Understanding the Mental Health Concerns of Tabitha: A Case Study

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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Introduction
The following assignment is based on the case study of a 16 year old girl Tabitha. She
hails from a well-to-be-family with working parents and one older brother. She has recently
completed her class 12 exams and is a sport enthusiastic with active social life. Recently upon
her return from the “schoolies” week “down the coast” with her best friend she is showing
unnatural behaviour like lack of interaction with family, indulgence to mobile phones and
keeping confined herself in one room. She is also showing a negative attitude to her mother
and has block her brother and mother from Twitter and other social medias. The following
paper will be structured from the perspective of the community health nurse with an aim to
critical analyse the current health behaviour of Tabitha. The paper will begin with general
introduction about Tabitha followed by her health concern and the model of health applicable
to her. This will be followed by discussion of the factors affecting her health behaviour and
decisions along with the psycho-physiological aspects of health. At the end the paper will
highlight the health promotion strategy that will be useful for Tabitha from the perspective of
the community health nurse in order to promote her comprehensive health and well-being.
Introduction to client
Name of the client is Tabitha. She is a 16 year old girl and has completed her 12th
grade last year (2018). She is youngest in her grade. She attended Pleasantville Secondary
College, one of the highest achieving OP1 School in Pleasantville. She resides in
Pleasantville, a large city with multiple recreational activities with her mother, father and
older brother. Both her parents have attended the university and are working professional
occupations. She is in her adolescence stage in her lifespan during this stage of life; she was a
consistent winner of skating championship. She is an outgoing girl and high-achieving
student who took pride in her appearance. She is well-mannered and used to lead an active

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social life like taking part in water sports and ice skating. She was a school leader with OP
score between 2 to 6. She aspires to be a nurse.
It is difficult to accurately ascertain her main health concern from the current
illustrations as Tabitha is refusing to discuss her concerns with her mother. But her unnatural
behaviour mainly started after her return from the “schoolies” week “down the coast”. Her
main symptoms include compete exclusion from parents like she has unfriended her mother
and brother and also blocked her Twitter handle. Development of a negative behaviour
against her mother especially as she constantly refused to go out for a coffee with her mother
which she used to love before, yelling at her mother saying that, “I hate you, I hate everyone”
and throwing ear-ring gifts from her mother in kitchen bench. Footfall of her friends visiting
her house has also reduced after she came back from “schoolies”. The symptoms of Tabitha
suggest that she might be suffering from post breakup symptoms or online bullying. Hint of
generation of a relationship or potential social bullying is evident from her extra addiction
towards phone and blocking access to family members to her social media profile. McGorry
et al. (2014) are of the opinion that the adolescents between the age group of 15 to 19 years in
Australia are vulnerable towards social bullying leading to the generation of severe mental
health consequences like depression, anxiety and social withdrawal. De Vries et al. (2014) on
the other hand highlighted that during the transition from school to college, young adults
suffer from anxiety, mood swings and that might be the case of Tabitha. The moods swings
and high anxiety levels are higher among puberty girls as their physiological transformations
are more significant than males (De Vries et al., 2014). The main model of health that might
be applicable is bio-psychosocial and medical model of health promotion (Dorrian et al.,
2017).

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Factors affecting health decisions and behaviour
The main factors affecting the health behaviours include social influences and
inequalities along with health literacy (Jonesv & Creedy, 2018). The health inequalities might
not be the case of Tabitha as she resides under standard socio-economic determinants with
proper access to healthcare under the parameter of finance, cultural factors and geographic
factors (Pleasantville has six hospitals). Social influences and complex social environment
might be the case for her abnormal behaviour. Online social networking sites (SNSs) have a
significant influence over the adolescents. Weinstein et al. (2015) further highlighted that
internet addiction among the youth is associated with social bullying leading to social
exclusion. Tabitha might also be suffering from social exclusion as she is unwilling to talk
with anyone. The study conducted by Huang et al. (2014) highlighted that exposure to risky
online content negatively impact the health behaviour of adolescents and thereby increasing
the chances of negative psychosocial outcome. This might be the case of Tabitha as she used
to have active social life. Romantic concerns can also be the case for Tabitha. Price et al.
(2016) stated that at least 50% of the young people have dated by the age of 15. Concerns
about initiation of relationships are common during early adolescences while the concern
about maintaining and repairing the relationships increases with age and hampers the peace
of mental health. Post-relationship concerns like breakups is associated with adverse
behavioural and mental health conditions leading to the generation of concurrent mental
health issues, suicidal tendencies and tendency of self-harm (Price et al., 2016). It coincides
with the psychological needs of the Maslow’s theory. Psychological needs like belongingness
need for love might have been endangered for Tabitha leading to the complex psychological
outcomes (Dorrian et al., 2017). Fazel et al. (2014) stated that esteemed schools in high-
income cities increases the peer-pressure over the students that increase anxiety and
depression. After high school, there is a transition to college. This transition generates an