Mental Health Issues of Nursing Question Answer 2022

Running head: MENTAL HEALTH NURSING
MENTAL HEALTH NURSING
Name of the student:
Name of the university:
Author note

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Question 1:
The case study represents mental health issues of a 45-year-old Cambodian man, Munny
Kaew Munny, who lives in Western Sydney with his wife, Ary, and their three children, a girl
Chan aged 10, and twin sons, Prak and Rith, aged 6 years. He was presented in the community
with his wife who stated that he had not been his usual self. His wife also suggested that Munny
has become less and less communicative at home and he was taking frequent sick leaves, spent
times in bed, tend to answer in one word or monosyllables and exhibit loss of interest on his
child and loss of appetite. In this context, mini-mental state examination is the best suitable
evaluation tool for gaining the understanding of the mental health status of the patient. Devenney
and Hodges (2017), highlighted that it is a structured assessment for evaluating behavioral and
cognitive functioning of the patient. It consists of few components such as appearance and
general behavior, level of consciousness and attentiveness, mood and affects, motor and speech
activity, attitude and insight, thought and perception, the reaction evoked in the examiner, and,
finally, higher cognitive abilities. (Sunderland et al., 2017) Taking a deep insight into the
situation, two crucial components such as appearance and General Behavior and thought the
process can be considered to structure the assessment of the mental state of the patient. In
appearance and general behavior, unusual behaviors observed by examiners such as lack of
appearance, lack of eye contact and lack of proper posture are considered as a manifestation of
mental illness. In this case, considering Appearance and General Behavior and thought process,
the patient did not make eye contact while greeted by a nurse and usually answer in
monosyllable such as “yes”, “no problem” and “fine”. While the nurse asked about how his
family might feel if anything happened to him, he simply shrugs his shoulders and he wore a
loosely fitted cloth. His wife even informed that he become less communicative with him,

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indicating he has a poor state of mind. On the other hand, in the thought process, attention
provided to the examiner and in other things reflects the state of wakefulness and lack of
attention indicate poor mental health (Ridley et al., 2016). In this context, the patient was
attentive to the examiner (nurse) while communicating and provide an answer in short syllable.
His wife suggested that he became less attentive to his children where his children were
previously the center of his attention, and no longer does anything around the house (Devenney
& Hodges, 2017),. He took frequent sick leaves and mostly spent time in his bed, indicating he
requires immediate clinical attention. Taking consideration of his clinical manifestation,
according to DSM criteria V, the patient might suffer from depression (Price & van Stolk-Cooke,
2015). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is a
handbook used by health care professionals to diagnosed mental disorders according to criteria
(Crome et al., 2015). DSM V for depression highlighted few criteria such as depressed mood
most of the day, significant weight loss or weight gain inpatient, marked diminished interested in
pleasure in all activities, a slowing down of thoughts, fatigue, and loss of energy and suicidal
ideation (Fried et al., 2016). While the patient did not exhibit the symptoms of suicidal ideation,
he showed a lack of interest in his work and took frequent leaves, stayed the best most of the
days. He exhibited loss of appetite and he felt he might losing weight. These symptoms exhibited
that he might be suffering from depression and require immediate medical assistance.
Question 2:
As discussed in this case study, the patient was experiencing major depressive disorder
where a series of events might facilitate the development of the disease. Considering the case
scenario, the stress vulnerable model can be applied to explain stressors that may contribute to
the development of mental illness. () define stress vulnerability model as a resolving tool or

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psychological theory which attempt to explain a disorder with the reference of interaction
between predisposition vulnerability and stress. Vulnerability defines as the basic susceptibility
to mental disorders which is either determined by our genetic makeup (biological vulnerability)
and life experiences (stress) (Kendler & Gardner, 2016). Becker et al. (2015), highlighted that
some people are biologically vulnerable to specific psychological disorders such as major
depressive disorder, post-traumatic stress disorder and schizophrenia due to genetic makeup,
drugs or substance abuse. On the other hand, the stress in the environment can worsen biological
vulnerability, worsen system as stress is considered as a feeling of emotional or physical tension
due to the life experiences the patient may subject to (Calvete, Orue & Hankin, 2015). These
stressors include loss of loved once, death of a spouse or family members, detention, injury or
illness (Colodro-Conde et al., 2016). In this current context, two major contributing factors that
facilitate the development of mental illness such as his family were forced to move from their
home into the countryside during the Khmer Rouge period in Cambodia in 1975 where his father
got shot and death of his mother. Considering the first factor, Guajardo et al. (2018), reported
that refugees have experienced many extremely stressful events due to political or religious
oppression, war, migration, and resettlement as observed in this scenario where the patient and
his mother forced to move out of from the home. During the migration from one place to another
place, refuges experience detention and violence which subjected them to the high psychological
distress rather such as anxiety as observed in the case scenario. Due to stressful events, the
cortisol level increase in patient, reducing the level of dopamine and serotonin in the body which
further increase vulnerability towards psychiatric disorder for patients. On the other hand, Savic
et al. (2016), opinioned that loss of loved one leave patient emotionally devastated and increase
onset vulnerability for mental disorder as an observed case of the patient. Munny was always

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very close to his mother, but she died after a long battle with cancer 6 months ago which had a
traumatic effect on Munny. The patient was experiencing grief which subjected him into trauma
and increase the vulnerability in patient for psychiatric disorders. Consequently, it impacted the
thought process, behavior and feelings of the patient as observed in case of the patient where he
feels distant from his family members, became less communicative, barely provide attention to
the children and spent most of the time in the bed (Afzali et al., 2016). To reduce the impact of
trauma and stressful events, a trauma-informed care approach is the most suitable care approach.
Trauma-informed care is a holistic care approach for treating a whole person while
taking into consideration of past trauma and stressful events and associated coping mechanism.
Trauma-informed care also emphasizes on psychological, emotional and physical safety for both
consumer and assist them to rebuild a sense of empowerment (Wilson, Hutchinson & Hurley,
2017). There are five principles of trauma-informed care such as safety, transparency, and
trustworthiness, choice, collaboration, and empowerment. To support the wellbeing of the patient
and reduce the symptoms of depression these principles can be incorporated into the care
approach which will further empower patient and give him hope to live a healthy and trauma-
free life.
Question 3:
As observed in this case study, the patient was experiencing major depressive disorder
due to the past trauma he was subjected and the stressful life experiences. In this current context,
three positive aspects of mental health recovery is crucial in order to support the wellbeing of the
patient. These three aspects include respect, empowerment, and hope. Considering respect,
Truong et al. (2016), highlighted that showing respect to the client through proper attitude and
effective communication not only make patient wanted but also restore the autonomy and dignity

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of the patient along with boost the self-esteem of the patient. In this case, his family members
and coworkers can show respect by involving in decision making and appreciating his
contribution in each case. Moreover, health professionals and community members can show
respect by involving him in therapeutic verbal and non-verbal communication and providing him
a self of security through non-stigmatized language. Consequently, it will facilitate self-respect,
eliminate symptoms and facilitate faster recovery.
Considering empowerment, Hildingsson et al. (2016) stated that empowerment in the
mental health recovery approach increases the degree of autonomy and self-determination in
patients and family members which further enhance faster recovery in patient. In this context,
health profession, his family member’s employer along with the wider community offer greater
empowerment to the client through proper health literacy of managing symptoms. His family
members collaborate with the community members and employees can motivate patient to
identify inner strength and live a healthy life. Consequently, through motivation and literacy
patient will feel empowered which will result in faster recovery.
Considering hope, his family members and health professionals can provide hope of
living a healthy life through empathy and compassion and create an environment which gives
hope (Newman et al., 2015). It will reduce suicidal ideation and increase the self-concern as well
as increase faster recovery.

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References:
Devenney, E., & Hodges, J. R. (2017). The Mini-mental state examination: pitfalls and
limitations. Practical neurology, 17(1), 79-80.
Sunderland, M., Anderson, T. M., Sachdev, P. S., Titov, N., & Andrews, G. (2015). Lifetime
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