Sarah Case Study (Care Plan) - Mental Health Assessment Findings

Sarah Case Study (Care Plan)
Mental Health Assessment (MSA) Findings
Sarah’s mental health assessment indicates her thought content based on passive
thinking, death wishes, and suicidal ideation. Her thought process appears blocked by her
withdrawal state to some extent however, she still exhibits a logical thinking pattern and
normal intellect. Sarah’s perception complications are based on auditory hallucinations
related to her stressful conditions. Sarah appears neat and clean in appearance, however,
limited eye contact with the interviewer indicates her emotional disturbance. Her affect-
parameter is related to low-mood, reduced self-esteem, and unstable psychosocial condition.
She does not exhibit any motor abnormality. She appears insightful and aware of her mental
health complications. The Glasgow Coma Scale indicates her good orientation and
appropriate motor and verbal responses. Sarah’s mumbling during interview reveals her
articulation difficulty and deficit related to the spontaneity of thoughts. Sarah’s reported
mental health complications are the direct outcome of several factors including broken
relationship, academic failure, employment issues, home-based conflicts, and elevated
caretaker burden. Sarah’s drug/substance abuse, alcohol addiction, medication overdose,
suicide attempts are based on her psychosocial isolation and ineffective coping skills. Sarah’s
other clinical complications include sleeplessness, loss of appetite, weight reduction, reduced
concentration, and elevated stress.
Sarah’s Safety, Care and Recovery Priorities
Sarah’s safety, care, and recovery priorities are based on her suicidal risk reduction,
self-esteem elevation, and improvement in overall coping skills. The reduction in Sarah’s
caretaker’s burden is also a preliminary necessity to effectively improve the quality of her
mental health care interventions.
Suicide Prevention
Sarah’s suicide prevention is necessarily warranted to minimise her risk of self-harm
and self-inflicted mortality. The minimisation of Sarah’s suicidal thoughts is also needed to
effectively reduce her predisposition towards suicide reattempts and resultant hospitalisation
(Ghanbari, Malakouti, Nojomi, Alavi, & Khaleghparast, 2016). Sarah’s suicidal ideation also

proves to be the greatest barrier to the improvement in her treatment outcomes. It also
elevates her risk for major depression and treatment non-compliance (Brachel, Teismann,
Feider, & Margraf, 2019). Sarah’s suicidal tendency potentially elevates her risk for HIV,
diabetes, liver disease, and other chronic disease conditions based on unhealthy behaviour
and lifestyle. The suicidal ideation could predominantly elevate Sarah’s intensity of
emotional stress, alcoholism, substance abuse, and drug overdose while elevating her risk for
personality/bipolar disorder (O'Rourke, Jamil, & Siddiqui, 2019). Sarah’s suicidal ideation
not only reduces her life satisfaction, coping skills, and interpersonal support but also elevate
the risk for psychiatric emergencies warranting hospitalisation (Weber, Michail, Thompson,
& Fiedorowicza, 2017). The suicidal ideation also proves to be the precursor of Sarah’s
disrupted relationships with her parents/caretakers.
Self-Esteem Elevation
Sarah’s self-esteem elevation is highly required to effectively improve her thought
content and lifestyle behaviours or HQoL (health-related quality of life). Sarah’s enhanced
self-esteem could potentially improve her psychosocial function, family relationships,
autonomy, peer/social support, employment issues, and academic performance (Knox &
Muros, 2017). Self-esteem reduction also proves to be the greatest predictor of psychosocial
deterioration based on adolescent’s anxiety, stress, or depression. It also drastically
challenges the personal and professional development that eventually leads to the feeling of
withdrawal and worthlessness. Accordingly, Sarah’s reduced self-esteem also elevates her
social avoidance tendency that eventually elevates her pessimistic approach, ambiguous
social cues, and negative memory (Masselink, Roekel, & Oldehinkel, 2018). Sarah’s reduced
withdrawal state and self-worth/self-esteem reduction prove highly detrimental to her
cognitive functioning and intellectual ability (Wang, Wu, Chang, & Chuang, 2013).
Accordingly, the systematic improvement of her self-esteem is highly warranted for the
enhancement of executive function and other mental health outcomes.
Coping Skills Enhancement
Sarah’s reduced coping skills substantially deteriorate the prognosis of her
psychosocial/mental health complications. The reduction in coping skills not only elevate her
risk for comorbidities but also increase the caretaker burden to an unprecedented level.
Sarah’s coping skills’ reduction potentially elevates the impact of her stressful circumstances

on her decision-making ability while concomitantly elevating the risk for anxiety disorder
and depression (Herres & Ohannessian, 2015). Sarah’s ineffectively coping strategies
substantially contribute to her reduce autonomy and tendency to commit errors psychosocial
stress and emotional disturbances (Britt, Crane, Hodson, & Adler, 2016). Sarah’s ineffective
coping skills also deteriorate her neurobiological adaptations and eating habits that eventually
leads to loss of weight and appetite reduction (Yau & Potenza, 2013). Sarah’s ineffective
stress coping continues to deteriorate her sleep cycle, thereby elevating her risk of
comorbidities and pathophysiological complications based on cardiac disease and metabolic
disorders (Matthews, Hall, Cousins, & Lee, 2016). Furthermore, Sarah’s mother’s stress not
only elevates decreases her self-efficacy but also increases the risk of treatment quality
reduction and behavioural complications. Eventually, Sarah’s health care goals’ deterioration
and therapeutic adherence issue not only increase her recovery time but also elevate the
socioeconomic burden of her caretakers (Li et al., 2018). These outcomes substantiate the
requirement of elevating Sarah’s coping skills in the context of minimising her stress level
and other mental health care issues.
Nursing Interventions and Strategies
Suicide Prevention Interventions
The mental health nurse will require assisting/supervising Sarah’s daily activities
while creating an environment conducive to psychosocial enhancement. Sarah’s regular
mental health assessment will reciprocate following the medicolegal requirements stipulated
by the Mental Health Act (2014) (Mental_Health_Commission_Western_Australia, 2018).
Accordingly, the mental health nurse will restrict Sarah’s access to undesired medications,
drugs, and sharp objects based on her reported suicidal tendency. The nurse will need to
encourage Sarah’s engagement in professional development activities in the context of
minimising her passive and self-destructive thoughts. This consistence mental health
monitoring will minimise Sarah’s risk of self-harm and suicidal attempt. The nurse will
require increasing Sarah’s awareness of suicide precautions and litigating issues that she and
her family members could encounter following the execution of a suicidal attempt. The
mental health nurse will also need to moderately enforce seclusion and restraint strategies
without compromising Sarah’s dignity and self-esteem (Health_Gov_Australia, 2019). The
nurse will need to insightfully monitor Sarah’s medication side effects and stress level based
on the recommended safety standard. The mental health nurse will attempt to increase social