Mental Health Nursing

This document discusses the assessment of mental status, diagnosis of posttraumatic stress disorder, the stress-vulnerability model, and the recovery-oriented approach in mental health nursing.

Running head: MENTAL HEALTH NURSING 1
MENTAL HEALTH NURSING
Name of Student
Institution Affiliation

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Question 1
The mental status examination is used to assess the psychological state of a patient and
give a mental description of the patient. It covers both clinician’s observations that are objective
and the description given by the patient which is subjective. Peter who is the patient in the case
study presents with two main components of mental status assessment which are thought content
and insight or judgment. Under the diagnostic and statistical manual of mental disorders, fifth
edition (DSM V) he has posttraumatic stress disorder. Thought content under mental status
assessment explores the ideas that occupy the mind of the patient being assessed, and in this case
study, Peter has been ruminating suicidal thoughts (Young, 2016). He has depressive cognition
because he has made comments like life is not worth living and felt hopeless for two weeks.
These two factors of suicidal thoughts and depressive cognition fall under the component of
thought contained in the mental status assessment. Insight under mental status assessment is used
to show that the patient is aware of the situation or illness that they are currently undergoing.
Judgment explores the ability of the patient to expect repercussion due to their behavior and
consequently take relevant actions to protect themselves and others (Jacob et al. 2013). Peter is
well aware of the situation he is in and as a result, is worried about chatting the details of his
ruminating suicidal thoughts as he fears that his employer will be informed. He is concerned that
if his employer were to know his current mental health status, then that would risk his accountant
job. This represents the judgment component of mental status examination because he knows the
consequence of his employer knowing his current condition is to risk his job. If he were to lose
his job his family would face more financial problems as the maternity pay they were expecting
was changed by the government regulations six months ago. To safeguard his family, he,
therefore, fails to discuss in detail about his current mental health.

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To diagnose an adult with posttraumatic stress disorder using the diagnostic and
statistical manual of mental disorders, fifth edition a traumatic event and of a certain type is
needed. The patient should have been exposed to threatening or actual death either by
experiencing the traumatic event directly or witness the event in person as it occurs to others
(American Psychiatric Association & American Psychiatric Association. 2013)). In the case
study, Peter witnessed his wife in an emergency that threatened her life as he was in the room
when the team was called to deliver the baby by emergency surgery. The patient has to
persistently re-experience the traumatic event that they witnessed or directly experienced to be
diagnosed with posttraumatic stress disorder (Cifu & Caruso2010). Peter has been having
flashbacks as he cannot get the images of his wife in the emergency out of his mind. He has
hyperarousal through sleep disturbances from the traumatic event as he reports insomnia and
early morning wakening. Peters has experienced this symptom from witnessing his wife in an
emergency, and this disturbance cannot be linked to any medical condition or physiological
effects of any substance.
Question 2
The stress-vulnerability model was a theory initiated by (Zubin et al., 1977) to explain the
cause of psychiatric disorders and their course over time. This model is a useful tool in the
treatment and identification of mental illness. The model states that there are elements
attributable to an individual such as social, psychological and biological about stress (Carvalho et
al. 2015). For stress to cause mental illness on a person, there are questions raised as to how
stress impacts on a person depending on their strengths and weaknesses in dealing with stress.
An individual with little vulnerability to stress can stand firm against large amounts of stress as

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opposed to an individual with high vulnerability to stress which would be largely impacted by
small amounts of stress.
Two factors that have contributed to Peters’ current mental health status are
psychological factors and social, environmental causes. Psychological factors refer to the
psychological state of the patient regarding managing current and past traumatic events (Hall and
Hall, 2017). These events have a strong influence on mental status and health. Mental
disturbances activate neural connections that provoke negative thoughts and emotions. It is
normal to experience a range of moods both high and low, in everyday life. Sometimes people
fall into depressing feelings that persist and interfere with their ability to complete daily
activities. Peter experienced a traumatic event when he saw his wife in a life-threatening
condition and this greatly affected his psychological state resulting in mental illness. For the past
two weeks, Peter has been experiencing feelings of hopelessness and feels it is not worthy of
living.
Social, environmental causes of mental illness refer to the factors around one about where
they stay and the living conditions. They refer to socioeconomic and relational conditions that
may influence one’s ability to cope with stress (Mackenbach 2012). Environmental factors are
external to the person experiencing the illness. Chronic stressors such as economic struggles as
depicted in the case study by Peter. When social stressors accumulate, mental health problems
are more likely to occur. This factor takes into account the support one has from their family and
their employment status (Di Fabio et al. 2016). Peter has been working long hours to sustain his
family because maternity pay they were expecting could not be received as the government
changed the regulations six months ago. The government changing regulations is an external

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factor that Peter did not influence over though it is affecting both his family financially and his
mental state.
Question 3
Recovery-oriented mental health theory is a holistic approach to mental health that is
person-centered. This theory and practice are built on the foundation that one can recover from
mental health, and patient-directed recovery is most effective (Jacob & Kuruvilla, 2016). From
the perspective of the person with the mental illness, recovery means gaining and retaining hope,
understanding of one's abilities and disabilities, engagement in active life, personal autonomy
and a positive sense of self. The purpose of this theory and practice is to ensure that mental
health services are being delivered in a way that supports the recovery of mental health
consumers.
Respect as a positive aspect of mental recovery means the removal of discrimination and
dishonor as a means to achieve recovery (Suwalska et al. 2017). Accepting and believing in
oneself are vital components of this aspect. In the case study, Peter can be shown respect in his
recovery process by his wife talking to him. She has to convince him that he is honored as the
head of the family and together they will overcome the current state.
Empowerment as a positive aspect of mental health recovery means improving the level
of belief in the person suffering from mental health. When their belief in themselves is improved,
they then have the belief that they are in control of their lives. For this to be achieved the patient
needs to possess skills and qualities like self-esteem and confidence to air their views and wishes
(Slade 2009). In the treatment of a person with mental health, one cannot reliably predict the
course of a patient’s illness and how they might respond to the treatment given. The
empowerment approach shows the patient that they have a say in the ongoing treatment, and they

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can recover from the illness. In the case study given Peter can be empowered by being assured
that patient’s privacy is valued and therefore he will not be reported to his employer.
Hope is the foundation upon which mental health recovery is established. The recovery
process from mental health illness is an exercise of hope that gives the patient an expectation of
what is to be gained after recovery. Hope as a positive aspect in the recovery process can be
external or internally driven with the desire for better mental health (Shin & Hwang, 2019). The
patient has to acknowledge that with help and support they can recover and live their normal
lives as before. Peter has feelings of hopelessness and felt life was not worth living. Family and
friends can help in fostering hope, and the case study peters wife can play a key role in this by
giving him hope.

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