Comprehensive Mental Health Assessment in General Hospital Settings

This report examines the critical role of mental health and wellbeing in healthcare, particularly within general hospital settings in Australia. It emphasizes the importance of holistic nursing care, encompassing biopsychosocial and spiritual dimensions to ensure a patient's quality of life and social wellbeing. The report discusses the necessity of addressing mental health issues alongside physical ailments, highlighting the prevalence of co-morbidities such as anxiety and depression. It underscores the significance of comprehensive mental health assessments, detailing the essential components nurses must employ, including a thorough patient history and mental status examination, to formulate effective treatment plans. The report provides examples of how mental illnesses can manifest with physical symptoms and the need for early detection of mental health conditions. The report also touches on specific cases, such as those with ventricular dysrhythmias and hypothyroidism, and their potential links to psychiatric illnesses. It advocates for educating patients about their conditions and the importance of empathy and communication skills for nurses to foster a therapeutic relationship and improve patient outcomes. The report concludes by stressing the interconnectedness of physical, mental, and social wellbeing, advocating for a comprehensive approach to patient care to address multiple co-existing diseases.

MENTAL HEALTH
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Mental health is at the core of an individual's health because this determines the
wellbeing of the individual. World Health Organization describes health as complete mental,
physical, and social welfare and not merely the absence of infirmity or disease. Mental health
promotion means the provision of an enabling environment that will support mental health and
improve the psychological wellbeing of an individual. This essay will discuss why mental health
and wellbeing of an individual must be addressed to ensure the quality of life and social
wellbeing. Anxiety disorders and depression are mental health problems, and this essay will
discuss why early detection of these mental illnesses is essential to promote a person's wellbeing
(Svalastog et al. 2017).
Quality of life and wellbeing of an individual is attainable when the spiritual dimension
and biopsychosocial aspects of their lives are adequately addressed. The biopsychosocial model
describes how biological, social, and psychological factors interact to affect an individual's
mental health (Wachholtz et al. 2016). Tim, who is a registered nurse working in a busy tertiary
general hospital, must his patients’ mental and health issues simultaneously for the wellbeing of
the patients' life. Psychological needs of a patient are related to the stress levels, lifestyle, and
personal characteristics of an individual. Patients are worried when they have physical illnesses,
and a nurse should address both the psychological and physical aspects of the sick individual.
Mental wellness is a state of wellbeing whereby an individual feels that they have the ability to
handle the normal stresses in life (Galderisi et al. 2015). Patients in hospitals need to be assured
by nurses that they are at a position to manage their physical illness. Tim, who is working in a
busy general hospital, needs to continually reassure his patients that they have the mental
strength to cope with stresses of their physical illness. Spiritual wellness is a social need of a
patient, and this need has to be addressed adequately for the patients to feel cared wholesomely.

Mental and physical illnesses bring spiritual distress to the patient, and therefore it is the mandate
of the nurses to address these spiritual needs. Tim, as a registered nurse in Western Australia,
needs to connect to his patients and understand their spiritual needs therapeutically. A good
therapeutic relationship between patients and nurses gives the patients a sense of care, and they
can tell the nurses what their needs are. Recent research has shown that patients who feel that
their spiritual needs are adequately addressed heal faster compared to patients whose needs are
foregone. Patients continuously need to feel loved and wanted while in the hospitals, and it is the
nurses' mandate and responsibility to make sure that this needs of a patient are achieved. Tim has
to reassure his patients that despite their physical and mental health issues, they are still human
beings who deserve love and care (Memaryan et al. 2015).
Patients with multiple co-existing diseases have two or more conditions affecting their
mental and physical health at the same time. General hospitals and health care system has to
address the co-morbidities simultaneously for the wellbeing of these patients under their care
(Navickas et al. 2016). Many patients diagnosed with chronic physical illnesses such as diabetes
mellitus type 2 or hypertension tend to develop mental illnesses such as depression. Chronic
diseases last for an extended period, and patients need to be adequately counseled on how to
cope with these illnesses. General hospitals need to have strategies on how to deal with such
patients and ensure that they are holistically taken care of in hospitals. Nurses working in public
hospitals should possess exceptional abilities such as empathy and excellent communication
skills to interact with patients and elicit the needs of the patient. Australian Burden of Disease
study takes data from chronic disease monitoring centers and gives objective recommendations.
Australian health care system advocates that patients should with chronic diseases be educated
on what the illness they have and its effects (Moon et al. 2019). Educated patients cope well and

manage emotional stress related to their condition than patients who do not understand what they
are facing. Comprehensive mental health assessment should be carried out on all patients with
co-morbidities to assess their mental health conditions. Nurses should include the following
features that are at the core of a comprehensive mental health assessment, signs and symptoms,
conversation and observation and lastly, create a therapeutic alliance. Tim, who is a registered
nurse working in a general hospital should possess the qualities of comprehensively assessing his
patients who have co-morbidities. After conducting a comprehensive mental health assessment,
Tim should come up with a formulation and treatment plan and goal for his patient. Global
mental health assessment should inform Tim of the mental state of his patients who have co-
morbidities. Patients with mental illnesses may not have insight and therefore are likely to suffer
physical diseases. Mentally ill patients cannot care for themselves and may suffer physical
ailments due to self-neglect or self-abuse. Comprehensive mental health assessment should
inform the nurse on how to deal with patients who have co-morbidities (Zamanzadeh et al.
2015).
Two possible occasions when a patient would present with a psychiatric illness but may
have physical ailments are patients with ventricular dysrhythmias and patients with
hypothyroidism. Patients with cardiovascular disease ventricular arrhythmia may present with
anxiety, and patients with hypothyroidism may present with depression (Yetkin, 2016).
Hypothyroidism means that the thyroid gland is hypoactive and therefore producing decreased
quantities of its hormones thyroxine and triiodothyronine. Patients with hypothyroidism present
with clinical symptoms that are similar to those of depression such as fatigue, depressed mood,
insomnia, and feelings of worthlessness. Ventricular arrhythmia is a cardiovascular disease that
occurs when there is loss of normal ventricular heart rhythms. Failure of ventricular rhythm may

result in inadequate perfusion of organs in the body, including the brain and the patient presents
with the clinical symptom of anxiety disorder such as panic attack disorder. Clinical signs shared
between ventricular arrhythmia and panic attack disorder are shortness of breath, chest pain, and
tachycardia (Bathla, Singh & Relan, 2016).
Tim should perform a comprehensive mental health assessment on Nicole to determine
her current mental condition and the treatment plan and goal for her. Nicole presents with typical
symptoms of a mood disorder which, according to Diagnostics and Statistical Manual 5(DSM 5)
are mental illnesses such as depression and bipolar disorder (Tandon, 2015). Tim should first
create a good therapeutic relationship between him and Nicole. Good therapeutic relationship
will enable Nicole to trust and open up to Tim, and therefore he will take a comprehensive
mental health history from her. After establishing rapport with Nicole, Tim should create a
conducive environment in the ward where she will be comfortable to prove the information
required. The critical component of the assessment that Tim will have to use to get the actual
problems from Nicole is a complete history of the current symptoms that Nicole is presenting
with at the moment. He will have to find from her when the current started and how they have
been progressing since then to establish which type of disorder she is presenting with currently.
History of past psychiatric illness will help Tim understand if Nicole could be having a
recurrence of a previous psychiatric illness (Sabella, 2017). Past medical history gives
information about last physical diseases that could be presenting again in the form of mental
illness. A psychosocial and developmental history will help Tim gather information on how
Nicole grew up, how her childhood was, her education performance and achievements. The
current living conditions and support network for Nicole will help Tim come up with a suitable
treatment plan for her according to her psychosocial framework. Nicole's social history will help

Tim understand the current situation that she is in, her family, her occupation, her financial
status, and her interests. Nicole's family history will give a comprehensive understanding of any
mental illnesses in her family, any history of suicide among her family members, quality of
relationship with family members and the attitude between her and her family members (Kumar
& Gupta, 2014). Mental status examination on Nicole will enable Tim in understanding if Nicole
is aware that she has a mental illness or not, and if yes, what she thinks of the disease. Tim has to
examine the appearance and behavior of Nicole to get information on any apparent marks on
Nicole, such as the one appearing on her forearm, which could be an indication of attempted
suicide. Tim should come up with a case formulation to explain the current mental illness that
Nicole has and what his treatment plan and goal are. Predisposing factors, precipitating factors,
perpetuating, and protective factors will determine the mode of treatment that will best suit
Nicole from her history (Schulz & Murray, 2016).
Anxiety disorders, according to Diagnostics and Statistical Manual, are pathological
anxiety disorders that occur due to inappropriate response to a given stimulus by virtue of its
intensity or its duration (Pumar et al. 2014). Depression occurs mainly after a psychosocial
stressor many of the cases tend to be self-limiting and last 6-9 months if left untreated. Women
tend to have an increased risk to a major depressive episode after childbirth, and there is an
increased risk at the age of twenty's. Jane is 27 years old and a mother putting her at risk of
developing major depression since she is a mother and falls within the age group of mid twenty's.
Anxiety disorders that Jane could be having are generalized anxiety disorder which could be
explained by her hyper vigilance due to her anxiety (Biaggi et al. 2016). Depression and anxiety
coincide in many patients, and it is essential that they are detected and treated very early. Jane,
who is a mother, has several responsibilities that she needs to take care of as a mother and

current mental condition limits them all. She is not sleeping and not eating, which could imply
that she is taking good care of her children as she otherwise does under normal conditions. It is
crucial that Tim takes a comprehensive history from Jane and determine whether she is suffering
from anxiety or depression to avoid escalation of the current symptoms. Depression and anxiety
are mental illnesses that reduce an individual's ability to carry out their daily routines usually,
and this stresses the individuals even more. Health care professionals can assist in early detection
of anxiety and depression by education the community on the typical symptoms of these two
mental illnesses. Individuals who understand the signs and symptoms of depression and anxiety
can present themselves to hospitals and get medical assistance from health care professionals like
Tim, who is a registered nurse (Lake & Turner, 2017).
Health is inclusive of physical, mental, and social wellbeing, and all these components of
health should be taken care of for one to be declared healthy. Patients who have physical
diseases also have mental health issues, and health care professionals should holistically care for
these patients. Physical ailments may occur at times, present as mental illnesses, and it is the
mandate of the health care professional to carry out tests that rule out medical diseases.
Comprehensive mental health assessment help health care professionals understand the
psychiatric illness of a patient, and this dictates the treatment goal and plan for the patient.
Anxiety and depression could occur at the same time, and one may mask the other, and this
necessitates the health care professional to conduct a thorough assessment of patients for early
detection of these two mental illnesses.
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