Understanding Mental Health Disorders with DSM 5

This article discusses mental health disorders and their diagnosis with DSM 5. It covers the principles of recovery-oriented mental health practice, the National framework for recovery-orientated mental health services, and the Barker's Tidal Model of Mental Health Recovery. It also explores social, psychological, cognitive, and physical factors that contribute to mental illness, as well as side effects of medication, poor nutrition, and reduced motivation for self-care.

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Name of the Student:
Name of the University:
Author Note:

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1. a. Mental health:
Mental health is defined as the psychological well-being and absence of mental
illness. Mental health is the psychological state of a person in which the emotional and the
behavioural satisfactory level is adjusted. It affects the thinking, feelings, emotion, stress and
behaviour of a person thus it is important to have mental well-being in every stage of life.
b. Mental illness:
Mental illness is defined as the mental condition in which alteration of mood, thinking,
behaviour and emotion occurs due to distress or any impaired functioning. Due to such
mental disorders a person could face depression, anxiety, addiction and even suicidal
thoughts. Such disorders could be cured through effective therapy, medication and
counselling (Fortinash and Worret2014).
c. Delusion:
Delusion refers to the false belief of a person which is held with credence even in the
presence of evidence to oppose the belief. Three main criteria for belief in delusion include
certainty, impossibility of content and incorrigibility. There are different kinds of delusion
and most of them caused due to brain disorder or influence of personality.
d. Phobia:
Phobia is a kind of anxiety disorder due to which a person experience high level of irrational
fear regarding any situation, place, object or living creature. It is also a mental disorder and
people usually shape their lifestyle to avoid the things that they thought to be dangerous for
them (Horváthová, Siládi and Lacková 2015).

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2. Mental health act 2015
Objectives:
The objective of implementing mental health legislation or Mental health Act in Australia is
to access the access the involuntary commitment and treatment for individual that are
suffering from acute mental illness in the population. The mental health legislation aims to
provide balanced civil liberties to individual in order to prevent harm due to mental illness
and provide effective care to the people with need (Legislation.act.gov.au 2018)
Involuntary admission:
In Australia involuntary admission is provided to a person against their will to a mental
health care organization with respect to the need. According to the Mental Health Act in
order to get access to the involuntary admission the person need to be mentally disordered
and there must be no other support such as voluntary admission, family support or support
from the community health care service (Legislation.act.gov.au 2018).
Consumer rights
The consumer rights include-
 Right to high quality treatment, that is appropriate to their age, religion,
gender, language and. Culture.
 Right to ask for explanation about their mental health condition and the
treatment procedure.
 Right to be treated with dignity, respect and consideration in the health care
organization.
 Right to advocacy.

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 Right to access information regarding the services available in the locality and
the mode of operation (Slhd.nsw.gov.au 2018).
Involuntary assessment:
The involuntary assessment includes a number of steps. Firstly, a legal documentation is need
to be done known as schedule 1 which provides permission to that the person can be taken to
the mental health care unit against their will for further assessment. Police and ambulance
officers are also able to request assessment for a person in the mental health care unit. In
addition assessment could be done on the written request of the primary care providers
(Legislation.act.gov.au 2018).
Seclusion and restraint:
Seclusion and restraint have authorised to manage serious harm where it is needed to apply.
The application of seclusion and restraint varies with respect to the authority that authorise
seclusion, the person to be notified and the time period for which seclusion is to be applied.
The act also includes emergency seclusion that is authorised for one hour by a health
professional if other applicable way to protect the patient is absent. The act provides effective
mechanical and physical restrain to prevent serious damage to property or provide treatment
to the patient (Ranzcp.org 2018).
Admission procedures:
The Act consists of enormous checks and balances. When a person has been brought to
hospital, the admission procedure starts after the assent of two doctors regarding the mental
illness of the person. Sometimes participation of a third doctor is required if the second one
fails to find any disorder within the person. If the majority of the doctor identified that the
person is mentally disordered then the person is detained for three working days. On the other
hand if majority of the doctor agree with that the person is mentally ill then he or she is

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admitted in the hospital and the person must be seen by the Mental Health Review Tribunal
(MHRT) if stay in the hospital for more than two weeks (Legislation.act.gov.au 2018).
Community treatment orders:
The community treatment order is a legal order which is made by the MHRT. It is an
alternative process of involuntary treatment in the mental health care unit. The community
treatment orders provide some conditions according to which a person needs to accept
therapy, medication, rehabilitation and other effective service during the stay in the hospital.
The community treatment orders are implemented by the Community Mental Health Team.
They develop effective treatment plan for individual according to their need
(Legislation.act.gov.au 2018).
Role of the mental health practitioner and consent:
The mental health practitioners play an important role in order to provide effective care to the
people with need. It is their responsibility to ensure that the patients are receiving appropriate
mental and physical assessment and assist the patients in resolving preventative needs. It is
the duty of the practitioners to provide effective medical management. They help in accessing
special care and treatment. It is the responsibility of the practitioners to refer the patient for
special counselling in case of need. Another important role of the practitioners is to provide
treatment with medical consent such as verbal consent and written consent. Without valid
consent the practitioners could be open to enormous allegations.
Confidentiality:
The standard 5 of Mental Health Act provides guidelines for privacy and confidentiality. The
staffs involved in the mental health care service comply with appropriate rules and

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regulations to protect the privacy and confidentiality of the carers and the patients. Effective
policy with understandable language is present in order to ensure privacy protection
(Health.gov.au 2018).
3. Self directed recovery:
Self directed recovery refers to the ability of a person to develop the meaning and
purpose of the life avoiding the effects of the mental illness. Such process of recovery
inspires a person to regain personal power and recover the affects of the poor mental health.
In self directed recovery the people support and avail service for their own recovery. It has
been found that such process takes less time to cure poor mental health (Hamm et al. 2017).
Recovery empowers:
Recovery through empowerment is an important part of mental health sector. Such
approach helps the health workers in order to support people with appropriate mental health
requirements. It provides the idea to empower that the people with mental illness are experts
in their own situation. The empowerment helps the patients and their family to take proper
decision regarding the health issue and meet their needs. Such encouragement helps the
patient to contribute in the treatment and recover soon.
Recovery includes support from others:
In case of mental illness treatment the support from the family, friends and society
play an important role in the recovery of the patient. The support provided by the family
friends and society helps the person to fight against the issue. The person got courage and
willingly participates in the mental assessment in order to recover soon. Proper attention and
care provided by the external support make it easy for the person to accept the mental
condition. Other support from community health service and carer helps to access the

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effective treatment thus helps the person to manage the mental health and well-being (Alcock
et al. 2014) .
4. Principles of recovery-oriented mental health practice:
The six principles of recovery-oriented mental health practice have been adopted by
the Australian department of health from the Hertfordshire Partnership NHS Foundation
Trust Recovery Principles in UK. The principles are as follow-
 Uniqueness of the individual.
 Attitudes and choice.
 Partnership and communication.
 Dignity and respect.
 Real choice.
 Evaluating recovery (Health.gov.au 2018).
5. Evidence based practice in the context of recovery in mental illness:
Evidence-based practice is one of the most developed strategies to help the health
professionals in order to provide care service to the individual in an effective manner. The
access to clinical epidemiology, information regarding mental illness and biostatistics help
the clinicians to provide appropriate approaches in order to resolve the mental health issue.
Evidence-based research to identify the main problem of the patient with effective
psychotherapy, appropriate use of medication and provide effective counselling help the

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patients in fast recovery. The evidence-based practice in mental health has decreased the gap
between research and practice. Thus, the implementation of evidence-based practice has
provided variation in the mental health treatment and helped to improve the care service
(Townsend and Morgan 2017).
6. Purpose of the ‘National framework for recovery-orientated mental health services’:
The purpose of the National framework for recovery-orientated mental health services
is to provide guidelines to the health practitioners. The guidelines provide knowledge
regarding the concept of recovery and lived experience. The guidelines describe the abilities
that are necessary to work in a mental health workforce through maintaining the recovery
oriented principles. It also provides guidance on the approaches to respond properly to the
different mental health issue according to different circumstances, ages, genders and cultures
(Health.gov.au 2018).
8. Example of Social factors:
 Poverty is one of the main social factors that causes mental stress and depression thus
lead to mental health issue.
 Social discrimination such as discrimination due to age, gender, culture, religion is
another factor that influences poor mental health.
 Social inequality due to class, race and ethnicity also contribute to the consequence of
mental illness.
Example of psychological factors:
 Childhood trauma such as physical, mental or sexual abuse could lead to mental
health issue.

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 The poor ability to relate with other people in the society could create mental distress.
 Early loss such as loss of parents or loved one could lead to mental disorder within a
person.
Example of cognitive factors:
 The poor ability to perform in various daily activities has been found to be affected
the mental health of a person.
 The poor ability to remember any incident create stress on the person thus could lead
to mental disorder.
 Cognitive factor such as memory of a past trauma play a role in posttraumatic stress
disorder.
Example of physical factors:
 Poor physical health condition such as long term suffering from severe disease could
lead to poor mental health.
 Physical disability also contributes to the consequence of mental illness.
 Severe brain injury due to accident plays an important role in mental illness (Lewis et
al. 2016).

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7.
The Barker's Tidal Model of Mental Health Recovery implements the recovery using
the person’s entire life’s experience. There are three stages like self, world and others which
plays a role in establishing an effort to investigate the ongoing experience of the person
(Storm and Edwards 2013). The model should be applied as soon as the individual gets
involved with the caregiving service. In case of self-domain the security should be assessed
that leads to development of a personal security plan. Next in the world domain there should
be a holistic approach that leads to one to one sessions. And in care of the other domain, there
shall be various groups like 1, 2 and 3. These phases explains the tidal process. The process
helps to address the sense of loss of purpose along with the need to focus within the nursing
procedure in the setting of acute psychiatric care.
10.
For such people the appointments must be kept short for the treatment. There must be
postponing of the procedures that are difficult to conduct until the patient is familiar with the
process or with the doctor and the staff who will carry out the procedure. Another method is
sedation and use of proper anaesthesia in such patients since they are not able to follow the
general procedures or instructions (Feudtner et al. 2014).
11.
a. Side effects of medication:
Medication causes a reduction in the secretion of saliva that leads to drying of the mouth.

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This leads to occurrences of dental carries, periodontal diseases and infections that rare pra in
nature such as candidiasis, glossitis, and others. Other problems include Dyskinesia and
dystonia due to prolonged used of antipsychotic drugs.
b. Poor nutrition:
Poor nutrition along with intake of high sugar can lead to dental carries along with oral
infections. Diseases like Erosion, cervical abrasion, gingival laceration along with gingival
necrosis can take place for such poor diet conditions.
c. Reduced motivation for self-care:
Reduced self-care leads to lack of attendance in towards oral care which leads to
cancellation of oral appointments. There are occurrences of fear and anxiety that leads to
decreased attendance towards oral care. Low self-esteem is another such cause that leads to
increased rate of periodontal diseases mainly due to neglect. Incidents of trauma and
dentofacial injury generally occurs in such cases (Chen et al. 2014).
12. Diagnostic and Statistical Manual of Mental
Disorders (DSM – 5)
Delirium, dementia, and amnesia and
other cognitive disorders
Alzheimer's disease
Mental disorders due to a general medical
condition
AIDS-related psychosis
Substance-related disorders Alcohol abuse
Schizophrenia and other psychotic disorders Delusional disorder
Mood disorders Major depressive disorder, Bipolar disorder
Anxiety disorders Generalized anxiety disorder, Social anxiety

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disorder
Somatoform disorders Somatization disorder
Factitious disorders Münchausen syndrome
Dissociative disorders Dissociative identity disorder
Sexual and gender identity disorders Dyspareunia, Gender identity disorder
Eating disorders Anorexia nervosa, Bulimia nervosa
Sleep disorders Insomnia
Impulse control disorders not elsewhere
classified
Kleptomania
Adjustment disorders Adjustment disorder
Personality disorders Narcissistic personality disorder
Other conditions that may be a focus of
clinical attention
Tardive dyskinesia, Child abuse.
International Classification of Diseases
(ICD - 10)
There are main 10 classifications that includes:
 F0: Organic, including symptomatic, mental disorders
 F1: Mental and behavioural disorders due to use of psychoactive substances
 F2: Schizophrenia, schizotypal and delusional disorders
 F3: Mood [affective] disorders

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 F4: Neurotic, stress-related and somatoform disorders
 F5: Behavioural syndromes associated with physiological disturbances and physical
factors
 F6: Disorders of personality and behaviour in adult persons
 F7: Mental retardation
 F8: Disorders of psychological development
 F9: Behavioural and emotional disorders with onset usually occurring in childhood
and adolescence
 In addition, a group of "unspecified mental disorders" (Feudtner et al. 2014)
13.
Mental health conditions treatment management
Personality disorders Psychotherapy is used for
treatment. Medications
administered includes
antidepressants, mood
stabilizers, antipsychotic
medications and anti-anxiety
medications.
For managing such patients
there are provisions of
hospital and residential
treatment programs. Certain
lifestyle and home remedies
are also implemented for the
management along with
self-management.

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Anxiety disorders Treatment by application of
cognitive and behavioural
therapy.
Can be managed by
recognition of the negative
thoughts, trying to challenge
such thoughts and
replacement of such
thoughts with the thoughts
that are realistic
psychoses Treated by using
Antipsychotic drugs
Can be managed by
maintenance if the phases of
schizophrenia by using
tranquilization and fast
acting medications.
Organic disorders Treated by implementing
rehabilitation therapy for
helping the patient to
recover the brain functions.
Managed by providing
proper nutrition and
modification by enhancing
the pharmacological
function of the
neurotransmitter, thus
increasing cerebral
metabolism
Panic disorder Treated by implementing
cognitive and behavioural
therapy
Managed by administering
doses of benzodiazepine in
order to improve the
confidence levels of patients

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along with compliance.
Social phobia such as fear of
animals
Psychotherapy required for
treatment. Medication
include antidepressants,
anti-anxiety medications and
beta blockers.
Can be managed via lifestyle
and home remedies.
Preparation for social
situations required along
with practising to the coping
process in small steps.
OCD Treatment included
ognitive-behavioral therapy
by exposure and response
prevention (ERP) and by
medication of serotonin
reuptake inhibition.
Can be managed by use of
medications such as
clomipramine (a tricyclic
antidepressant) and four
SSRIs (fluoxetine,
fluvoxamine, paroxetine,
and sertraline).
Post-traumatic stress
disorder
Treated by Cognitive
therapy, Exposure therapy
and Eye movement
desensitization and
reprocessing (EMDR).
Can be managed by
medications along with
lifestyle management such
as following the treatment
plan, self-management,
avoiding self-medication
and such other measures.
depression Treatment involved
psychotherapy. Medications
taken like antidepressants
and vitamins.
Management involves life
style management like
exercise, social support,
proper nutrition and good

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amount of sleep.
Bipolar disorder Psychotherapy is used for
treatment along with
medications.
Management via education,
lifestyle management and
support from social groups.
Anorexia nervosa Psychotherapy that is family
based along with individual
therapy.
Management by programs of
hospitalization and by
restoration of a healthy
weight through proper
nutrition.
Borderline personality
disorder
Treatment implement
through psychoeducational
approaches.
Management strategies
includes use of arts
therapies, complementary
therapies and therapeutic
communities.
schizophrenia Use of second generation of
antipsychotics like
Aripiprazol and Asenapine.
First generation can also be
used such as
Chlorpromazine and
Fluphenazine.
Can be managed by
Psychosocial interventions
such as individual therapy,
training in social skills and
family therapy.
dementia Treatment using
Cholinesterase inhibitors
Can be managed by
therapies such as

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and Memantine. occupational therapy,
Modifying the environment
and task modification.
14.
The values that are applicable to mental health care involves showing respect and
trust, implementing inclusion by understanding the wellbeing of an individual, displaying of
responsibility , promoting debate on the cause of mental health in order to strengthen the
diversity of the culture that exists. Additionally action should be shown along with refection
so that all can work together for promotion of culture. Unity and diversity is highly required
for the efforts of mental health improvement of all the members of the community (Norman
and Ryrie 2013).
Principle of mental health includes respecting the rights and needs of consumers along
with carers and families, services delivered for recovery with commitment, principle of social
inclusion, recognition in terms of social, cultural and geographic diversity and experience,
Recognition that the focus of care may be different across the life span, delivery of services
in order to support coordination of care, service of equity, communities and age groups and
consideration of the mental health and its problems and mental illness (Reiss 2013).
15.
Mental health conditions Signs and symptoms
Post-traumatic stress disorder Emotional numbness, elevated arousal,
reoccurrence of trauma, distress, nightmares
and flashbacks and trigger.
Anorexia Nervosa Increased weight loss, abnormal blood

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count, lack of sleep, discoloration of fingers,
fatigue, dizziness and no menstruation.
Delirium Loss of consciousness, occurrence of
hallucinations, distress, shifting attention,
and variation in consciousness
16.
There are several explanations of the mental health problems that can be explained in
terms of biological and psychological concepts. These includes the nature of the mental
disorders that are unique and immutable. These occur in the brain or in the DNA that lead to
symptoms. This is seen in the view that people who suffer from mental disorders are not
similar with the normal individuals. This leads to formation of social boundaries around such
people which makes way for attitudes that are negative towards the intergroup. There is also a
belief that mental disorders are difficult to treat which is known as prognostic pessimism. The
individuals with such illness are caused due to the aberrations of genetic and neural nature
(Crawford et al. 2013).

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