Mental Health Treatment: Ethical, Legal, and Recovery Essay

This essay presents a comprehensive analysis of a mental health case study involving a 17-year-old, Josh, who is struggling with substance abuse, potential schizophrenia symptoms, and behavioral issues. The essay begins with a detailed mental health assessment, considering potential diagnoses and the impact of substance abuse. It then explores the psychological consequences of mental illness on Josh and his family, including the ethical and legal considerations of potentially depriving Josh of his freedom. The essay delves into theoretical frameworks like attachment theory and family systems theory, and it examines ethical dilemmas based on beneficence, non-maleficence, and utilitarianism. The legal aspects are considered, with a focus on Australian drug laws. Finally, the essay proposes a recovery framework based on the National Framework for Recovery Oriented Mental Health Services, emphasizing the importance of family support and the utilization of personal recovery resources to help Josh overcome his substance abuse and mental health challenges. The essay also underscores the role of community-based approaches in his recovery, highlighting the importance of a holistic and person-centered care plan.

Running head: MENTAL HEALTH
Mental Health
Name of the Student
Name of the University
Author Note

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MENTAL HEALTH
Introduction
The following essay is based on the case study of Josh, the son of Alice. Josh is 17
years old, school drop-out and suffers from substance abuse. He injects intravenous drugs for
intoxication. His mother is anticipating that Josh is suffering from schizophrenia as the
symptoms are likely to be similar to her brother who also had schizophrenia. Josh has anger
issues as he punches hols inside the walls also yells and steals. The following essay aims to
conduct a mental health assessment with proper assessment tool in order to ascertain the
mental health complications through which Josh is passing. This will be followed by the
analysis of the psychological consequences of mental health over Josh and his family
members. The essay will also highlight the theoretical, legal, ethical and policy related
frameworks in order to justify or refute the arguments behind why Josh must be deprived of
freedom. At the end, the paper will highlight the recovery principle for Josh based on the
recovery model framework. The essay will also focus on the recovery framework under
community-based approach to help Josh overcome from his habit of substance abuse and
mental health complications.
Mental health assessment
A mental health assessment is designed to diagnose mental health conditions like
depression, anxiety, schizophrenia, postnatal depression, eating disorders and other psychotic
illness. The mental health assessment also helps to discriminate between the mental and
physical problems (Victoria State Government, 2020). In case of Josh, mental health
assessment is important as he suffers from substance abuse. He smokes marijuana ad
consumes alcohol. His mother Alice has found used needles in Josh’s bedroom. Alice has
also complained that Josh looses temper frequently, mingles with bad crown while punches
holes inside the walls to manage his anger. He has also developed tendency of stealing and

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yelling. Thus it would be the duty of the Glenauries Child Youth Mental Service (CYMNHA)
to conduct a detailed mental assessment over Josh in order to understand his actual mental
alignment. Proper identification of the mental illness will help in drafting person-centred care
plan thus, improving the overall outcome of care. Alice thinks Josh is suffering from
schizophrenia just like her brother. The DSM-V (The Diagnostic and Statistical Manual of
Mental Disorders, Fifth Edition) criteria for the detection of schizophrenia include
identification of two or more of these following symptoms: delusions, hallucinations,
catatonic behaviour, disorganized speech and other negative symptoms (Berendsen et al.,
2018). Mezquida et al. (2018) stated that use of marijuana and consumption of uncontrolled
alcohol might be associated with the development of severe anxiety and depression. Josh also
had previous reported cases of depression and anxiety according to the case study and this
further increase the vulnerability of developing other mental health complications. Mezquida
et al. (2018) further highlighted that tendency of hallucination is common among the people
who are addicted needle-based drugs or intravenous drugs. However, the case study fails to
highlight any significant schizophrenic symptoms in Josh.
Impact of mental illness over self and family
The people who are suffering from psychological complications are more likely to
suffer from poor-quality of life (Adhvaryu, Fenske and Nyshadham 2019). Six different
domains of mental health and well-being are hampered among the people who are suffering
from complex mental illness. These six different domains include ill-health, poor self-image,
decrease in the level of autonomy, a sense of belongings, decrease in the level of engagement,
decrease in the level of optimism in life (Adhvaryu, Fenske and Nyshadham 2019). Overall
Ellicott et al. (2019) stated that the generic measures fail to address the complexity of the

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overall quality of life among the mental health patients and the condition becomes more
significant when the person suffers from substance abuse.
The mental health complications of a person also cast a significant impact over the
mental health status of his or her family members. The mental illness of one of the family
members, becomes the primary focus of the rest of the family members. The family members
have different perceptions towards mental illness and its problems. They also suffer from
conflicts among other family members. The common impact of the mental illness over the
family members includes frustration depression, helplessness, guilt, loss along with
compassion fatigue (Ellicott et al., 2019). In case of Alice, it can be said that she is worried
about her son’s health such that contacted her local Glenauri Child and Youth Mental Health
Service. She is frightened she due to aggressive behaviour of Josh and at the same at worries
that Josh is with bad crowd. Josh’s brother Daniel (19 years old) has moved out of the home
due to the nuisance created by his Josh.
Depriving a person’s freedom: Justification
Theoretical dilemma
The effects of substance use disorder (SUD) are experienced by the entire family. The
family members hold significant information regarding how SUD has developed. In this case,
Alice is aware of the illicit drug abuse tendency of Josh. The family members cast a
significant positive and negative influence on the overall treatment of this disorder. This can
be explained by the family systems theory and attachment theory. Attachment theory states
that having parents with SUD, inflicts the children (even during their minor age), to develop
the same disorder (Lander, Howsare & Byrne, 2013). This concept is true in case of Josh.
Alice drinks and smoke and so is Josh at the age of 17 and Alice has no problems with the
same. Families with SUD have children who struggle with their emotional and behavioural

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problems. Josh also had certain complex emotions as he tries of contact his biological father
and is unable to manage his temper. Family systems theory states that n individual cannot be
fully understood or treated without first understanding the family (Lander, Howsare & Byrne,
2013). So in order to understand the Josh, Alice needs to be studied in detail. Thus restricting
Josh first from executing personal independence is not an option; at first Alice needs to be
studied in detail.
Deprivation of a person suffering from the mental health complications from freedom
is justified when the person has substance abuse. Allowing persons with SUD to stay free
under comprehensive freedom might inflict harm to others. It might also increase the chances
of spread of the substance abuse among rest of the family members or friends. Substance
abuse is a detrimental lifestyle habit and it increases the tendency of developing other
physiological and psychological complications. So in order to avoid the chances of spreading
of illicit drug use among others and to decrease the level of harm over others, restricting the
person or confining the person is justified (Borsboom, 2017).
Ethical dilemma
According to the ethical theory of beneficence, it is the duty of the nurse is to promote
good. Alternatively it can be said that the action of nurse must be designed in such a way that
it promotes the overall betterment of a person (Zwitter, 2019). Restricting the autonomy of
Josh and keeping himself under the confinement might increase the level of anger and thus
increasing the attitudes of self-harm. Padmanathan et al. (2020) stated that people who are
suffering from substance abuse are at the greater risks of developing suicidal tendencies in
comparison to the general population and the tendency increases when the people with
substance abuse are kept in confinement.

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According to the ethical theory of non-maleficence it is the duty of the nursing
professionals to act in favour of the betterment of everyone. Alternatively, it can be said that
ethical theory of non-maleficence helps in promoting the good for the mass (Zwitter, 2019).
Thus keeping Josh in confinement and restricting him to execute the personal independence
will help to restrict his destructive behaviour and thereby helping to reduce his level of harm
over others. Keeping Josh in executing personal independence will also restrict him from
injecting intravenous medication and thereby reducing the level of harm over Josh (Stein &
Manyedi, 2016).
However, to lawfully deprive a person of freedom is against the ethical morale of
utilitarianism. This ethical theory mainly advocates or promotes the overall happiness of a
person. The theory strictly restricts the actions that cause unhappiness or harm (Zwitter,
2019). Thus in relation to this theory, it can be said that any restriction to release Josh in
public or violating his autonomy might impose harm or reduce his level of happiness thus,
violating the ethical theory of utilitarianism. However, the theory of utilitarianism is directed
towards making social, political and economic aims for the betterment of the society (Zwitter,
2019). In relation to this aspect of the theory, it can be said that confining Josh will help his
neighbours to stay in peace and will also given his mother a sense of relief and thus not
breaching the ethics of utilitarianism.
Legal dilemma
Drug law in Australia are complex. Some of the drugs law are federal while rest of the
laws are territory or state based. The legal drugs in Australia are alcohol, caffeine, nicotine
and other over-the counter medications and prescribed rugs. However, the consumption of the
drugs and alcohol is only permissible for the older adults (Australian Government
Department of Health, 2020). Here Josh is still a minor (17 years old) and thus can be

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regarded as a punishable offence. Thus restricting Josh from consumption of alcohol by
reducing his level of personal independence is justified under the legal framework. The
illegal drugs in Australia include amphetamines, cannabis (marijuana), heroine and ecstasy
(MDMA) (Australian Government Department of Health, 2020). Thus consumption of
marijuana by Josh is illegal and restricting his personal independence and forbidding him
from taking medications is justified. Josh also suffers from illicit drug abuse. This further
justifies taking the personal independence or freedom of Josh and lawfully deprives him from
conducting illicit drug abuse.
Mental health assessment recovery framework
The mental health policy framework that coincides with the scope of this case study is
National Framework For Recovery Oriented Mental Health Services. The National
Framework For Recovery-Oriented Mental Health Services is endorsed by the Australian
Health Ministers Advisory Council (AHMAC) and was launched on 2013 (Australian
Government Department of Health, 2013). According to this framework, the recovery of the
mental health status of a person is dependent on their socio-economic determinants of health
and psychological state of mind. According to the case study, Josh had tried to reach out to
his biological father who is an Aboriginal but his mother refused to do the same. Josh also
identifies himself as an Aboriginal but he is not concerned with the local aboriginal
community and culture. Carpenter and Sly (2018) stated that aboriginals mainly reside under
the poor socio-economic determinants of health however, since Josh is out of touch with his
father and lives with his mother and his partner, social determinants of health was not a
concern for Josh. However, Josh’s psychological state of mind is poor as he is more
concerned about contacting his biological father and restricting him to conduct the same is
further forcing him to indulge in substance abuse. Thus in order to promote proper recovery

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of his mental health and overcoming substance abuse, the first support that he needs is family
support. Alice must allow Josh to interact with his father once. If she is not willing to do the
same due to the criminal history of his biological father, she must also explain Josh the
concern in detail. LeCloux et al. (2017) stated proper support coming from family members,
helps to reduce tendency of conducting substance abuse. Another aspect of the recovery
oriented mental health policy approach for the promotion of mental health of Josh will be
utilization of the personal recovery resources (Australian Health Ministers’ Advisory
Council, 2013). Proper allocation of nursing professionals, followed by effective counselling
conducted by the mental health nursing professional will help Josh to understand his personal
resources and same will be utilized by him in order to recover from mental health
complications (Jones, 2018). Proper use of the support networks is also important in order to
promote effective mental health while reducing the chances of substance abuse. The friends
of Josh “bad friends” as stated by his mother thus availing help from his friends in order to
overcome his complex mental health condition and substance abuse will not be an option.
The recovery plan must be designed based on the uniqueness of the individuals and this will
help to improve the overall quality of care (Australian Health Ministers’ Advisory Council,
2013). However, designing of cultural competent plan will not be a case for Josh, as he does
not connect with the aboriginal culture. The real choices of the service users must also be
given preferences and in this case it would be contacting his father.
Collaborative mental health care plan
Trani et al. (2016) stated that community-based interventions are effective in reducing
the overall mental health-related complications among the individuals or group of
individuals. This is mostly done in groups and thus helping to increase the overall rate of
participation of the mental healthcare service users. The first community-based intervention

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for Alice will be education and spreading awareness among her about the ill effects of
substance abuse and alcohol consumption. She will also be advised to reduce her smoking
rates and alcohol use while forbidding the tendency of substance abuse in his son. The health
awareness will be done by community nurse. Patterson, Edwards and Vakili (2018) stated
that family awareness help in comprehensive promotion of health while helping to increase
the level of therapy adherence. The second community-based intervention would include
conducted a stringent mental health counselling with Josh and to understand the underlying
reason for substance abuse and destructive attitudes. This will help in framing of person
centred intervention. This will be executed by metal health nurse under the presence of
community health nurse. Josh will be asked to take part in the group based activity like
physical exercise programs. Hanlon, Morris and O’Sullivan (2018) stated that regular
practice of the mild to moderate physical activity helps to reduce the tendency of smoking
and helps to reduce the withdrawal symptoms of marijuana. However, Kim and Harley
(2019) that people who are on intravenous drugs are advised to stay in rehabilitation unit for a
certain period of time in order to reduce withdrawal symptoms. Keeping Josh in the
rehabilitation unit will require the permission of his mother as he is still a minor. In order to
reduce his level of destructive attitude, he will be trained in anger management. Anger
management can be undertaken by the use of the music therapy. Proper use of the music
therapy under periodic interval helps in reducing anger or to effectively manage temper.
Regular counselling of Josh along with community-based participation will help him to
recover from his tendency of substance abuse.
Conclusion
Thus from the above discussion, it can be concluded that Josh is suffering from
certain mental health complications and he has also developed intoxication towards illicit

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drugs. The ethical principle of non-maleficence goes in favour of restricting Josh towards
executing personal wish. The Australian legal aspect also goes in favours of restricting Josh
as he consumes marijuana that is illegal in Australia. Though alcohol is legal in Australia, but
he is a minor and thus considered to be violation o the law. The theoretical perspective also
states that in order to improve the comprehensive health and well-being of Josh, he must be
forbidden to execute personal independence as he is also causing harm to others. The
community-based health interventions include family-based education followed by
counselling to Josh in order to identify his actual mental health complication. Social
participation and regular practice of yoga will help to reduce the withdrawal symptoms. At lat
the recovery oriented mental health approach can be effectively used for improving overall
health and well-being of Josh throughout his life-span.

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