Evidence Based Mental Health Nursing

Running head: EVIDENCE BASED MENTAL HEALTH NURSING
EVIDENCE BASED MENTAL HEALTH NURSING
Name of the Student:
Name of the University:
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1EVIDENCE BASED MENTAL HEALTH NURSING
Table of Contents
Introduction..........................................................................................................................2
The Tidal Model and Care Programme Approach Framework...........................................3
Biography............................................................................................................................5
Assessment..........................................................................................................................7
Risk Assessment............................................................................................................13
Care Planning.....................................................................................................................14
Care Planning for Harper...............................................................................................14
Conclusion.........................................................................................................................17
Reference...........................................................................................................................18
Appendix 1: Care Plan.......................................................................................................25

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Introduction
This essay discusses on the assessment and formulation of a care plan with the help of
evidence based mental health services. According to James et al. (2014), adherence to an
evidence based approach, will help in the development and performance of good quality
screening, assessment and care planning procedures. Evidence based practice encompasses the
performance of research and the utilization of knowledge obtained through research, during the
execution of successful professional practice and also necessitates incorporation of ‘tacit
knowledge’ – that is the, the information or knowledge from additional clinical professionals
(Moreno, Becerril and Alcalde 2018).
For the purpose of assessment ‘Care Programme Approach’ has been adopted. This
approach to mental health was formulated with the aim that individuals requiring specialist
treatment for mental health treatment, may also need additional assessment and management of
their social and physiological needs (Farrelly et al. 2016). This will aid in the development of a
multidisciplinary treatment approach for the mental health management of the patient, which
will further specify the key professional services required. (Tyrer et al. 2017). The essay also
discusses about the utilization of the Tidal Model for Mental Health Nursing, which aims at
treatment of the individual, through emphasis on patient empowerment and change processes
encountered (Ramage, Ellis and Marks-Maran 2018).
For the purpose of keeping the identity of the patient receiving care confidence and
anonymous, in accordance to the NMC Code, the name of the service use has been altered. My
duties and responsibilities as a student nurse, includes maintenance of confidentiality and
anonymity of the individuals to whom I am imparting my treatment and care services, along with

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obtaining consent prior to execution of treatment procedures and conducting appropriate
communication with them concerning the details of their care plan (Fisher 2017).
The Tidal Model and Care Programme Approach Framework
The Tidal Model, as researched by Savaşan and Çam (2017), entails an approach towards
mental health recovery, through the encouragement and empowerment of the concerned patient,
through extensive evaluation and emphasis on the changes faced by him or her, the usage of
metaphors and by involvement of the patient in the care planning process, by allowing his or her
changing needs to direct the treatment, rather than relying solely on professionals. The Tidal
Model was developed by Professor Phil Barker and aims to empower individuals by helping
them to recovery through the usage of metaphors and allowance for the patient to liberally
engage in their personal expression of needs, preferences and personal stories (Ramage, Ellis and
Marks-Maran 2015).
The Care Programme Approach or CPA, as stated by Brooker and Forrester 2017),
highlights the key guidelines to be followed for the successful conductance of assessment,
planning, coordination and reviewing the essential needs of a person suffering from mental
health disorders. According to Kingdon (2018), the usage of CPA has been documented to be
effective, especially in the treatment of patients suffering from severely detrimental symptoms
of mental health disorders. Additionally, CPA has also been found to be helpful for clients with
sensitive needs, such as victims of abuse, or for those whose treatment of mental difficulties is
not financially feasible (Power et al. 2016).
For the successful conductance of a CPA framework, the service provider must adhere to
four salient principles. As stated by Brooker and Webster (2017), these include assessing the

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requirements of the patient, delegating a coordinator of care, planning the fulfillment of the
specialized needs of the patient along with reviewing or follow up of the patient’s condition
during as well as after the conductance of the chosen treatment procedures. The chosen
coordinator of the CPA framework will ensure that the patient possesses complete accessibility
of the required treatment services along with the incorporation of the NHS, additional
organizations and the family members in the treatment process. As researched by Kemp (2016),
in accordance to the CPA, the treatment plan must also undergo regular monitoring and
reviewing by the coordinator to asses patient progress, along with the presence and requirement
of additional factors such as medications, side effects, education, social networks or health
literacy training. The principles of assessment highlighted by the CPA also includes the
evaluation of the presence of substance abuse or alcohol and the potential risk the service user
may possess towards others or towards oneself (Moody et al. 2018).
Considering the need for mental health patients to engage in feelings of mental security
of reduction of distress during provision of mental health treatment, associating the mental health
needs along with the social and emotional needs of the client is of utmost importance, which the
CPA saliently highlights (Asaria et al. 2015). However, as researched by Ryan et al., (2016), the
CPA framework has not been devoid of criticism, where certain professionals have regarded the
practice as being inconsistent and autocratic. Nevertheless, as researched by Eaton, Roberts and
Turner (2015), it has been documented that the CPA framework is an ideal approach for mental
health nursing, due to adherence of an integrated treatment approach encompassing required
referral or specialized services for the management of multifaceted client needs, which has been
found to be advantageous. CPA along with the Tidal Model has been documented to be an
efficient care planning model of treatment for mental health patients, and hence, has been

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utilized extensively for the management of the service user highlighted in this essay (Savaşan
and Çam 2017).
Biography
The chosen case subject is Harper, a 49 year old woman, who was previously engaged in
receiving residential care services for the previous 10 weeks. Harper has been found to be
suffering from cerebral palsy, mild symptoms of learning disabilities and major symptoms
associated with Personality Disorders, namely Emotionally Unstable Personality Disorder. Prior
to being admitted to our community health center, we received information from the residential
services in which Harper was engaged in previously, which highlighted incidences of violence,
self harm and aggression towards herself and towards the workforce. Harper had a record of
over 60 incidents where she exhibited unpredictable behavioral outbursts of violence, aggression
and self harm, towards herself, as well as towards others involved in her care and treatment.
The residential facility has issued Harper a notice for eviction.
Harper was born as the third child to a single mother. Harper’s parents had previously
divorced due to repetitive alcohol abuse by her mother and the constant conflicts between the
two. After the divorce, her mother engaged in constantly abusing Harper and her two siblings,
her sisters. Harper was born with learning disabilities which resulted in her poor academic
performance and further resulted in being constantly abused by her mother, who would hit her
repetitively and deprived her of food for days, as punishment for the same. One night, after a
period of excessively drinking, Harper’s mother began to recklessly break things in the
household, terrorizing the children in the process. As a result, Harper and her sisters ran away
from the house and after being reported by a passerby to the nearest police station, they begun