Mental Health Assessment: Case Study of Lucinda Okiro

This case study examines the mental health status of Lucinda Okiro, focusing on her mood, affect, and risk of depression. Factors contributing to her current mental health status and three factors for her recovery are also discussed.

Running head: MENTAL HEALTH
Mental health
Name of the student:
Name of the University:
Author’s note

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1. Mental status of the client in the case study:
The case study is about Lucinda Okiro, who presented to the peri-natal mental health
service for a mental health assessment with her eight months daughter, Emily. The main
concern for Lucinda was feelings of fear and anxiety because she was pregnant with her
second child. She is feeling frightened at the thought of second pregnancy because her first
pregnancy was complicated and she is still feeling challenges in taking care of Emily. To
assess overall mental status of client, the components of the Mental State Examination
(MSE) has been used. MSE is a widely used test to evaluate cognitive status of a client and
the focus is main observed appearance, behaviour, affect, mood, thought form, thought
content, perception and judgment of client (Su et al., 2014). Based on appearance, Lucinda
was found to be well-groomed. Lucinda was found to wring her hands further mirroring that
she upset with her life. In addition, various impairments in the area of mood was found as
Lucinda expressed feeling frightened and very unhappy after finding out that she is pregnant
with her second child. She was worried about the birth of her child due to her previous
pregnancy complications.
She was found in a dysphoric state as she was very upset and depressed. Patel et al.
(2015) explains mood impairment as a common clinical manifestations of different types of
mental disorders as 8 out of 10 people report some degree of mood impairment and it is
associated with reduced capability for daily life activities, lack of happiness and poor self
esteem too. The impact of poor mood on Lucinda’s overall functioning was seen too as she
founds no motivation to get out of bed. The assessment of Lucinda in the areas of thought
process, content, insight/judgment shows no impairment in overall thought process and
content. There is no sign and hallucination and she is making logical interpretation of events

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in her life. For example, she expected her mother to come up and help her. However, she
gave valid reasons regarding shy she cannot come and why her husband Jerome’s family
cannot come too. Therefore, no irrational thought pattern is seen. Hence, two components of
the MSE that is found to be affected for Lucinda include mood and affect. Her mood is really
down and affect is dysphoric and congruent.
As Lucinda expressed feeling very upset because of her second pregnancy and again
leaving her studies and work because of it, there is a need to assess risk of the depressive
symptpms in the client. This has been done by comparison of symptoms that Lucinda is
experiencing to the DSM-V criteria for depressive disorder. According to the DSM-V criteria
for depression, a person is diagnosed with depression if four or five of the following
symptom is presence in patient for more than two weeks. This includes depressed mood, lack
of interest activities of pressure, sleep problems, lethargy, feelings of worthlessness, suicide
ideation and lack of concentration (Schmidt & Tolentino, 2018). Out of these symptoms,
Lucinda is found to have diminished interest in activities of daily living evidence by low
motivation to get out bed. She had feelings of guilt and depressed too. Three-four symptoms
of depression is found in Lucinda too indicating she is at risk of depression. She feels very
lonely too and research literature gives the idea that loneliness is a major risk factor that leads
to fear, anxiety and depressive thinking. It increases pattern of negative thinking and
decreases self-confidence of affected individuals (Grover et al., 2018).
2. Factors contributing to the development of the current mental health status of the
client:

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Lucinda is currently found to be suffering from depressed mood and feelings of fear because
of her second pregnancy. To identify the factors contributing to the current mental health status
of Lucinda, the Stress Vulnerability Model and the Trauma informed care concept will be
applied to understand the reason behind current mental health state of client. Stress Vulnerability
Model focus on identifying factors in life of an individual that makes them susceptible to mental
health disorder and reviews the kind of stress present in life to influence coping skills and social
support for a client (Calvete, Orue & Hankin, 2015). In addition, trauma informed care is an
approach that emphasizes that each individual may have a history of trauma and understanding
the nature of trauma is important to take respond according to those traumas (Raja et al., 2015).
The first contributing factor leading to depressed mood and feelings of worthlessness for
Lucinda includes the presence of stress in her life due to the need to take care of her child, lack
of family members to provide supports and poor economic status. After the birth of Emily, she
feels challenges in taking care of her and often feels exhausted. She could have managed if her
mother was there to help her. However, she cannot bring her mother because of poor economic
circumstances. Hence, her stressor is indirectly linked to poor economic status too because she
has stopped working since the birth of Emily and her husband Jerome is the lone member
bringing wages for the family. Freeman et al. (2016) explains poor socio-economic status is
strongly associated with increased likelihood of depression as it increases stress and it leads to
higher odds of being depressed. Her first pregnancy was a shock for her as she was studying at
that time and after Emily’s birth, she had to stop studying and working. Hence, her second
pregnancy is a new stressor for her as she feels that will have to discontinue work and studies for
a longer period. Nath et al. (2019) revealed that prevalence of prenatal depression is high in
young pregnant women only in case of low income group. Low income increases the need to live

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in poor living condition and make women vulnerable to financial struggle and psychosocial
stress. Presence of similar pattern of stress in the life of Lucinda is the reason behind risk of
depression and feelings of anxiety due to second pregnancy.
By analysing the factors behind Lucinda’s current mental state using the trauma-informed
care approach, it has been found that Lucinda has been influenced by an episode of trauma
during her first pregnancy. The traumatic event that she witnessed during her first pregnancy was
that there was complication during the birth of her first child, Emily’s birth as she had a posterior
presentation and she had to go through a prolonged labour period of 12 hours. Emily had to be
extracted by a forcep extraction process. Hence, the overall process was a very traumatic
experience for her as it led to pain, sufferings and impact on her physical health too (Elder,
Evans & Nizette, 2011). Because of this trauma, she took a long to be physically ready to take
care of Emily too. Aziato, Acheampong and Umoar, K. L. (2017) gives the understanding that
long labour is a traumatic experience and for this reason, women experience intense worries,
panic and depression on thought on thought of going through similar process in the future.
Therefore, because of the traumatic experience of her last labour, Lucinda is suffering from
depression and state of panic again. To provide trauma-informed care, it is necessary to employ
trauma-specific strategies to address current symptoms (Raja et al., 2015).
3. Three factors contributing to client’s recovery:
To promote mental health recovery in client, considering the impact of respect,
empowerment and hope on client’s journey towards recovery is important. Hence, when mental
health nurse engage with Lucinda during the care process, it is important for them to show
respect to client by their verbal and non-verbal communication skills. For example, when client

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expresses her worries, it is necessary to show appropriate gesture, be non-judgmental about
patient’s concern and accept a patient’s response in the most professional manner. This will help
to develop strong therapeutic working relationship with client (Bhanji, 2013). Ziedonis, Larkin
and Appasani (2016) support that dignity and respect promotes healing and brings clients one
step closer to recovery.
As Lucinda is depressed by her second pregnancy and the thought that her life will be
stressful again because of it, her mother can be involved to empower her to deal with her
pregnancy in a positive way. Her mother can supports her in giving good advice related to
pregnancy. In addition, the employer can empower Lucinda by giving her the opinion that her
second pregnancy can go normal too. Inculcating positive thoughts in related to her pregnancy
and future life can address her current mental status. The recovery model of mental illness
emphasizes on empowering mental health clients to build their resilience and aid them in
recovery (Hungerford et al., 2018).
Mental health professional can work with Lucinda to give her hope that her pregnancy
will be fine and she can continue with her studies after that too. Her family member can support
greater help for the client as they would help her to balance her maternal responsibilities as well
as fulfil her life aspirations. In addition, mental health staffs can give positive hopes to her
regarding her second pregnancy by referring her to appropriate antenatal service. The mental
health standards for nurse mentions that mental health nurse must develop therapeutic
relationship with client by respecting client’s choices and experience and holding hope to
promote recovery (Australian College of Mental Health Nurses (ACMHN), 2018).
References:

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