Delivering Bio Psychosocial Interventions in Mental Health Nursing

This assignment focuses on the case study of a patient named Peter who is suffering from cognitive impairment, depression, and severe hypoglycemia. It discusses the background of the patient, their medical and psychiatric history, and the impact of their mental health problem on themselves and their family. It also evaluates the processes used to ensure high-quality care for the patient.

The aim of the module is to increase mental
health nursing students’ knowledge,
understanding and skills in delivering bio
psychosocial interventions

INTRODUCTION
Mental health nursing includes the working in mental health settings to deal with patients having
psychological problems. It includes the criterion of providing medications, nutrition and several
therapies in order to make individual wellbeing. Meanwhile, it is necessary for mental healthcare
professionals to remain calm and confident to deal with mental patient in effective manner. It
consist the way of diagnosing specific problem along with behaving properly with patient having
psychological issues. It is also required to pay respect dignity along with following ethics while
dealing with mental patients and deliver appropriate care services for their wellbeing. In context
of this assignment, it is based on the case study of patient named Peter who is suffering from
cognitive impairment, depression and severe hypoglycaemia. It includes the complicated
condition of patient who requires appropriate care facilities and treatment to overcome with
mental health condition to become normal. This project will focus on information and
background related to selected case study of given patient about their specific psychological
problems. It will also include description about local and national policy for delivering high
quality of care for patients. The difficulties to follow policies and relevant strategies to address
them along with critical evaluation are given below.
MAIN BODY
A brief, anonymised introduction to the person, their background and the service in which the
case study takes place
Peter is 67 years old widower and his occupation is retired accountant who was referred for
psychosocial evaluation at diabetes clinical post emergency room visit at local hospital. He has a
problem of confusion and a severe hypoglycaemic episode after intake overdose of insulin due to
which he get admitted in emergency room. Patient deny of having suicidal intent or alcoholic
abuse along with claiming for intake insulin lispro besides of insulin glargine dose by mistake.
The staff working in emergency room were suspicious because the patient has been visit for
eight times for severe hypoglycaemia since past two years, the patients explained about previous
visits due to intake of mixed insulin injected by himself. In addition to this, the proper
psychiatric assessment has been carried out which results that patient was not at suicidal risk and
hence get discharged after stabilised condition of blood glucose levels respectively. Petre
promised to their practitioner for in taking proper medication and pursue outpatient mental health
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treatment accordingly. It is observed that is blood glucose levels show wide swings generally
which and patient explained that high glucose levels make him feeling more apathetic in terms of
eating as well as depressed regarding his self-management diabetic condition.
Previous history
Considering the childhood of Peter, he got all the developmental milestones on time and his
father was in Army so that patient move around 32 times before his graduation from high school.
He was an excellent student and manage mediocre grades in college because of conflicts occurs
in family. Further, Peter took a drop from college in his junior years and prefer to travel South
Pacific Island for the duration of one year. When he returned to U.S. and gain undergraduate
degree in the subject of English along with achieving second degree in specialisation of
accounting. Peter has been began their own firm of accounting but face problems to manage all
the operations which leads to delayed visit for meetings. He fails to complete the projects often
and he realised of struggling with depression after some time round the age of 30 years. He
acquired severe mental health condition when he lost his 47 years old year sister due to the
problem of colon cancer in the year around 1988 and then he lost his father diet at the age of 74
years from the severe problem of heart disease in the year around 1991. Besides of all this, Peter
lost his wife due to lung cancer an then he contemplated suicide for 3 months but never acted. He
moved to West Coast to live with his mother but diabetes make complication in his emotional
struggles and blood glucose levels fluctuates. He acquires severe hypoglycaemic condition and
stop working along with approved for social security due to his condition of psychiatric
disability.
Medical and psychiatric history
Peter has diagnosed with neuropathy, retinopathy and unpredictable blood glucose levels due to
which he tries to monitor the blood sugar levels by eating proper diet. It includes the problem of
sleep apnoea and their sleeping patterns are observed to be highly erratic as Peter does not fall
asleep until 4:00 A.M. early in the morning and only sleep for 2 hours. He took nap in after noon
and started the positive airway pressure treatment continuously in order to overcome with his
sleep disorders. It consist the further diagnosis of several condition including hypertension,
hyperlipidaemia, atrial fibrillation, tinnitus, arthritis for which he get several medications such as
atorvastatin, lisinopril, hydrochlorothizide, warfarin, meclizine, and folic acid. Peter did not
smoke but he drink alcohol sometimes. Depression affect Peter since he was diagnosed with the
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problem of diabetes, his depression acquire complicated state after death of his father and sister
but suicidal thoughts never influence him. He has family history of depression and dementia
along with alcohol abuse habit of his mother.
Use person-centred language to discuss the features and wider context of the mental health
problem the individual was experiencing
Person centred care can be defined as an important factor which is required to be considered
while dealing with mental patient. It is an approach in which decision making of treatment is
individual based which facilitate to provide improved patient outcomes. Basically, person
centred language includes the way of interaction with patient which is favourable to them and
make them comfortable to share their problem in accurate manner. It is necessary for care
professionals to communicate respectfully with an individual to reduce their fear of
hospitalisation and make them comfortable to convey their actual problem as well as difficulties
without hesitation. It will provide support mental healthcare practitioners to formulate more
effective as well as efficient plan of care in order to deliver desired medications for making
patient wellbeing. Meanwhile, it has been analysed that care professionals should communicate
effectively in order to identify relevant signs and symptoms so that appropriate decision of
treatment can be established to deliver better quality of care respectively. In context of given
case of Peter, it is required for associated care professional make healthy conversation with him
and make him realise to understand their feelings which develop mutual understanding between
patient and nurse. It will facilitate to establish an effective patient nurse relationship which is
very important to provide accurate treatment for making selected patient disease free. However,
the effective conversation with Peter helps to evaluate the level of complicated depression he had
according to required dose of medications along with appropriate therapies can be provided. It
will facilitate to improve the condition of patients. It is necessary to make an effective care plan
with the help of evaluating the medical history and family history of psychological problems
which will provide support to formulate accurate psychosocial interventions for wellness of
selected patient.
In addition to this, it has been analysed that depression can be defined as mental condition on
which a person’s mood become low and remain confused. It includes several symptoms through
which depression can be recognised problems of mood including aggressiveness, anger,
irritability, restlessness and anxiousness. Basically, it consist the emotional problems of feeling
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empty, sad, hopelessness and behavioural issues like feeling tired, thoughts of suicide, drinking
in excess, engaging high risk activities and loss of interest. It involves the lack of sexual
performance, abnormal sleep patterns, cognitive disabilities including inability to focus,
difficulty to complete tasks & delayed responses and physical problems like pains, headache,
fatigue as well as digestive issues. However, there are several kinds of causes behind depression
such as family history of depression, early childhood trauma, brain structure, drug use and
medical conditions like insomnia, chronic pain, chronic illness and attention deficit hyperactivity
disorder. It has been identified that several risk factors of depression such as personal history of
mental illness, certain medications, stressful events like loss of loved one, economic issues or
divorce and low self-esteem or being self-critical. The care professionals diagnosing Peter should
analyse these symptoms of feeling low, sad, hopeless etc. to determine the condition of
depression.
Behaviourism theory states that depression can be caused due to the combination of stressors
which are present in environment of an individual and their lack of personal skills. It includes the
fact that presence of stressors to cause less receiving positive reinforcement by an individual.
Meanwhile, it has been analysed that dysfunctional behaviour like depression can be learned
including its respective causes and symptoms which help to treat the same in effective way. The
depression may occur due to several reasons when a person, face death of loved one, severe brain
injury, economic crisis, divorce etc. It is observed that depression become complicated when it
continually happens with an individual for a long period of time.
According to the psychoanalytical theory, it has been analysed that depression is psychological
condition which can occur due to biological factors besides of loss, or rejection via the parent
can trigger depression. It includes the analysis of emotional factors which are responsible for
occurrence of depression which facilitates to improve the condition of selected patient through
treating their problems. However, it is necessary to make an effective communication with Peter
by care professionals to evaluate their actual problems that is death of his father, sister and
mother along with having problem in working. All the factors are responsible for developing
depression and continuous emotion crisis induced relevant complications. The psychoanalytic
theory has several principles which are required to be considered while dealing with patient
having psychological problem like depression that are mentioned here. It includes that functions
of human mind are as much unconsciously as consciously. However, it consist that everything is
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an utterance and no utterance is innocent. It involves the principle that utterances are always
motivated via forms of desires. Moreover, these principles should be considered while dealing
with Peter to identify actual problems and causes which helps to treat the problem appropriately.
Analyse the impact of the mental health problem on the person, their family, carers and
significant others
Mental health condition impact negatively on an individual and disturb their life completely until
they become wellbeing by taking appropriate treatment. It includes that people lost their
confidence and remain confused which affect their regular activities to be carried out. It is
observed that patient forget to conduct regular routine work and remain sad by having lack of
interest in their favourite things. However, a person with depression has condition of feeling
sadness and emptiness which are responsible for affecting regular activities and routine work. it
consist the condition of developing insomnia which interrupt the sleeping patterns of patient as
they cannot take proper sleep. In case of Peter, he has not fall asleep until 4 A.M. and take only
two hours sleep daily after that he took a nap in the afternoon. The depressed condition impact
on ability of an individual to memorise anything and they are not able to make regular decision
effectively. This condition is responsible to develop high risk of occurring heart attack and
weight fluctuations which may cause complicated health condition of an individual accordingly.
The pain sensitivity and fatigue is always present which reduce comfort level of patient that
impact negatively on their heath condition.
With reference to local and national policy, evaluate the processes utilised to ensure high quality
care for the service user
DISCUSSION
If your evaluation identifies gaps or difficulties in service provision, discuss these within the
wider context of implementing local or national guidelines and how potential strategies
might address these problems
If no gaps or difficulties are identified, outline the key requirements for ensuring consistency of
care provision alongside a critical evaluation of why this might not always be the case
CONCLUSION
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