Mental Health Collaborative Assignment

Mental Health Intervention and working
Collaboratively with Patients

Table of Contents
INTRODUCTION...........................................................................................................................3
Section 1. Principles of Mental Health Promotion .....................................................................4
Section 2. Tools used to for health assessment...........................................................................6
Section 3. Working collaboratively with Rasheeda....................................................................8
Recommendations :...................................................................................................................10
CONCLUSION..............................................................................................................................11
REFERENCES..............................................................................................................................12

INTRODUCTION
Mental health is important for everyone in every stage of life. If the issues related to
mental health left untreated than it can cause a serious mental health problem to an individual.
Therefore early intervention is the effective way in order to manage the mental health problem
which an individual is facing (Clement, S., & et al., 2015). In order to provide better health and
good environment to the patient in the hospital the nurse should teach its patient to handle the
stressful situations and should provide them resource in order to improve their health. In this
study Rasheeda is a patient who is facing mental health problem and due to her weight is also
been affected. The study highlights the principles of mental health promotion and has also
explained various tools and technique for health assessment. The importance of nurse to work
collaboratively with the individual in order to improve the health of patient has also been
discussed in the study.
Scenario of case
The patient name Rasheeda Haddish is facing weight loss problem and mental health
problem. According to information which is provided by the GP nurse she had lost her weight in
the past few years. Rasheeda spends most of her time in her bedroom and in bathroom. She used
to spent her time on writing in her diary. Many a time the girl feel restless and look in a
mistrustful way towards the friends and family. Rasheeda does not have any past record related
to mental health problem. Rasheeda body temperature is 36.7 degree C, blood pressure of
100/55, respiration 21 per minute and pulse rate 70 per minute which is the normal rates in the
children body. The girl does not suffer from any type of allergies and does not intake any type of
drug or alcohol.
The girl family background also seems to be normal. Her father is a system analysts in
Scottish government and her mother is housewife the parents are living happy married life . So it
can be said that the girl is not facing any type of family problems. The girl was very popular in
her school with her friends. But now she is loosing its contacts with them. Earlier Rasheeda use
to visit her friends house after school but now she want to remain at home and revise her
learning. The girl has lose contact with all her friends she has isolated herself. The girl is not too
much concerned about her physical appearance. The girl looks sad every time. Her sleep pattern
has also been changed in the past few years see find it difficult to get sleep and feel tired every-
time.

Section 1. Principles of Mental Health Promotion
Different persons have different mental health inequalities. The reason behind the health
inequalities can be due to environmental influence, individual experience such as learnings,
services etc, inequalities in well being or due to various fundamental issues such as global
economic forces, discrimination, societal values of equity etc.
The mental health of the individual influence their physical health as well. The mental
health of an individual helps them to realise their ability and handle the difficult situations.
According to World Health Organisation (WHO) mental health of an individual is essential.
Because mental health problem can create a huge impact on the persons life therefore proper
promotional measures should be taken to avoid such issues(Cuijpers, P. & et al., 2016). Mental
health promotion is important in order to provide care to the individual, reduce mortality,
disability of person, and promote mental human rights for the persons who are suffering having
mental disorders. The purpose behind the mental health promotion is to promote mental health of
an individual by creating positive and supportive environment to the person in order to improve
their mental health(Karp, D. A. 2016). In order to promote mental health of the patient a nursing
staff should provide effective care to the patients by using positive attitude and good behaviour
toward patient in order to provide them good care.
The various principles in order to promote mental health of the patient are :
1. The nursing staff treat everyone with care and respect everyone, they understand
individual needs
2. The nursing staff takes the responsibility of the care and service which they provide to
the patient. The staff is responsible for their actions and judgement
3. The nursing staff holds the responsibility to manage risk in order to keep the people safe
where they receive health care
4. The nurses provide information to their patients about the treatment in order to help the
patient to make choices with the treatments offered
5. Nurses also provide information to the patient family about the persons health and guide
them with how to handle and take care of patient
6. The nurses play an important role as they record the information related to treatment,
handle the information confidentially and deal with the complaints of an individual

7. Nurses with closely with the team members and their senior authority to make sure that
the right treatment is been provided to the patient
As Rasheeda is gaining its weight and facing mental health problem as stated by her
parents. But according to the girl she is not facing any type of problem and she don't know the
reason that why everyone is been unfair with her and treating her like this. Therefore in order to
assist Rasheeda and provide her mental health guidance and support the nurse can apply the
following actions in order to improve mental health of Rasheeda, firstly the nurse can build a
healthy and trusting relation with Rasheeda. The nurse can listen to the Rasheeda and can
communicate her about the problems she is facing or the reason that why she has been isolated
herself and does not like to meet her friends. The nurse can try to get the information about what
she is feeling. The motive behind building a healthy and trusting relation with the patient is that
to make them feel comfortable.
The nurse can approach girl in a clam way as the girl is not open to anybody. Rasheeda
feels that she is okay and nothing is wrong with her. So nurse can approach her in a calm manner
so that the girl feel comfortable with the nurse and express her feelings. The nurse need to have
therapeutic skills to deal with such situation so that patient feel ease while interacting with the
nurse and feel free with the nurse in order to discuss sensitive matters.
Secondly the nurse can interact with Rasheeda parents and ask about the possible reasons
behind her behaviour. In order to do so the nurse can do counselling with Rasheeda's family in
order to activate self-help group for the patient. Nurse can ask her mother about the reason
behind her behaviour, why the girl is going through such mental health problem. The nurse can
ask her mother and father to talk to the girl and provide her emotional support and guidance.
The motive behind this approach is that the patient needs a network in which they can express
their personal feelings such as worthlessness, isolation and self helplessness etc. The nurse can
also encourage Rasheeda to participate in various programmes and activity in order to promote
patients socialization skill. This will help the patient to interact with large number of people
which can help her to remain away from being isolated and it may help the patient to improve
her health.
The nurse can also use the cognitive behavioural therapy, this therapy can assist people to
change their thought pattern so that they can find a new ways to deal with the situation. The
therapy can help Rasheeda to reduce stress, and deal with the difficult situation, and to copeup

with the difficult relationship. With the help of this therapy Rasheeda might start evaluating her
behaviour and analyse what is wrong with her and can become able to deal with the difficult
situation.
In order to reduce any chances of medication error the nurse can consider five medication
right i.e., right patient, right dose, right time, right route and right drug. According to Judy
Smetzer, a vice president of Institute of Safe Medication Practices there are no stated goals of
proper medication process and no guidance to carry these process to achieve goals. Therefore
these five rights will help the medical practitioners to ensure safety from the medication to the
patient. By considering five medication principles the nurse can reduce errors in medication
safety and can provide proper care to the patients.
Section 2. Tools used to for health assessment
Nurses' observation scale for inpatient evaluation (NOSIE) is a rating scale which is used to
measure the behaviour of an individual. The tool is used to analyse the behaviour of patient with
mental health problem. The benefit of using NOSIE is that it is easy to administer and help in
gaining the information from the patient which cannot interact for example non-verbal
individuals.
The NOISE can be used to assess the behaviour of patient, the scale is also used to
analyse the change in behaviour of individual. This instrument helps the nurses to plan a health
care process for the patient. As nurses spent most of the time with patient therefore it they can
provide the best comment on the presence and absence of various patterns of behaviour which
are associated with the mental health(Moran, S. 2017).
In case of Rasheeda this tool can be very useful. As we can see the girl behaviour has changed
from the last few years such as the girl has suddenly changed her behaviour, earlier she use to
visit her friends house after school but now she wants to remain at home and does not want to
meet anybody. She has isolated herself and also seems tired every time and seems mistrustful
towards her friends and family. This tool will help the nurse to identify the possible reasons
behind her changing behaviour.
HADS is a hospital anxiety and depression scale which is used in order to analyse the
level of depression and anxiety in an individual. The HADS consist of 14 item scale which helps
in the generation of original data. The level of anxiety and depression is found with the help of
filling questionnaire by an individual.

De Oiveria GN & et.al., has used the HAD tool in order to compare the psychometric
properties of HADS -D i.e., Hospital Anxiety and depression scale. About one hundred twenty
six people has been diagnosed with epilepsy and then these people were recruited on the basis of
their socio demographic and clinical features and with the help of this HAD-S is evaluated.
They found that HADS-D shows more than 80% sensitivity and shows specificity which is
around 90%. The authors concluded that HADS is an efficient screening instrument in order to
identify the depression in an individual with epilepsy(de Oliveira, G. N. & et al., 2014).
Yang, Y. and et.al., 2014 has used the HADS tool on cardiovascular patients. The
purpose behind this is to examine reliability of chinese version of HADS on the patient with
psycho cardiological. In doing so the one hundred people with the psycho cardiological were
given a task to complete the chinese version of HADS and then the people were interviewed by
using MINI I.,e., Mini international neuropsychiatric interview(Yang, Y. & et al., 2014). By
doing this it was found that about 38% patients were suffering from depression and 15 were
suffering form anxiety disorder. The authors found that it is reliable instrument for measuring the
depression and anxiety.
In the case of Rasheeda the HADS can be used to measure the level of anxiety and depression.
As the girl use to write diary and spend lot of time in her bedroom so there can be chances of
anxiety and depression thus this tool will help in analysing the level of depression and anxiety in
her. Which will help in reaching to the solution and provide her better treatment.
Liu, L., Gou, Z., & Zuo, J. has conducted the study in order to investigate the impact of
loneliness on depression and than analyse the effect of social support on depression. About 320
people were asked to fill the questionnaire on the emotional and social scale, self rating
depression scale and multidimensional scale of perceived social support(Liu, L., Gou, Z., & Zuo,
J. 2016). And it was found by the author that social support also helps in improving depression
of the individual up to some extent. Therefore in case of Rasheeda the social support can play a
important role. In order to do so the Rasheeda parents help can be taken and the girl can be
encouraged to take part in various programmes and activities which will help her to become
social.
The tools which has been discussed above can be prove beneficial in order to find out level of
anxiety and depression in the patient and to find out the reason behind the changing behaviour of

Rasheeda. The interaction of Rasheeda with other will also help her to get out of depression. The
nurse can indulge girl or motivate her to take part in activities and programmes which will help
her to become more social able and come out from her depression and feeling of anxiety. The
nurse should encourage Rasheeda to find new ways by herself to deal with anger and sadness.
Section 3. Working collaboratively with Rasheeda
Ethical values are necessary for any health care provider. In the case of Rasheeda, nurse
can work collaboratively with the individual and enhance their engagement by considering
ethical aspects (Gask et al., 2018). To practice the work competently and with integrity, nurses
must have guidance and regulations within their profession. In the treatment, nurses are require
to ensure she feel comfortable and collaborative with them. As this is her first treatment and the
most important thing is she has no adherence and engagement with the health care services, it is
essential to carefully handle her situation with considering ethical aspects. Nurse will work
collaboratively with the patient to support the engagement by working with her and treating her
with patiently and try to gain her trust and build a relation with the patient. But it is essential for
the nursing staff to consider ethical elements as the situation is very critical and sensitive
(Kangasniemi, Pakkanen, & Korhonen, 2015). The code of ethics outlines how the nurses should
behave ethically as a profession. Nursing encompasses autonomous and collaborative care of
individual of Rasheeda and include the promotion of health.
In the treatment of Rasheeda, nurse has been start counselling with her parents to get an
understanding of the situations. In ethical aspects, nurse consider the truthfulness and
confidentiality. Under this, nurse will tell the exact truth regarding the extent of the outcome if
Rasheeda will recover or not that the parents has right to know the truth. The concept of
confidentiality urges nurses to keep the secret of the collected information that has been collected
by the nurse (Matthews et al., 2015). Nurse should consider the ethical aspect and not to disclose
the issue with other person. This is the foremost essential things that the service provider ensures
all the benefits and consequences share with them and after their approval treatment will
conduct. The engagement of parents is essential in the treatment and for the improvement in
Rasheeda's behaviour.
Another treatment has been done for Rasheeda is cognitive behavioural therapy that
might be work effectively that lead the nursing staff to gain her trust and able to build
relationship with her (Schmidt, MacWilliams, & Neal-Boylan, 2017). The staff should consider

beneficence and non maleficence while changing the perspective and behaviour of Rasheeda.
The beneficence tells the nurses to doing good for the patients. On the other hand, non-
maleficence enable nurses to understand to not to harm her and her whether intentionally or
unintentionally. As the therapy will enable Rasheeda to evaluate herself should be lead in
positive way while change her thinking pattern.
Autonomy is another principle that ensure ethical actions by nurse. Under this, Rasheeda
have right of self-determination, freedom and independence to make their own choice regarding
the treatments and medications and nurse are require to respect her choice. However in the
context of Rasheeda as she is not aware about her condition in which autonomy may restricted
because of concern of her well being as well as of community. This upheld by the nursing staff
as the patient has her own perspective, values and beliefs (Wang et al., 2017). This will enable
nurse to encourage Rasheeda to participate in her treatment and it will support engagement in
health promotion.
Moreover, nursing staff should consider the informed consent in all the therapies and
medication. It is essential for them to take inform Rasheeda and take her approval for the further
process. It might be difficult as she is not in the condition that she can realise the present
condition of her (Code of Ethics, 2019). As she does not really understand why the behaviour of
all is changing towards her and why she need treatment. But as per the ethical nursing action, in
the treatment staff are require to provide her all the information before every medication and
therapy that why she is getting the therapy and what and how it will work on her. There is
possible consequences in this ethical obligation that she might does not attend. It is essential for
the nurse to inform about her situation calmly and tell her that many people suffering and it is all
normal. It is essential for the staff to implied ethical consent because the medication and
treatment has benefit for her but it may also have side-effects (Schmidt, MacWilliams, & Neal-
Boylan, 2017).
Nurse that are responsible for treatments, can work collaboratively with Rasheeda if she
is comfortable and approve the treatment and medication. The ethical code encourage her to
understand that the activity is done for her and all are here for her betterment. Without her
consent not a single process will carry out that build a positive engagement in health promotion.
The ethical aspect also help in managing the risk associated with the patient. Such as she is
mentally disturbed and small things can hurt her (Matthews et al., 2015). She feel sad with little

things and loving to be alone. Thus, ethical concern must be considered when designing a
treatment. All the information regarding treatment, medication and chances of being well should
be informed to the parents of Rasheeda as well as to her. That will minimise the future risk for
the nursing staff and they get to know the consent of them for the treatment procedure. The
ethics are essential to be consider as it create an environment of mutual trust, positive
engagement and respect between patients and healthcare professionals (Wang et al., 2017).
Advocacy promotion by the nurse enable a safe environment for the patient and encourage the
collaboration between Rasheeda, Nursing staff and her parents.
Recommendations :
Following are the recommendations in order to promote individual health :
1. The nurse should be available for the patient every time so that when the patient had a
severe panic attack than the nurse should be there to provide her help. The nurse should
be present to assure safety and security of Rasheeda. The patient with the anxiety should
not be left alone it may result in increase of anxiety(Smith, C. A. & et al., 2018).
2. Nurse should built a strong relation with Rasheeda by having good communication with
her. The nurse should use language which shows concern about the patient health. The
nurse should make efforts to gain the trust of Rasheeda so she can feel comfortable in
talking to the nurse.
3. The nurse should take the help of friends and family of patient in order to improve
mental health. The family can help the nurse in finding out the solution and analyse the
main problem behind patient such behaviour. The nurse should ask her family members
to participate in the process and try to find out the reason that why the girl is facing such
situation what can be the possible thing which is affecting her so much that she does not
want to talk to anybody or interact with anybody.
CONCLUSION
At the time of adolescence a person goes through the rapid change in their physical, social and
psychological development. The possible reason behind this can be academic failure , functional
impairment and poor mental health. The study gives the understanding of the importance of
mental health and reason behind mental health promotion. The study also explains how a nurse

can minimize its medication error with the help of five medication right. The study also gave the
knowledge that how important it is for nurse to work collaboratively with the individual.

REFERENCES
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Online
Code of Ethics. 2019. [Online]. Available Through:<https://www.nmc.org.uk/standards/code/>.