Mental Health Case Study Analysis

This document provides an analysis of a case study on mental health, including a holistic mental health assessment, factors contributing to the patient's condition, and recovery-oriented practices.

Running head: MENTAL HEALTH CASE STUDY ANALYSIS
MENTAL HEALTH CASE STUDY ANALYSIS
Name of the Student:
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1MENTAL HEALTH CASE STUDY ANALYSIS
Question 1
A holistic mental health assessment comprises of one of the most essential steps
underlying the deliverance of a comprehensive mental health services to the concerned patient.
As researched by Sullivan et al., (2019), Mental State Examination (MSE) is considered to be an
effective tool of evaluation for understanding the mental health status of an individual in terms of
multifaceted components like attitude, appearance, mood, behavior, speech, affect, process and
content of thought, cognition, perception and insight.
Aligning an MSE assessment with the case study of Munny Kaew, it can be observed
Munny’s physical appearance of wearing loosely fitted clothes, slouching at his seat and an
overall look of disregard towards himself demonstrates a sense of apathy and lack of interest
towards aspects of his health, grooming and eating habits which he attended to previously (Kim
et al., 2016). While Munny does not demonstrate any form of aggressiveness of retardation, his
behavior, as per the MSE examination, displays a lack of concern towards himself and his
family, which is unusual considering his previous reports of showering affection towards his
children. When asked to describe about his mood, Munny’s lack of self-esteem and disregard
towards himself, his family and his job is evident from his short, incomplete answers and his lack
of eye contact (Gallo et al., 2016). While the content of his thoughts are free from hallucinations
or delusions, and MSE observation of his thought form demonstrates an interconnection
between the negative appreciation from Munny’s job and his gradual loss of interest towards
pleasurable activities. As per MSE observations, it is evident that Munny is cognitively sound.
However, his lack of affection towards his family and absence of a will to live, demonstrates

2MENTAL HEALTH CASE STUDY ANALYSIS
discrepancies towards Munny’s insight and judgment towards his personal as well as his familial
wellbeing (Holwerda et al., 2016).
Taking insights from the details of the MSE examination as well as the diagnostic criteria
postulated by the Diagnostic and Statistical Manual of Mental Health Disorders, 5 Edition
(DSM-V), a diagnosis of clinical depression can be stipulated for Munny. According to the
DSM-V diagnostic criteria, an individual is considered to be inflicted with depression, if he or
she appears to project a state of sadness, emptiness or hopelessness for a major part of the day, a
lack of interest towards previously pleasurable activities, a loss of appetite and associated weight
loss, a constant sense of tiredness and fatigue, a sense of hopelessness and worthlessness and loss
of self-esteem and a preoccupation with thoughts of death (Schmidt & Tolentino, 2018).
Munny’s state of depression is evident in his loss of pleasure towards his job or his children, a
lack of interest towards eating and taking care of himself and his constant tendency to lie in bed
throughout the day.
Additionally the research by Brådvik (2018), individuals who are immigrants, have
experienced traumatic childhood events and have symptoms of depression, are highly susceptible
to suicide and suicide ideation. Munny’s immigration from Cambodia, the tragic loss of his
father and his disregard to live as evident in his conversation with the nurse, demonstrates a
diagnosis of suicide ideation as a part of his current mental health status.
Question 2
Two of the major factors which could have contributed to Munny’s present condition is
stress and traumatic incidences encountered during childhood.

3MENTAL HEALTH CASE STUDY ANALYSIS
As researched by Schönfeld et al., (2016), stress can be defined as a range of
psychological and physiological reactions occurring with an individual, when met with situations
which are challenging, demanding or adverse. In the case of Munny, a key incident which may
have contributed to this condition of stress and hence the resultant depression, is the unpredicted
negative feedback and possibility of unemployment communicated to him by his employer. The
intricate association between stress and Munny’s present condition of clinical depression can
further be attributed to and well articulate by the Stress Vulnerability Model.
The Stress Vulnerability Model postulates the certain individuals, due to specific
biological characteristics are more susceptible to acquire symptoms associated with excessive
stress and the resultant multiple mental health psychological morbidities related to the same
(Armstrong & Rimes, 2016). According to this model, individuals who have been found to be
highly susceptible to stress and it associated psychological complications (clinical depression,
anxiety disorders, bipolar disorders, schizophrenia) are those who have encountered traumatic
experiences at childhood, are genetically predisposed to the condition or have encountered poor
lifestyle and nutritional conditions by the mother during the prenatal stage (Sachs, Ni & Caron,
2015). While factors like prenatal nutrition and genetic predisposition of Munny can only be
considered after further in-depth evaluation, the factor which forms a striking contributor to
Munny’s condition of clinical depression is trauma to experience at childhood.
As researched by Nievergelt et al., (2015), trauma can be defined as an experience which
is adverse highly stressful and often disturbing. From the case study, it is known that Munny’s
family had migrated to Cambodia during the reign of the Khmer Rouge which was preceded by a
tragic incident of his father being killed. Additionally, this was followed by a life of hardship at
the refugee camp where his mother acquired cancer. Hence, such an incident of trauma coupled

4MENTAL HEALTH CASE STUDY ANALYSIS
with the sudden stress and occupational pressure from his employer about his poor performance
and possibility of unemployment, could have contributed extensively to increasing Munny’s
biological vulnerability to acquire stress and associated psychological conditions according to
the Stress Vulnerability Model.
The biological impact of stress as per this model can be attributed to endocrinal
mechanisms. Stress or any challenging situation results in the release of cortisol – hormones
essential for inducing the fight or flight mechanism. While certain levels of stress and associated
biological mechanisms are intrinsic to survival, excessive levels results in an imbalance of
neurotransmitters such as decreased serotonin and dopamine - neurological components
contributing extensively to regulation of appetite, mood, sleep, energy, behavior and thinking
processes (McEwen et al., 2015). Thus, taking insights from the case study, traumatic incidents
like the tragic loss of father and Munny’s helplessness in his mother’s battle against cancer
coupled with the stressful situation at work, can be implied to have contributed to specific
neurological and biological changes which have not only increased Munny’s susceptibility to
stress, but have also resulted in unhealthy behaviors of loss of appetite, shrunken appearance and
distorted thinking, judgment and insight of hopelessness towards himself and his family, which
have been identified previously in the MSE observation.
Trauma informed care would be the most preferred mode of therapeutic intervention for
Munny, which comprises of development of treatment mechanism taking into account the
holistic and comprehensive needs of a patient, including experiences of trauma and possible
strategies of coping which are relevant to the patient’s unique scenario (Oral et al., 2016).

5MENTAL HEALTH CASE STUDY ANALYSIS
Question 3
According to the Department of Health (2019), adoption of a recovery oriented practice
implies management of the mental health condition of the patient, by encouraging him or her to
communicate and take control of his or her life, through the identification and consideration of
personal strengths and weakness and regaining of hope of further find a sense of purpose,
meaning, autonomy and positivity in life.
‘Respect’, as outlined in the fourth principle of recovery oriented practice can play a key
role in the mental health recovery of Munny (Departent of Health, 2019). Respect towards the
client, as researched by Davidson (2016), not only involves adherence to courteousness and
transparency during client interactions, but also a sense of empathy, sensitivity and non-
judgmental attitude which will challenge and mitigate the experience of discrimination and
stigmatization which the client may have encountered throughout his or her life. Thus, in the
case of Munny, along with the mental health nurse, his family as well as employer must also
consider conversing with him in a respectful manner, demonstrate a sense of empathy towards
his present condition and thought as well display sensitivity when discussing his occupational
performance with considering his unique cultural and childhood experiences. This will enhance
Munny’s recovery since it has been implied that treating a client with respect and empathy,
results in positive perceptions where he or she feels that his or her needs are respected, viewed
non-judgmentally and empathized with like any other individual which further grants him or her
a sense of value and purpose in life (Corrigan, Bink, Schmidt, Jones & Rüsch, 2016).
Empowerment is the ability within an individual to gain a claim and control over his or
her personal life. Empowerment is a key construct within recovery oriented mental health
practice since clients with lived experiences generally arrive for assistance with a diminished

6MENTAL HEALTH CASE STUDY ANALYSIS
sense of self- control and self-esteem over their lives (Grealish et al., 2017). In the case of
Munny, his wife Ary, can empathetically discus with him on his needs, preferences and
possibilities of alternative jobs. Similarly, instead of merely expressing dissatisfaction, Munny’s
employer can empathetically discuss on areas of improvement and provide him a second chance
or suggest him referrals or alternative prospects. Client centered approaches, referrals to
advocacy groups and self-help groups comprising of like-minded individuals, have been
postulated to empower and instill optimism in clients, which Munny’s healthcare professionals
can suggest (Naslund, Aschbrenner, Marsch & Bartels, 2016).
Instilling hope is be of major benefit to Munny who is currently inflicted with a sense of
hopelessness in his life. Hope, as researched by Marino (2015), can instill positive perceptions
within the client and make him feel that he is loved, cared for and that his efforts are valued.
Munny’s family, employer and health professionals can ensure this via empathetic, affectionate
and non-judgmental conversations when interacting with him.

7MENTAL HEALTH CASE STUDY ANALYSIS
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