NSB204 Assessment Task 2: Case Study Analysis of Post-natal Depression

This case study presents a comprehensive analysis of a 38-year-old woman named Michelle, who is experiencing post-natal depression. The assignment begins with a mental status examination, detailing Michelle's behavior, appearance, speech, perception, thought content, cognition, memory, and judgment. Following this, the 5Ps of mental health (presenting, predisposing, precipitating, perpetuating, and protective factors) are used to formulate a clinical understanding of Michelle's condition. The case study then focuses on planning and prioritizing care, including both pharmacological and non-pharmacological interventions such as counseling, various therapies, dietary and exercise plans. A clinical handover using the SBAR approach is provided, followed by a discussion on developing a therapeutic relationship and implementing recovery-oriented practices. The assignment concludes by addressing potential issues like acceptance and the importance of creating a positive environment for recovery, supported by relevant references.

Running Head: NURSING 0
MENTAL HEALTH NURSING
[Document subtitle]

NURSING 1
Mental status examination
Michelle has just given birth to a baby girl and she is going through post-natal
depression. Her instant weight loss and inability to do anything makes her feel that she is
incapable of doing anything. According to the Mental health examination, Michelle is suffering
from the post-natal depression. The points to be considered for her mental health examination
(Crowe, 2015).
Mental Health Examination
Behavior and Appearance Physical appearance Loss of weight from60 kg to
55kg
Highly exhausted and puffy
eyes
Tainted clothes
Trouble falling asleep
Level of activity High level of inactivity
No-sex drive
Mood High level of mood swings
Plaintive mood
Speech Voice is low
Slow in speech
Perception Negative perception of body
Low-self esteem
Thought Content Dark thoughts
Overwhelmed with the
responsibility of handling

NURSING 2
infants
Form Disordered of thoughts
No connections of thoughts
Cognition Attention High level of Distractibility
Level of consciousness Drowsy and low attentiveness
Memory Problem of recalling things
Judgment and Insight Judgement Negative judgement
Insight Impaired insight
After conducting Mental status Examination, Michele is suffering from Post-natal
depression (Kozinszky & Dudas, 2015). Her symptoms of feeling highly overwhelmed to cater
to her child and the act of doing nothing but simply staring, when the child cries are the major
factors suggestive of her depressive condition. The other symptoms such as high level of
exhaustion and mood of doing nothing is suggestive of the condition (Katherine M. Fortinash,
2014).
5Ps of Mental Health
The five Ps of mental health nursing is helpful in diagnosing the mental health problems
suffered by the individuals (Miller, 2015). The five Ps of mental health nursing are Presenting
the problems, Predisposing factors that made an individual to suffer from the problem,
precipitating factors that led to the problem, perpetuating factors are those factors that are still
causing the problem and the protective factors.
5ps of Mental Health
Presenting problem Michelle is suffering from depression. From
the past few days, she is physically unwell
and has high-level of mental exhaustion. She
gets overwhelmed on small things that made
her feel sad all the time.

NURSING 3
Predisposing factors During pregnancy, she felt good but after the
birth she started feeling depressed. Her
difficult birth is the cause of her post-natal
depression.
Precipitating factors The difficult birth by C-section, inability to
breast feed the child and no support from her
mother at night resulted in depression
Perpetuating factors No support from mother and husband, she
spends most of her time alone as her husband
is late from work most of the time. her
husband negatively taunts her incapability of
having sex that affected her self-image as a
wife and mother.
Protective factors Michelle’s passion for teaching high school
children was relaxing for her
The main reason that resulted in the mental depression of Michelle is the difficult birth of
her first child and it carried on due to factors such as no support from her mother and husband
aggravated her mental depression.
Planning and Prioritizing Care
It is important to plan and prioritize the planning care for the women with post-natal
depression. The planning of care depends a lot on the severity of the mental trauma. In the case
study, Michelle is suffering from severe post- natal depression that is reflective from her highly
overwhelming attitude towards managing small things and loss of attentiveness. The care for
Michelle can be prioritized through pharmacological and non-pharmacological means.
The first step to be taken is to prioritize the care is an effective counselling. The
counselling will be helpful in clearing the mental trouble from her head. It will be helpful in
taking out the negativity from her head. Weekly counselling session should be conducted that

NURSING 4
helps in the relieving of the anxiety from her mind and heart. There are various kind of therapies
that can be incorporated in the counselling session. The therapies include behavioral therapies,
cognitive analytical therapy, and psychoanalysis. The psychoanalysis therapy can be applied as it
will be helpful in replacing the negative unconscious pattern with the positive one. The nurse can
guide Michelle to do meditation, as mediation is proven to cure all the cognitive disabilities in
the human being. It is also helpful in curing the clinical depression from the root the cause.
The nurse can set up a good dietary and exercise plan for the patient. An individual’s diet
has an impact on what the person thinks. The unhealthy diet could result in poor thinking process
of the patient. The patient should be advised to take in healthy level of water as water hydrates
the body which results in clear thinking. The food rich in fibers should be promoted in the diet of
an individual as fibers are the good source of vitamins and minerals required for the body. The
good exercise plan is helpful in reliving an individual from the stress of the days.
Clinical Handover with SBAR Approach
Clinical handover is concerned with handing over the case of patient in the hands of other
professional. It involves the description of the person’s clinical situation. The SBAR approach is
used (Yu & ja Kang, 2017).
Situation-
The patient named Michelle is suffering from the Post-natal Depression. The severity of
her mental illness is high as she has developed problems in her cognition abilities. The
pharmacological and non-pharmacological means should be used for her treatment.
Background-
Patient “Michelle” has been experiencing dark thoughts, loss of weight and high-level of
mental exhaustion after the difficult birth of her first daughter. Her inability to breastfeed her
first child added to the woes of her mental stigma. No support from her husband and mother
made her more mentally depressed.
Assessment-

NURSING 5
The assessment of the mental disorder of the patient was carried out by using the mental
Health Examination in which various components of mental illness were analyzed according to
the patient’s condition and the patient was proved to be suffering from the disorder.
Recommendation-
It is important to provide her pharmacological and non-pharmacological treatment. The
non-pharmacological intervention should be the focus of the treatment as post-natal depression is
the mental disorder that can be cured through self-empowerment and positivity thinking.
Therapeutic Relationship
To cure the patient physically and mentally. The development of the good therapeutic
relationship is important. The therapeutic relationship is concerned with developing the good
relationship between the healthcare professional and the client (Steel & Schroder, 2017). The
good therapeutic relationship is essential for the increased recovery rate of the patient. It has its
major components that include trust, empathy, acceptance, and positive regard (Slemon &
Bungay, 2017). The proper adherence of the components in the practice could lead to better
relationship between the client and the healthcare professional. The strategy that can be used to
develop therapeutic relation with the Michelle is effective conversation. It is said that the right
kind of conversation could with an individual could open gateways to the heart of the person
(Bambara, 2016). As Michelle is suffering from the post-natal depression so it becomes
important to communicate effectively to the person as a depressed person is a lonely person and
needs a companion who could be empathetic with her situation. Michelle’s husband and mother
do not support in caring for a child. Her husband comes late from the work and her mother do
not stay awake with her and moreover, her husband negatively taunts her on her incapability of
doing sex. The difficult birth and incapability to breast-feed her child made her feel that she is a
terrible mother and a wife.
Recovery oriented practice
The incessant negative emotions are the root cause of her depression. In this moment the
best strategy to develop good relationship with her is a heartful conversation on daily basis. It is
important for her as a good conversation will develop trust, empathy, and acceptance in the

NURSING 6
Michelle. She will be able to relive herself from negative emotions and anxiety. The good
conversation will result in the feeling that she has a good companion who listens to her problems
and trauma and understands everything about it. The conversation will be helpful in the nursing
interventions as Michelle will be able to respond positively in counselling. The development of
the trust and empathy will make Michelle to follow her prescribed interventions diligently
without any doubt.
The recovery model is a model used in the treatment of full mental recovery. The model
assumes that the recovery from mental ailments is possible and the patient-directed is the most
effective way of recovery (Burmeister & Marks, 2016). The recovery model principles include
empowerment, self- directed, person-centered, holistic, peer support, responsibility, respect, and
hope (Hipfner & Howell, 2017). The nursing intervention of counselling and usage of various
types of therapies include self-talk therapy, behavioral therapy and psychoanalysis are related to
the principal of empowerment, responsibility, respect, hope and peer support. As counselling is
all about empowering an individual from the situation of distress to the situation of happiness. It
is an intervention where an individual develops the responsibility to get over from the mental
stigma and trauma. The counselling intervention also develops hope in an individual to fight the
problems in the life (Rose, 2019). The principal of peer-support is also applied to the counselling
intervention as it is the intervention where the support from the counsellor is required.
The issue that can be encountered while working with the person is issue of Acceptance.
The Acceptance issue is the most common issue faced by the patients of mental ailments. It is
difficult for them accept their mental situation that they suffer from a mental disorder. The
unclear behavior of Michelle with people and the high- level of mental exhaustion could make it
difficult to accept the situation. The lack of acceptance could create mental and physical barriers
for the recovery. it is important to resolve this issue by creating the high degree of acceptance in
them. The high- level of acceptance can be developed by creating the positive image of the
mental ailment in the eyes of Michelle. The nurse logically and with facts could convey them
that the mental disorder is just a small mental disease that can cured with proper pharmacological
and non-pharmacological interventions. A good educational session for the patient could do the
job. Various inspiring cases of patients positively recovering from the mental disorder could be
laid out to Michelle that will serve as the positive empowerment for her to get over the disease.

NURSING 7

NURSING 8
References
Bambara, L. M. (2016). A peer-mediated intervention to improve the conversational skills of
high school students with autism spectrum disorder. . Research in Autism Spectrum
Disorders, 29-43.
Burmeister, O. K., & Marks, E. (2016). Rural and remote communities, technology and mental
health recovery. Journal of Information, Communication and Ethics in Society,, 170-81.
Crowe, M. I. (2015). Conducting qualitative research in mental health: Thematic and content
analyses. Australian & New Zealand Journal of Psychiatry,, 616-623.
Hipfner, C. M., & Howell, S. (2017). Teaching recovery principles with concept map care
planning. The Journal of Mental Health Training, Education and Practice,, 292-299.
Kozinszky, Z., & Dudas, R. B. (2015). .Validation studies of the Edinburgh Postnatal Depression
Scale for the antenatal period. Journal of affective disorders, 95-105.
Miller, J. D.-K. (2015). A test of the empirical profile and coherence of the DSM–5 psychopathy
specifier. Psychological assessment, , 870.
Rose, N. N. (2019). EMOTIONAL COPING THROUGH SOLUTION FOCUSED
COUNSELLING THERAPY: CASE STUDY OF PSYCHOLOGICAL DISTRESSED
WOMEN. In PROCEEDING . The International Conference On Social Work, 198-201.
Slemon, A. J., & Bungay, V. (2017). Safety in psychiatric inpatient care: The impact of risk
management culture on mental health nursing practice. Nursing inquiry, 121-190.
Steel, C. M., & Schroder, T. (2017). A systematic review of the effect of therapists’ internalized
models of relationships on the quality of the therapeutic relationship. Journal of clinical
psychology, 5-42.
Yu, M., & ja Kang, K. (2017). Effectiveness of a role-play simulation program involving the
sbar technique: a quasi-experimental study. Nurse education today, 41-47.

NURSING 9