while
working at the
company, he
felt that e has
been following
and people are
intruding into
his personal
space. This
affected his
sanity levels
and led him to
hopelessness
and loss
Goal 3:
Ben must
focus on
bringing
Strength 3:
-He has no
signs of
disruptive
behaviour
despite
continuous
deteriorating
conditions and
it is one of the
key features
that might
help to recover
faster from
Schizophrenia
Intervention
3:
Nurse has
outlined a
planning care
to prioritise
the goals and
applying
strategies to
meet with
Ben's
behavioural
changes and
bring recovery
at faster
modes
(Gulanick &
Myers, 2016)
-An
Responsibilit
y 3:
-His sister
Estelle can
also help him
as they are
close and she
is able to
understand his
conditions
properly.
-She must
interact with
him to
maintain the
sanity by
discussing the
things he was
once
Time frame
3:
-His
conditions
must be
analysed by
the Case
Manager on
daily basis to
understand his
diagnosis and
fluctuations
through record
keeping.
-There is a
need to
establish
cordial
relations for
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himself to the
normal life
and it must be
understandabl
e that his
delusional
concepts must
be removed by
engaging
back into an
active social
life
HONOS
Score: 3
independent
functioning
unit is
developed to
look after the
steady changes
and
improvements
of Ben by the
assigned
nurse.
-The focus is
to maintain the
mental well
being of Ben
through
collaborative
approaches
that assist in
bridging the
gaps which are
found in the
professional
context when
dealing with
such
delusional
cases
passionate
about like
reading,
engineering
career
prospects etc.
-His social
circle became
restricted thus,
she must try to
encourage him
to interact
with their
neighbours
and mutual
contacts
establishing
trust and
mutual respect
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REFERENCES
Gulanick, M., & Myers, J. L. (2016). Nursing care plans: diagnoses, interventions, and
outcomes. Elsevier Health Sciences.
Guo, P. (2015). Preoperative education interventions to reduce anxiety and improve recovery
among cardiac surgery patients: a review of randomised controlled trials. Journal of
clinical nursing.24(1-2). 34-46.
Wilson, D. S. & et.al. (2016). Nurses’ perceptions of implementing fall prevention interventions
to mitigate patient-specific fall risk factors. Western journal of nursing research. 38(8).
1012-1034.
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