Comprehensive Report on Mental Health Nursing and Cormac's Case

This report presents a comprehensive case study in mental health nursing, focusing on a 24-year-old patient named Cormac diagnosed with schizophrenia. It begins with a detailed mental status examination, assessing his appearance, mood, thought processes, and risk factors. The report then provides a clinical formulation table, identifying presenting, precipitating, predisposing, perpetuating, and protective factors impacting Cormac's condition. A nursing care plan is outlined, including both short-term and long-term interventions such as delusion control, family-based interventions, and psychosocial treatment. The report further explores the development of therapeutic relationships, specifically the use of face-to-face support strategies, and relates these strategies to the recovery model in mental health. Challenges encountered while working with Cormac, such as his lack of trust and disorganized thinking, are addressed, along with strategies for overcoming these challenges, including active communication and coordination. The report concludes with references to relevant literature.

Mental Health
Nursing

Table of Contents
INTRODUCTION...........................................................................................................................1
PART 1: Holistic Assessment and Planning....................................................................................1
A Mental Statement Examination..........................................................................................1
b Clinical formulation table....................................................................................................2
C Plan for nursing care...........................................................................................................3
D Clinical handover................................................................................................................4
PART B............................................................................................................................................4
2. A identify and discuss about one strategy that can use to develop therapeutic relationship
within Cormac........................................................................................................................4
2. B describe how specific nursing strategy relates to recovery model in mental health.......5
2. C determine one challenge that encounter when working with Cormac............................5
2. D identifying the one strategy that can use to overcome challenge...................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Mental health refers behavioural well being. This present study is based on case in which 24
year old man suffering from mental illness Liu & et.al., (2020). This study is going to show some
mental and other presenting and other factors which can help out in taking better decision about
interventions. It will also discuss effectiveness of therapeutic relationship and others delusion
therapies in reducing negative effects of mental illness.
PART 1: Holistic Assessment and Planning
A Mental Statement Examination
Appearance & behaviour
 Appearance: Thin, long blondegreasy hair, beard, wear crushed and stained clothes.
 Attitude to situation and interviewer: Avoids eye contact, give replies in brief and not
relevant to questions, cooperative, give answers in monotonous tone
Mood and Affect
 Mood: Unable to seat for long term, irritability, lack of trust, hostile and shout when
told by parents to take medicine.
 Affect: Smoking marijuana several times which affects his body and becoming thin?
Form of Thought
 Excess, absence, quality of thought: He thinks that medicines makes him tired and there
is someone who is taking to him and it is hallucinations experience.
 Continuity of ideas: Believes that he can send as well as receive messages from god via
radio. Also believes that some videos contain information related to him.
Content of Thought
 Delusions: Yes there is false belief that he can send messages to god via television,
 Suicidal thoughts: No.
 Other: Feeling of someone around him who is talking to him.
Sensorium and Cognition
 Level of consciousness: Lack of concentration at workplace.
Risk Assessment
 Potential for harm to self: There is no evidence of hurting to self.
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 Potential for harm to others: Cormac only shout and behave in ineffective manner but
never tried to hurt others and self.
 Potential for absconding: It is found that manager of Cormac at workplace found
Cormac that he is committing mistakes and misguiding customers and also dropped out
from studies as he does not believe on his assessor and feedbacks given by them.
b Clinical formulation table
Presenting factors: In the context of Cormac it is found that at the age of 20 he had his first
admission to psychiatric hospital and diagnosed with schizophrenia and now at present after 4 years
again he is facing problems. Some presenting factors include: problems in completing study due
to lack of trust, erratic friendship and relation with parents, physical health complications like
laughing for no reason, becoming thin etc.
Precipitating factors: It includes several factors like legal, financial, occupational and others
and in the case of Cormac it is all related to physical and interpersonal stressors.
Predisposing factors: It includes those factors which lead to the problem and in the context of
Cormac it can be said that environmental factors like socio economic status, lack of friend group
and lack f participation in social activities. Other psychological factors like core belief are some
factors associated with the patient Paul & Kamrul-Hasan, (2019).
Perpetuating factors: It includes those factors which maintain current problems which include:
behaviours in anxiety disorders, withdrawn from friends, parents, and problems in remaining
seated for long.
Protective factors: It includes some strength which can mitigate risks such as social support,
interest. In the context of Cormac it can be said that it may include: positive therapeutic
relationship. So, it can be said that by making use of effective strategies like family involvement,
patient centre care and other medications which can help him out in engaging with people,
making eye contact and preventing him against schizophrenia.
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C Plan for nursing care
In the context of Cormac who had diagnosed with schizophrenia and now also suffering from
mental health require proper medications and interventions. Some short term and effective
interventions include:
Delusion control: It is one of the effective ways in which safe and therapeutic environment is
being provided to the patient in acute state of confusion. One of the main reasons of this
intervention is to increase trust in the patient as Cormac has trust issue and that is why he
dropped out from studies. In this type, nurses require reinforcing reality and talk about all those
things and people that are real. At the time of medications and feeding it is also important for
nurse to be around of the patient in order to make sure that patient is taking medicines because in
such cases like Cormac, patients often feel and believe that food as well as medications is to
poison him Nursing Interventions Schizophrenia, (2017). So, that is why it is important taking
proper medications and nutritional food for Cormac.
Family based intervention: This Schizophrenia not only affects the patient but also to the
family members. In the case of Cormac it is found that Cormac shouts and does not listen to their
parents. For making he able to interact with parents and family member this intervention is
considered one of the best intervention. By involving all family members of Cormac in
intervention and making able to family members about importance of extra care, support and
need which Cormac negative effects can be decreased Middaugh, (2018).
Long term intervention: Rather, short term therapies and interventions it is important to
provide long term interventions to Cormac in order to prevent him against mental illness
completely.
Psychosocial treatment and rehabilitation: This long term treatment
and intervention include: cognitive behavioural therapy and social skill
training. The main aim of providing social skill training to patients and
Cormac is to make him able of performing all of their works independently
and with concentration. By focusing on changing behaviours of the patient,
making abel to take participation in social activities, talking with friends and
increasing trust are some main objectives Varga & et.al., (2018). It is found that
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Cormac face problems in trusting people, talking with friends so, it will be the
best intervention for Cormac.
In addition, it can also be said that by providing narcoleptic drugs as
antipsychotics in drug therapy in prescribed manner, negative effects can be
reduced.
Objectives
All these above discussed interventions are being discussed for accomplishing some goals such
as:
 To improve overall mental health of Cormac.
 To make Cormac able in interact with friends and family members.
 To increase concentration power.
D Clinical handover
Situation: Hallucinations is one of the main situations as Cormac feel that someone is talking
with him. Living with parents.
Background: Around 4 years ago or previously diagnosed with schizophrenia.
Assessment
Mood: Laughing at times.
Cognition: Hopeless
Social: Lack of trust and interaction with friends.
Recommendations: Therapeutic relationship and family based approach.
PART B
2. A identify and discuss about one strategy that can use to develop therapeutic relationship
within Cormac.
According to case study, it has identified the person whose name is Cormac 24-year old.
He was not focused on the study and other extra activities. He has never had a strong network
with friends. At age of 20, he had his first admission to psychiatric hospital by relationship
breakdown. Afterwards, he was diagnosed with schizophrenia. It is a kind of mental disorder in
which people interpret reality abnormally. As a result, it may identify the combination of
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delusions and hallucinations. These are considered as extremely disorder thinking and behaviour
which impaired with daily functionality.
By providing the better treatment of Cormac, which mainly used “Face to Face” support
strategy that always support for promoting therapeutic relationship Foster & et.al. (2019). It help
for establishing the good coordination with patient, make sense that are active listener and
receptive what they are saying. Thus, Cormac should express their own idea, behaviour and
opinion towards certain condition. This will help for changing their psychological condition and
also improved the mental disorder problem in quickly manner.
2. B describe how specific nursing strategy relates to recovery model in mental health
A nursing strategy is based on the plan that can identify the current mental health condition
of Cormac. In another word, it is based on the tactics towards improvement and enhance their
patient capabilities Foster & et.al. (2019). Generally, nursing professional can use coordination
or interaction strategy to maintain social relations between them. This strategy is relates to
recovery model for reducing distress of Cormac in proper manner.
The primary aim of recovery model is to help other people with mental illness and distress
to look beyond the survival. It is always support for encouraging the Cormac to improve their
own mental disorder. Sometimes, it encourages them to move forwards and also setting own goal
and target İnan, Günüşen & Ertem. (2019). In order to develop ability for developing better
relationship with other people. The recovery model emphasis with Cormac to control over their
symptoms. Thus, they can easily control over their lives. This can be possible when recovery
model integrate with nursing strategy.
2. C determine one challenge that encounter when working with Cormac.
As per given scenario, it has encountered the problem of Schizophrenia, which is mainly
consider as brain disorder that effects on the human being. İnan, Günüşen & Ertem. (2019) It is
one of challenge that require to reduce the complexities otherwise, it completely damage the
overall brain functionality. Another way, it also increased the chances of death. Initially, it can
be identified the symptoms such as delusions, disorganised speech and lack of motivation.
Cormac has communicated with friends, family members. That’s why, it turn to convert into
complex problem or issue.
Moreover, Schizophrenia is also challenging of professional to monitor and track daily
activities of Cormac. On regular basis, it always inspiring or motivating towards personal goal
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and achievement. Mental illness is depending on the certain condition, if it can be identified at
early stage which has possibilities to overcome by different medical treatment, therapies.
2. D identifying the one strategy that can use to overcome challenge.
Coping with Schizophrenia challenge is becoming lifelong process. it would require to
identify the appropriate need and requirement Afterwards, it help for eliminating the symptoms
of challenges. In this way, nursing professional can perform significant role which always
support for developing and effective treatment plan İnan, Günüşen & Ertem., (2019).
Afterwards, it combine with medication with self-examine, supportive services and other
psychological therapies. These are effective way to overcome mental disorder challenge in
proper manner.
Strategy: Get Active and communication/coordination
The strategy will support for providing both physical as well as emotional benefits,
conducting the professional counselling session to interact with Cormac. In this way, it become
useful for identifying their own view point or opinion of İnan, Günüşen & Ertem., (2019). This
will help for providing the better treatment according to their needs. Furthermore, nursing
professional has experienced the psychotic, getting the physically active and something that can
do right. In order to improve the concentration level, relive stress, pain. Afterwards, this strategy
is directly impacting on the behaviour, attitude of Cormac.
This strategy will support for establishing better relation between Cormac and other
professional. Therefore, Cormac can feel free to share their idea, thoughts, belief and innovation.
So as it become easier for professional to check improvement progress in step by step manner.
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REFERENCES
Books & Journals
Foster, K. & et.al., (2019). Resilience and mental health nursing: An integrative review of
international literature. International journal of mental health nursing. 28(1). 71-85.
İnan, F. Ş., Günüşen, N. & Ertem, M. Y. (2019). The Impact of Mental Health Nursing Module,
Clinical Practice and an Anti-Stigma Program on Nursing Students' Attitudes toward
Mental Illness: A Quasi-Experimental Study. Journal of Professional Nursing. 35(3).
201-208.
Liu, S. & et.al., (2020). Online mental health services in China during the COVID-19
outbreak. The Lancet Psychiatry, 7(4), e17-e18.
Middaugh, D. J. (2018). Delusion of Control: Pushing Buttons. Medsurg Nursing, 27(6), 399.
Paul, A. K., & Kamrul-Hasan, A. B. M. (2019). Predisposing Factors of Hypoglycemia in
Patients with Type 2 Diabetes Mellitus Presented with Symptomatic Hypoglycemia in a
Tertiary Hospital of Bangladesh. Age (years), 60(47), 47.
Varga, E. & et.al., (2018). Community-based psychosocial treatment has an impact on social
processing and functional outcome in schizophrenia. Frontiers in psychiatry, 9, 247.
ONLINE
Nursing Interventions Schizophrenia. 2017. Online Available through: <
https://medcraveonline.com/NCOAJ/nursing-interventions-in-schizophrenia-the-
importance-of-therapeutic-relationship.html>
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