Analyzing Mental Health: A Case Study of Lucinda Okiro's Recovery Plan

This report presents a case study of Lucinda Okiro, a patient experiencing mental health challenges during her second pregnancy. It begins with a Mental Status Examination (MSE) and a discussion of Diagnostic and Statistical Manual (DSM) criteria, revealing diagnoses of depressive and anxiety disorders. The report then explores the contributing factors to Lucinda's condition, including the stress-vulnerability model, complications from her first pregnancy, lack of financial and family support, and feelings of helplessness. The report then proposes a recovery-oriented mental health practice, focusing on fostering hope, empowerment, and respect for Lucinda's choices. The recovery plan emphasizes her aspirations, health issues, and the importance of support from her husband, friends, and clinicians. The report references various sources to support the analysis and proposed interventions.

Promoting Mental Health
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Table of Contents
Answer 1....................................................................................................................................3
Answer 2....................................................................................................................................4
Answer 3....................................................................................................................................6
References..................................................................................................................................7
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Answer 1
Lucinda Okiro visited perinatal mental health service for her mental health assessment as she
was referred for urgent appointment by her midwife at her antenatal clinic. With the help of
Mental Status Examination (MSE), comprehensive cross-sectional description of the mental
state of the patient will be determined which will then be combined with the biographic and
historical information of the psychiatric history and allows the clinician to make accurate
diagnosis and formulation. The MSE provides a framework through which, mental status of
the patient could easily be determined (Potter, 2019).
Appearance - The appearance of the patient may provide some clues regarding their lifestyle
and ability to self-care. It includes various features such as distinctive features, clothing,
posture or gait, grooming or hygiene and evidence of self-harm.
When Lucinda visited prenatal mental health service for mental health assessment, she came
along with her daughter Emily, who was only 8 months old. However, both were well-
groomed, her daughter was wearing a short-sleeved onesie despite cold day out there. It
showed that she was unable to take good care of Emily due to her mental condition. Lucinda
complained that she feels frightened and was very unhappy to know about her second
pregnancy, which might be because of her previous pregnancy experience (Potter, 2019).
Mood - It refers to a sustained state of the inner feelings of a patient. In order to explore it
more, some questions need to be asked to the patient such as, in the case of Lucinda, she is
feeling frightened and unhappy to know about her pregnancy. She was just 22 when she gave
birth to Emily and was not physically ready to take care of a child. She went through a lot of
stress and now, when she knew about second pregnancy, she is really scared about the same
and starts feeling anxious and has trouble in breathing (Potter, 2019).
Through Diagnostic and Statistical Manual (DSM) of mental disorders, mental disorders
could be classified and serves as a historically determined cognitive plan imposed on clinical
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as well as scientific information to enhance its utilization and comprehensibility (Nuckols,
2013). Through this approach, dimensional approach to diagnosis include genetic risk factors,
specific environmental risk factors, temperamental experiences, abnormalities of emotional
or cognitive processing, symptom similarity and such others. The diagnostic tests revealed
that Lucinda has Depressive and Anxiety disorders due to which, she is over-analysing about
the future and her pregnancy (Brannon, 2016). Because of her previous pregnancy issues in
delivery of Emily, she is scared. Secondly, she is not ready mentally, physically and
psychological prepared to have another child within such short duration, when she is just 22-
year-old. All these stress factors combined along with the lack of financial support has added
to her mental state.
Therefore, through MSE and DSM, it has been revealed that the mental health status of
Lucinda is not in a stable condition and her condition is worsening day by day after she came
to know about her second pregnancy.
Answer 2
Various factors have contributed to the development of the current mental health status of
Lucinda. The Stress Vulnerability Model helps in understanding the causes of psychiatric
disorders and how psychiatric disorders and addiction can influence each other. The two main
elements of the stress-vulnerability model are biological vulnerability and stress, which are
influenced by various other factors such as substance abuse, alcohol, social support,
medications, coping skills and meaningful activities (Hazelden Foundation, 2018).
Some people might be vulnerable to physical illnesses or certain psychiatric disorders. The
stress causing environment can deteriorate biological vulnerability, worsen symptoms, and
result in relapses (Hazelden Foundation, 2016). The stress is a kind of challenge for an
individual requiring some kind of adaptation. The serious stressful events are often associated
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with negative events; however, some positive events or experiences might also be stressful
for people. In the case of Lucinda, at the time when she gave birth to her daughter, she faced
so many difficulties that she is feeling anxious after knowing about her second pregnancy.
She is only 22 and is not ready to take the responsibilities of two children especially when
she is just studying and is not financially stable. There are a number of factors that contribute
to her present mental health conditions. One factor out of these is complications during
delivery of first child, which affected Lucinda deeply. Secondly, her physical strength does
not allow her to take care of her child as she gets exhausted easily and has difficulties
sleeping and in caring for her child (Quaedflieg & Smeets, 2013). She becomes tearful and
her stress and anxiety is clear through her behaviour, as she started staring at the floor and
wringing her hands when she is asked about the difficulties she face during caring for Emily.
The other stress related factors include lack of financial sufficiency and lack of family
support and such others. In this context, the stress factors worsen more when the individual
suffering from stress does not have enough to do. It means when people experiencing mental
disorders do not have something purposeful to do, the symptoms deteriorates more. Lucinda
was studying previously but, because of taking care of Emily, she had to defer her studies and
she is feeling guilty as she is unable to help Jerome by working. Furthermore, she is more
upset that she will have to take more time off studying and working because of having
another baby. So, she is unable to work these days which has worsened her situation terribly
and her stress and anxiety is increasing more. Out of all these factors, lack of financial
availability and first pregnancy complications have contributed a lot to the stress
enhancement in the case of Lucinda. She scored 12 on the Edinburgh Perinatal Depression
Scale, the maximum score for which is 30. However, item 10 on this scale is considered as
significant, she denied thinking about harming herself on this question. She has all the
symptoms of depression and she feels that the situation will become worse day by day. She
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feels loneliness and does not know what could be done and where to seek help (Cox, Holden,
& Sagovsky, 2010). Therefore, she is feeling helpless at this point of time.
Answer 3
As Lucinda is not in a good mental health condition, recovery-oriented mental health practice
should be utilized for the purpose of developing sense of self-respect, empowerment and
hope within her. In order to bring Lucinda back to normalcy, it is essential that proper
recovery plan should be developed. In the first phase of the plan, more emphasis should be
given to the future aspirations and goals of Lucinda (Picton, Patterson, Moxham, Taylor, &
Perlman, 2018). She is concerned about the fact that she is not helping Jones in earning more
and will not be able to for a long period of time because of her second pregnancy. So, she
should be supported and encouraged to continue her studies until she give birth to second
child. In the second phase, her health issues should be emphasized as she is not in good
mental as well as physical health conditions (Commonwealth of Australia, 2010).
Hope - The development of hope and optimism for future needs to be developed within
Lucinda as she has lost all hopes in future. Hope is a key to recovery and by making her
believe that she will soon be able to have control over her life after the delivery of her second
child. It is just a matter of few months or a year, after which, she will be able to continue her
studies or work and will have regular schedule with the babies. In order to make her believe
that change in circumstances is possible, hope-inspiring relationships should be fostered with
her husband, friends, and relatives who can value her feelings and encourage her to achieve
success in life (Samuelsen, Moljord, & Eriksen, 2016).
Empowerment - Lucinda needs to be empowered and should be given the choices regarding
what she needs currently and in future. She should be given sufficient time to study or work
for some time and Jones should take care of Emily meanwhile. Lucinda needs some free time
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for her to sleep, to work or to study, for which possible support should be given by her
husband (Funk & Drew, 2017).
Respect - The right of Lucinda to take decisions for her should be respected so that she could
make her own choices with or without the support of others. It is essential to respect values
and preferences of individuals to develop recovery-oriented relationships. Listening actively
to the person when he/she is discussing or telling something about them is also a part of
giving attention and respect to that person. Currently, the preferences of Lucinda include
caring for her baby Emily and taking good care of herself so that she could deliver second
child without any complications (St Vincent’s Mental Health, 2014). Her preferences should
be respected by her husband, clinicians, and her family. She should not be treated against her
will as it would make the condition worse for her.
References
Brannon, G. E. (2016). History and Mental Status Examination. Retrieved from
medscape.com: https://emedicine.medscape.com/article/293402-overview
Commonwealth of Australia. (2010). Principles of recovery oriented mental health practice.
Retrieved from Health.gov.au:
https://www1.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-
n-servst10-toc~mental-pubs-n-servst10-pri
Cox, J. L., Holden, J. M., & Sagovsky, R. (2010). Detection of postnatal depression:
Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of
Psychiatry, 150(6), 782-786. Retrieved from fresno.ucsf.edu:
https://www.fresno.ucsf.edu/pediatrics/downloads/edinburghscale.pdf
Funk, M., & Drew, N. (2017). Promoting recovery in mental health and related services:
handbook for personal use and teaching. Retrieved from who.int:
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https://apps.who.int/iris/bitstream/handle/10665/254811/WHO-MSD-MHP-17.11-
eng.pdf;jsessionid=24443948034AC8C8FC49603E2D4C233D?sequence=1
Hazelden Foundation. (2016). The Stress-Vulnerability Model of Co-occurring Disorders.
Retrieved from bhevolution.org: http://www.bhevolution.org/public/stress-
vulnerability.page
Hazelden Foundation. (2018). The Stress-Vulnerability Model of Co-occurring Disorders.
Retrieved from Bhevolution.org: http://www.bhevolution.org/public/document/stress-
vulnerability.pdf
Nuckols, C. C. (2013). Diagnostic And Statistical Manual Of Mental Disorders 5th edition.
Retrieved from delaware.gov:
https://dhss.delaware.gov/dsamh/files/si2013_dsm5foraddictionsmhandcriminaljustice
.pdf
Picton, C., Patterson, C., Moxham, L., Taylor, E. K., & Perlman, D. (2018). Empowerment:
The experience of Recovery Camp for people living with a mental illness. Collegian,
25(1), 113-118.
Potter, D. L. (2019). Mental State Examination (MSE) – OSCE Guide. Retrieved from
geekymedics.com: https://geekymedics.com/mental-state-examination/
Quaedflieg, C. W., & Smeets, T. (2013). Stress Vulnerability Models. Retrieved from
Psy.uni-hamburg.de:
https://www.psy.uni-hamburg.de/arbeitsbereiche/kognitionspsychologie/
publications/quaedflieg-smeets-2012-stress-vulnerability-models.pdf
Samuelsen, S. S., Moljord, I. E., & Eriksen, L. (2016). Re‐establishing and preserving hope
of recovery through user participation in patients with a severe mental disorder: the
self‐referral‐to‐inpatient‐treatment project. Nursing Open, 3(4), 222-226.
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St Vincent’s Mental Health. (2014). The Strengths Model: A Recovery-Oriented Approach to
Mental Health Services. Retrieved from semanticscholar.org:
https://pdfs.semanticscholar.org/2e89/d7ac2f5c7166c1ed89dd286c1302873ce9e0.pdf
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