Holistic Care Plan for Mental Health Nursing Case Studies

This article discusses holistic care plans for two mental health nursing case studies. It covers the issues faced by the patients and the interventions required to resolve them. The article also discusses the role of allied health service providers and community resources in the treatment plan.

Running head: MENTAL HEALTH NURSING
Case Study Analysis
Name of the Student
Name of the University
Author Note

1MENTAL HEALTH NURSING
Case study 1
Health issues
An analysis of the case study of 20 year old Anton suggest that he suffers from a range of
biological, psychological, social, and sexual health issues that have deteriorated his quality of
life. Health is generally defined as the state of complete mental, physical, and social wellbeing,
in addition to the major absence of some infirmity or disease (Stoddart & Evans, 2017). Upon
collecting cues from the case study, it is quite evident that the patient Anton is overweight, which
can be attributed to the high intake of fried food, sugar-rich soft drinks, and beverages that he
consumes for a minimum of 4 litres, each day. All of these factors have contributed to a sudden
increase in weight, by approximately 15kg in a year and a body weight of 97 kg. Upon
calculating his BMI with respect to the height, it has been found to be 29.9 that categorises him
as overweight and on the borderline of being called an obese adult (Jensen et al., 2014). The
major psychosocial issue that he suffers from is paranoia, a mental condition commonly
characterized by delusions of exaggerated self-importance, or prosecution, which in turn is an
aspect of drug abuse and chronic personality disorder (Freud, 2014). This has made him lose
touch with reality. Unemployment, financial instability, social withdrawal, and distress regarding
the impending future are some of the social issues that have also affected his life. Besides all of
these aforementioned problems, he is also suffering from risks of sexual disorder, particularly
impotency that has created a negative effect on his health and wellbeing.
Resolving health problems
Holistic medicine most often encapsulates different forms that help in healing the person
and focuses on lifestyle changes, self-care and patient education to promote a general sense of

2MENTAL HEALTH NURSING
wellness (Papathanasiou, Sklavou & Kourkouta, 2013). This often includes exercise,
psychotherapy, diet, acupuncture, spiritual and relationship counselling. The issues that are
currently faced by Anton comprise of his being overweight, substance abuse, and psychosis,
risks of sexual disorder, lack of social engagement, and unemployment and lack of companion.
Issue faced Goals Intervention
Overweight Anton will understand
the ill effects of being
overweight and will
actively participate in
weight management
 Formulating an effective diet plan
 Making him adhere to lifestyle
modifications such as, participation in
physical activities, moderate physical
exercise for a minimum of 40 minutes,
each day (Hutchesson et al., 2015)
 Referring him to effective obesity
prevention programs.
Paranoia He will get rid of the
delusional beliefs and
episodes of hallucination
or irrational
suspiciousness
 Administration of antipsychotic or
anti-anxiety drugs (Kohut, 2013)
 Cognitive behavioural therapy to
improve mental functions
 Educating on different coping skills
such as, relaxation therapy and
behavioural modifications (Morrison

3MENTAL HEALTH NURSING
et al., 2015)
Substance abuse He will become aware of
how substance abuse
creates an impact on
major life areas
 Administer effective medications to
reduce craving and suppress
withdrawal symptom (Volkow et al.,
2014)
 Refer him to long-term alcohol and
drug rehabilitation program
 Engage him in mindfulness exercise
such as yoga and meditation (Khanna
& Greeson, 2013)
 Make him adhere to consumption of
herbal medicines
Unemployment
and financial
instability
He will be able to better
seek employment
opportunities and utilise
the pension
 Refer him to financial consultants and
organizations that provide
employment services
 Engagement in community programs
for coping with uncertainty and stress
(Cylus, Glymour & Avendano, 2014)
Lack of
companion and
sexual issue
Anton will be able to
cope up with the
psychological impact
 Refer him for a counselling program
 Prescribe DHEA and DHA

4MENTAL HEALTH NURSING
these sexual issues create supplements (Moyad, 2014)
Table 1- Holistic care plan for Anton
Allied health service providers
These health professionals apply their expertise, with the aim of preventing transmission
of disease, diagnosing, treating, or rehabilitating individuals, of all specialties and ages. They
usually work in healthcare teams, in order to facilitate the entire healthcare system, to function
properly by delivering a range of technical, diagnostic, and therapeutic patient support and care
services. An analysis of the case study suggests that Anton has certain specialized healthcare
needs that can be holistically and effectively managed only with the help of allied healthcare
professionals. Proper nutrition is utmost important to overall wellbeing and the healthy living. A
nutritionist is imperative in his treatment plan that will help him show adherence to dietary
modifications that focus on consumption of food rich in fibre and with low fat and sugar content,
thereby triggering the process of preventing weight gain (Orzech et al., 2013). A psychotherapist
will also be essential in improving his mental health and wellbeing, by resolving troublesome
beliefs, behaviours, compulsions, emotions, and thoughts. This will directly create a positive
impact on his social skills and facilitate treatment of the emotional problems that he is currently
suffering from, with the help of interpersonal or cognitive behavioural therapy (Erlich, 2018).
Help of a physiotherapist will also be required who will focus on exercise therapy and
kinesiology, in order to promote the function and impaired mobility in the patient. This in turn
will assist him in getting rid of the sedentary lifestyle, a major step towards reduction of weight.

5MENTAL HEALTH NURSING
Community resource referral
Community resources are often considered essential and help in meeting specific needs
for the people around them. They enhance the quality of life or enjoyment in a particular area,
and often include a neighbourhood, libraries, volunteers, or organisations. Most health issues that
deal with psychological abnormality require interventions for treatments that are able to address
the holistic wellbeing of the affected person. Engagement in the community and volunteering in
social work have been identified as useful community resources that help in improving the
psychological condition of a patient. The case study suggests that Anton is suffering from a lack
of self esteem, social exclusion and uncertainty, regarding his health, which in turn is affecting
his quality of life. Therefore there is a need to refer him for participation in a psychology
community engagement program, which will play an essential role in promoting empowerment
of the patient (Acharya et al., 2017). This will directly facilitate in bringing about a modification
in his personal views, regarding self-worth and will also provide opportunities to learn effective
coping strategies to deal with the barriers that he is currently facing. Other resources to which
Anton can be referred to include several eating disorders specialists, who will reduce the stigma
surrounding the condition, and will also, make him feel the compulsion to engage in healthy
eating behaviours that will improve his health. Referral to body image recovery services would
also be beneficial in this case. The patient will also be referred to support services for sexual
disorders and addiction that will provide immediate crisis assistance, and enhance the quality of
life. Anton will be referred to the Lismore Community Health Centre that will allow him to
access a wide range of health services. Some of the services that will be beneficial in this case
are the helpline for ‘Area Wide Intake for Cannabis Clinic’, mental health line and healthy eating
groups (Northern NSW Local Health District, 2018).

6MENTAL HEALTH NURSING
Narrative
Upon analysing the case study of 20 year old patient named Anton, it can be deduced that
his severe addiction to cannabis created the negative impact on his personal and social life
thereby deteriorating his overall health and wellbeing. There is a need to address the issues faced
by implementation of a holistic care plan that will focus on administration of both
pharmaceutical and non-pharmaceutical interventions to help him overcome his eating disorder,
psychological disorder, sexual issues and financial instability. Strict adherence to a healthy diet,
participation in exercise and other physical activities, and an engagement in cognitive
behavioural therapy and other community programs would prove successful in eliminating
chances of recurrence of the health abnormalities. These interventions will eventually help him
secure unemployment and get rid of stress in the long run.
Case Study 2
Health issues
Prolonged substance abuse is frequently intertwined with the range of mental health
issues and results in mild to severe psychological distress in the addicted individual (Lewis et al.,
2014). Childhood history of sexual abuse can be regarded as one of the primary reasons that
made the patient, Cat resort to habits that involve the use of drugs. The fact that she has been
using methamphetamines for a long period of time can be attributed as the primary reason for the
different health issues faced by her. The primary biological issue identified in this case is a
sudden and sweeping reduction in weight, which is one of the most common adverse effects of
prolonged methamphetamines consumption. Time and again the drug has been identified as a
powerful stimulant that results in alterations in physical appearance, including loss of appetite

7MENTAL HEALTH NURSING
and weight reduction. The rapid loss in body weight has also resulted in development of
amenorrhea or interruption in the menstrual cycle (Westerberg & Waitz, 2013). Binge eating
disorder is the psychological issue identified in this case that is often associated with emotional
and behavioral signs of grief, anxiety, self-hatred, and depression (Ashrafian et al., 2013).
Research evidences have established the fact that consumption of methamphetamine for a
significant time creates an adverse impact on the signalling pathways that control sexual
hormone secretion, thereby resulting in disruption of menstrual cycles (Bourne et al., 2015). In
addition, another psychological issues faced by Cat is the presence of borderline personality
disorder, a mental illness that is characterized by variations in self image mode and behavior. It
creates an impact on the way that an individual feels send things about himself in everyday life.
Not being concerned about transmission of STD and engagement in unprotected sex can be
categorised as some of her sexual issues. Estrangement from family members, lack of companion
and isolation are some of the social issues faced by her.
Holistic address
Holistic care most often involves taking steps to heal the body mind and soul of the
patients and it ensures care for different aspects of life. In other words, it can be defined as an
integrated healthcare approach that treats the entire person, rather than just the disease or
symptoms.
Issues goal intervention
Addiction of
methamphetamines
Cat will be able to identify
the negative impacts of the
 Educate the patient on the ill
effects of addiction on the

8MENTAL HEALTH NURSING
drug on her health and
lifestyle and adopt a
necessary steps for
preventing its consumption
mental, physiological, and social
wellness of an individual
(Shariatirad, Maarefvand &
Ekhtiari, 2013)
 Conduct an assessment in order
to ensure proper recovery of the
patient
 Engage her in detoxification
program that will make her
emotionally stable and help her
develop recovery skills
(Courtney & Ray, 2014)
 Implement non-pharmacological
interventions such as meditation,
yoga, and nutritional therapy to
prevent use of the drug
Sudden weight loss She will understand the
negative impacts that a
sudden reduction in body
fat can create on the
different physiological
 Administer dopamine antagonist
for restoring normal endocrine
function of the ovary (Billes,
Sinnayah & Cowley, 2014)
 Make her adhere to dietary

9MENTAL HEALTH NURSING
systems modifications such as, protein
rich diet that will focus on
consuming healthy food items in
order to gain weight
 Engage her in different
behavioural therapy to reduce her
life stress
 Refer her to counselling services
 Suggest intake of nutritional
supplements for healthy weight
gain
 Prescribe vyvanse for treating
the binge eating disorder (Turer
& Palmer, 2015)
Borderline
personality disorder
The patient will gain her
self-esteem and be able to
overcome the psychological
issue
 Engage her in psychotherapy
such as dialectical behaviour
therapy or mentalization based
treatment that will be based on
her individual needs (Tomko et
al., 2014)
 Initiate cognitive behavioral
therapy to change her beliefs and

10MENTAL HEALTH NURSING
behaviour, in addition to
reducing self harming tendency
and suicidal thoughts (Chanen &
McCutcheon, 2013)
 Prescribe antipsychotics such as,
haloperidol for reducing
impulsivity and likelihood of
suicidal ideation (Ringbäck
Weitoft et al., 2014)
 Administer mood stabilizers such
as, well valproate semisodium
(Stoffers & Lieb, 2015)
 Provide encouragement for
engaging in volunteering and
community services
 Refer to counseling services
Sexual health issues She will gain an awareness
of the risks of engaging in
unprotected sex
 Provide patient education on the
adverse impacts of STDs
 Determining the need of using
pulsatile gonadotropin-releasing
hormone therapy to induce

11MENTAL HEALTH NURSING
(Kumar & Sharma, 2014)
 Providing vitamin D supplements
(Canguven et al., 2017)
 Addressing her emotional health
concerns and helping her
formulate her body image and
self-esteem.
Loneliness and lack
of willingness to live
Cat will be empowered and
feel the desire to enjoy her
life
 Engage her in different
community and recreational
activities to overcome depression
(Cacioppo et al., 2015)
 Re-establish links with family
members
 Refer her to community services
that provide employment
opportunities
 Refer to support groups that deal
with victims of suicide and
sexual abuse
Allied health workers

12MENTAL HEALTH NURSING
Poor mental health is a significant challenge for the entire community and calls for the
need of seeking help from allied health professionals, who will provide community care,
substance abuse, and mental health services to the affected individuals. Upon analysing the case
study it can be suggested that Cat is in need of support from allied health workers such as,
holistic nutritionist, psychotherapist, and sexual health practitioners. A nutritionist or registered
dietician is integral in providing help to Cat with her binge eating disorder and will guide her in
adopting or selecting appropriate food (Katterman et al., 2014). She will also be provided
assistance through food with fallacy and misconceptions, related with its intake and weight gain.
A psychotherapist will work towards improving her mental health and wellbeing by mitigating or
resolving her troubles some compulsions, behaviours, thoughts and beliefs (Jørgensen et al.,
2013). With the use of evidence based strategy a psychotherapist will effectively diagnose her
mental disorder and implement several techniques in reducing its severity. Social workers will
also play a crucial role in re-establishing her association with her family members, community
and group, in order to enhance her overall wellbeing and social functioning (Worden, 2018).
This will be an essential step in reducing the trauma associated with childhood abuse. A sexual
health practitioner will be responsible for engaging in effective communication about public
health messages related to sexual health, thereby helping her modify her behaviour.
Community resource referral
Community resource will uplift her mood and help in diverting her mental state from the
event of being a victim to childhood sexual abuse. Furthermore, referral to recovery resources
will also help her acquire necessary skills and information that will facilitate better management
of her emotions. This will be facilitated by engaging in dialectical behaviour therapy, workshops
and practice sessions. Facilitating community engagement is an essential step in preventing

13MENTAL HEALTH NURSING
suicidal thoughts among all patients (Denno, Hoopes & Chandra-Mouli, 2015). Cat can be
recommended to healthy eating resorts that will help in improving her diet and make her
physically active, thereby delaying or preventing the onset of chronic diseases. She will also be
referred to community plans for intake of drug and alcohol that will provide medical support,
treatment, detoxification and counselling for the use of methamphetamine (Northern NSW Local
Health District, 2018). Referring her to the mental health access line will also be an essential step
in preventing for the deterioration of the borderline personality disorder (Andrews et al., 2015).
The community resources will provide her the necessary social support, and an engagement in
follow-up care will help in fighting the stigma associated with abuse and psychiatric disorders.
Narration
It is not uncommon for people having experienced childhood sexual assault to develop
suicidal ideations late in their life (Devries et al. 2014). Furthermore it also creates an impact into
the wellbeing and mental health into adulthood (Dyer et al., 2013). An analysis of the case
scenario suggests that sexual assault faced during childhood had a lasting impact on Cat and
resulted in the development of borderline personality disorder and suicidal tendency.
Implementation of the holistic care plan will help her in maintaining a healthy weight and
reducing addiction to methamphetamine. Engagement in community services and regular
counselling will improve her optimistic views and enhance the overall quality of life.

14MENTAL HEALTH NURSING
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