Promoting Mental Health and Wellbeing: Assessment, Stress-Vulnerability Model, and Recovery Model

This article discusses the assessment of mental health through Mental State Examination (MSE), the Stress-Vulnerability Model, and the Recovery Model. It also analyzes the case study of Chung and his panic disorder. The article emphasizes the importance of respect, empowerment, and hope in the recovery process.

Running head: PROMOTING MENTAL HEALTH AND WELLBEING 1
Promoting mental health and wellbeing 1
Name of the Student
Name of the University
Author note

1PROMOTING MENTAL HEALTH AND WELLBEING 1
Answer to Question 1
Mental State Examination (MSE) is an important assessment in psychiatric practice
which provides a structured way of describing psychological functioning of a patient at a given
time frame. Considering the case study of Chung, domains of speech, mood and affect are
explicitly relevant that provides a comprehensive description of his mental state and allows
accurate formulation and diagnosis for treatment (Mitchell, 2013). The speech of the patient is
observed based on paralinguistic features like rhythm, loudness, pitch, rate, quantity and latency.
His speech was slow and purposeful (Taylor, 2013). There were repetitions of questions and it
was difficult to get information from him. Most of the time, Chung was non-responsive when the
nurse inquired about his health. Speech is also associated with mood and affect. Chung’s affect
is sad and restrictive and he was quiet, slow and flat in mood and tearful. According to the case
study, Chung’s mood is described anxious as apparent through his non-verbal behaviour. There
is blunted or flat affect that may be associated with any sort of heightened or dramatic effect
showing anxiety. During the assessment, the patient had restricted affect where he was totally
un-reactive and not with the flow of the conversation. A bland lack of concern in response to the
conversation was observed in Chung.
According to the American Psychiatric Association, DSM V, anxiety disorders shares
its features with anxiety and fear. Anxiety is anticipatory and in the given case study, Chung is
anxious in response to a perceived threat where he is experiencing thoughts of a heart attack in
the future. The signs and symptoms experienced by Chung meet the DSM-5 Diagnostic Codes of
300.01 Panic Disorder. The primary features that define panic disorder experienced by Chung
are inappropriate worries or fear about future, unexpected and persistent panic attacks as he
might get a heart attack (American Psychiatric Association, 2013). Various changes take place in

2PROMOTING MENTAL HEALTH AND WELLBEING 1
the body due to panic attacks like trembling, dizziness, sweating and increased heart rate that is
also witnessed in Chung. Physical and cognitive symptoms also accompany in panic attacks that
is enough to recognize panic attacks and diagnose panic disorder of a certain expected nature. In
the case study, Chung persistently worried about his recurrent physical symptoms and intense
fear that he might get a heart attack in the future and die. He has been experiencing chest pains,
palpitations and breathlessness, sleeplessness particularly initial insomnia and early wakening.
Panic Disorder Diagnostic Criteria: 300.01 (F41.0) outlines the unexpected panic attacks when
there is an abrupt increase of intense discomfort or fear reaching peak within a short period of
time. This abrupt surge occurs from anxious or calm state where symptoms like sweating,
shaking, pounding heart, and feeling of choking, discomfort or chest pain, fear of dying or losing
control occur and also manifested in Chung (Edition & American Psychiatric Association, 2013).
Therefore, the symptoms manifested by Chung in the given case study fulfil the criteria outlined
in anxiety disorders, panic disorder 300.01 (F41.0).
Answer to Question 2
The Stress-Vulnerability Model explains that there are three critical factors that are
responsible for the development and progression of a psychiatric disorder over the course of
time. The interaction between stress, biological vulnerability and protective factors contribute to
a psychiatric condition. Stress has a great impact on the vulnerability that can trigger the onset of
a disorder or worsen it. Stress is thought to be caused in response to life situations that make it
difficult for an individual to change or adapt to the situation (Russo, 2015). If an individual is
unable to adapt to the stress, mental issue or psychiatric symptoms may develop or progress in
response to the stressors. The examples include tense relationships, life events and lack of
productive life activities that are witnessed in the given case study (Butcher, Mineka & Hooley,

3PROMOTING MENTAL HEALTH AND WELLBEING 1
2013). Chung is a doctor working in Accident and Emergency (A&E) department at a busy,
inner city hospital migrated from China to Australia. Two years back he was under investigation
due to wrong route medication error and was placed on practice supervision for a year. He
always remained tired and stressed out due to overnight calls and that resulted in the medication
error. On his wedding day, his parents were not present and the ceremony lacked reference to
Chinese culture made him emotionally weak due to lack of family support. Moreover, he was
unable to participate in the wedding planning due to his long working hours.
As described by the model, life event, birth of a child is a psychosocial stressor also
contributes to stress and can trigger psychiatric symptoms. Chung and his wife, Harriett has a
three week old baby girl, Charlotte and during delivery, his wife had an infection that resulted in
pain, dressings and difficulty in mobility. Due to Chung’s long working hours and hectic
schedule, he is unable to take care of his wife and baby depicting tensed and detached
relationships. He is stressed due to long working hours and high pressure environment at A&D
acting as an occupational stressor. Altogether, the three stressors, wife’s health, Charlotte’s
birth and lack of productive and useful activity made him anxious and he is experiencing chest
pains, palpitations breathlessness. He is also experiencing feelings of hopelessness and
helplessness and wanted to die. He is feeling worthless, unproductive and failure in his medical
role and letting his family down as he lacks healthy coping skills with the present situation that
is progressing towards a psychiatric condition (Brewin, 2013). He is attacked with suicidal
thoughts, blaming him for the situation and is panicked that he might get a heart attack and die.
The current situation of Chung is explicitly explained through the stress-vulnerability
model where the environmental stressors are contributing to psychiatric disorder experienced by
him. This stressful situation is challenging for him as the situation demands good adaption and

4PROMOTING MENTAL HEALTH AND WELLBEING 1
family support that is lacking in the current scenario. The lack of Chung’s involvement in
meaningful life-in activities such as parenting and medical work is sources of stress that is
contributing to his psychiatric condition. Therefore, lack of coping skills, social support,
involvement in meaningful activities are the contributing factors to Chung’s stress and course
of psychiatric condition, panic disorder.
Answer to Question 3
Positive mental health recovery is not only being free from mental illness, but also
allows an individual to enjoy pleasures of life, believe oneself and have the ability to cope with
the daily life challenges while working productively and enjoy socializing (Slade et al., 2014).
Recovery model of mental health is an approach to emphasize and support an individual’s
potential towards the process of recovery. This is helpful in providing a new purpose and
meaning in an individual’s life so that one evolves beyond their mental illness condition
(Chronister, Chou & Liao, 2013). Recovery oriented mental health practice has three important
positive aspects that comprises of hope, respect and empowerment that facilitates recovery and
impart positive sense in oneself. Dignity and respect are important for Chung as there should be
honest and respectful interactions. The recovery process should involve respect and sensitivity
being courteous in every aspect (Davidson, 2016). A mental health professional should
appreciate and accept the Chinese culture, beliefs and values of Chung so that he feels valued
and respected crucial to recovery. The uniqueness of the individual should be recognized and
there should be inclusion of one’s health beliefs so that the one has opportunities for choices and
live a satisfying, meaningful and purposeful life (Storm & Edwards, 2013). As a mental health
professional, it is important to accept that recovery outcomes are unique and personal and
beyond physical health focusing on quality of life and social inclusion.

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As depicted in the case study, Chung is experiencing feelings of helplessness and
hopelessness being a failure in medical role and personal life, therefore empowerment is
important for his recovery process. He should be empowered so that he recognizes his
capabilities and potential in engaging in meaningful activities. He should be empowered and
supported in making his own choices about how he want to lead his life and make real choices in
living a creative and productive life (Jacob, 2015). He should be supported building on his
strengths and empower him referring to level of influence, choice and exercise control over
events in his life. Empowerment would help Chung to overcome his state of powerlessness and
gain control of his own life. Gradually, he would be able to define his ambitions and needs and
focus on the development of his resources and capacities that support him. His family can
support him in the recovery process by establishing healthy social network with him, promoting
cohesion and empowering him through period of vulnerability and difficult transition (Priebe et
al., 2014). This empowerment is also intended to help him adopt autonomy and self-
determination and gain self-esteem and hope in his life. Empathetic communication can help to
instil hope in Chung about his future and capability to live a purposeful and meaningful life
(Gilburt et al., 2013). Healthcare professionals should acknowledge that every individual is a
master in his or her life and work in realistic and positive ways so that one realizes their own
goals, hopes and aspirations in life.

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