NCS2102 Mental Health and Illness: Case Study Essay on Nursing Care

This essay presents a comprehensive case study on mental health nursing within a general hospital setting, focusing on the provision of holistic care to patients with co-morbid physical and mental health conditions. The essay addresses key aspects of nursing practice, including the importance of holistic care, risk assessment (suicide and depression), and the interconnectedness of mental and physical health. The case study involves a registered nurse, Tim, and his approach to patient care, including assessing patients admitted to the general ward. The essay explores the assessment of patients, including the evaluation of both physical and mental health conditions, and highlights the impact of mental health on physical well-being. It also discusses the recognition of psychiatric symptoms, the prioritization of suicide risk assessment, and the differentiation between anxiety and depression. Early diagnosis and the use of questionnaires are also highlighted. The essay emphasizes the importance of early diagnosis, care plans and appropriate interventions for patients. The essay utilizes academic references to support the discussions and findings.

Running head: MENTAL HEALTH- NURSING
MENTAL HEALTH- NURSING
Name of the student:
Name of the university:
Author note:

1
MENTAL HEALTH- NURSING
Question 1:
Mental health is demarcated as the mental stability of the individual. As per the
statement, mental health is a broad area which possesses an impact on both the bio psychosocial
and spiritual aspect of the health. It not only affects the mental health but also have a adverse
consequence on the physical wellbeing of the patient. Therefore, to ensure the eminence of life
of patient, it is essential to address all the aspects of the mental and social well-being. To
enhance the worth of life of patient, it is vital to deliver holistic care to the patient. Tim in this
case study knows that holistic care of the patient is crucial to provide safe and appropriate care to
both mental and physical health, as Holistic care is measured as the care process which considers
the physical, emotional, economic and spiritual need of the patient. Complete care or Holistic
care also focusses on patient’s reaction to the illness, effect or impact of the illness and their
aptitude to meet the self-care needs (Zamanzadeh et al., 2015). There are five main areas of the
health care such as, emotional, social, physical, intellectual and spiritual which was considered
while delivering holistic care to the patient. Thus by the aid of holistic care, the spiritual,
physical and mental well-being of the patient is maintained and hence it is important to provide
holistic care to the patient suffering from any illness for the proper recovery. Holistic care is a
patient care approach where the registered nurse engages themselves in a therapeutic relationship
with the patient in order to elevate and promote wellness and healing of the individual (Bester &
Van Deventer, 2015). The holistic care approach of the nurse focuses on the dietary habits and
therapeutic practices of the patient. In the holistic care, the patient is encouraged to involve
themselves in the physical exercise such as brisk walking, yoga which is proved to be effective
in improving the overall health of the patient.

2
MENTAL HEALTH- NURSING
According to the Lindquist, Tracy and Snyder (2018), physical and mental well-being of
the individual is associated to each other. Mental health of the patient also delivers negative
consequence on the physical and social well-being of the patient, hence for the appropriate
recovery of the mental health patient, interventions related to the physical, emotional and social
health is required which can be achieved by the aid of holistic care. Tim was well aware of the
above discussed facts and hence due to that he ensures that every patient should be provided with
holistic care.
Question 2:
As per the statement, proper assessment of the risk factor and the objective and subjective
signs is essential in the healthcare for conveying safe and appropriate care to the patient suffering
from multiple diseases. Tim was aware of the fact that both mental and physical health are
correlated to each other and hence while admitting a patient to the general ward both physical
and mental health assessment of the patient is required. Mental and physical health is correlated
with each other and its association negatively impacts the quality of living. For the proper
management and care of the individual suffering from any illness, it is significant for the
registered nurse to evaluate the physical and the mental health condition of the patient (Davis et
al., 2015). Poor mental health condition of the patient often give rise to chronic physical
condition and hence the individual who are suffering from any pernicious mental illness are at
the extra risk of getting affected with physical complications and vice versa. Rendering to the
study piloted by Rumpold et al., (2016), 32% of the total population suffering from any stress or
anxiety disorder is likely to experience cancer. Mental disorder or depression is considered to be
one of the risk factor of coronary heart disease and people suffering from schizophrenia increases
the risk of heart disease and respiratory disease by two times and three times respectively. It is

3
MENTAL HEALTH- NURSING
because an individual associated with any mental illness receives less care for their physical
health and often ignores the common signs and symptoms such as, blood pressure, cholesterol
and weight which can lead to chronic health condition such as, hypertension, cardiovascular
complications. Individuals suffering from depression are often observed to smoke, which
increases the risk of the individual by getting affected to any lung and cardiovascular disorder.
According to Triguero-Mas et al. (2015), people suffering multiple chronic illness are at the
higher risk of getting affected with depression or mood disorder. Hence, by considering the
above facts, it can be stated that proper mental health assessment of the patient is must before
admitting it to the general ward. Therefore it is necessary for the nurse to undertake mini-mental
state examination before admitting the patient to the hospital in order to evaluate the mental
health condition of the patient. In the mini-mental state examination, the mental health of the
patient is evaluated by the aid of the open end questions and by assessing the vital signs and
symptoms.
Question 3:
According to Ferro & Boyle (2015), there are multiple number of physical symptoms
which gives rise to high rate of psychiatric symptoms apart from that of the physical symptoms.
Therefore identification of psychiatric symptoms in the in the person suffering from any mental
illness is commonly observed. Rendering to the study piloted by Parker & Brotchie (2017), in the
person suffering from pancreatic cancer usually experience high rate of the psychiatric
comorbidity and emotional disability. The psychological symptoms which are commonly
observed includes, mood swings, adjustment disorder, anxiety and loss of self-esteem. Apart
from that, multiple sclerosis which is an immune-mediated disorder are also associated with high
prevalence rate of mental symptoms such as, change in emotional well-being, memory

4
MENTAL HEALTH- NURSING
complications, shortened attention spans, language difficulties and complications in staying
organized (Feinstein, Brochet & Sumowski, 2019). Therefore, in case of the above physical
illness mentioned, the patient would come with the mental symptoms, however have a different
underlying physical illness associated.
Question 4:
From the case study of the Nicole, it has been identified that she is emotionally unstable
and has also threatened to commit suicide. The patient has been admitted for the overdose of the
psychotropic medication and is also demanding medication during her hospitalization which
increases the possibility of the patient to get affected by the chronic mental condition. Tim has
also recorded old scars on her forearm. From the scars, it can be stated that the patient might had
tried to commit suicide earlier. Therefore, by considering the current situation of the patient, the
priority assessment that Tim should undertake is suicide-risk assessment. Rendering to the study
performed by Cramer & Kapusta (2017), suicide risk assessment is demarcated as the process of
evaluating the risk and likelihood for an individual to attempt suicide. In the assessment, the
warning signs that might lead to suicides are evaluated. Apart from that, another risk assessment
that is vital in case of patient is depression risk assessment (Wolanin, Gross & Hong, 2015). By
considering the patient’s present emotional instability, it can be stated that Nicole is at the high
risk of getting into depression, therefore depression risk assessment is required. In the
assessment, the patient is interviewed with the aid of open end questions which aims to evaluate
the risk of depression into the patient.
For the assessment mentioned above, Tim will be able to identify the risk that can lead to
depression and other chronic psychiatric illness in Nicole. By critically observing the case study

5
MENTAL HEALTH- NURSING
of the Nicole, there are certain risk factors or signs such as, emotional instability, which has
been observed which indicates the possibility of depression, hence it is necessary for Tim to
undertake depression risk assessment. It will help Tim to identify the primary issue that has been
affecting Nicole and is responsible for her deteriorating health condition.
In the depression risk assessment, the patient is interviewed with the aid of different
questionnaire which help in the evaluation of the severity of the disease and the chance of the
patient getting into depression (Bolton, Gunnell & Turecki, 2015).
Another mental disease which seems to prevalent in the case of Nicole is the thought of
suicide and self-harm. As the patient is getting frustrated due to the hospital setting and also has
previous scars on the forearm, suicide risk assessment will evaluate the chance of self-harm in
patient (Cummins et al., 2015)
Question 5;
Depression and anxiety both are a form of chronic mental illness and are proved to be
link with each other. According to Schaefer et al., (2017), 45% of the individual suffering from
one mental health condition also possess the criteria one or two other mental health condition.
Although both the disease have its own cause associated for the occurrence of the disease, they
might share signs, symptoms and treatments and masks the symptoms of each other. The
symptoms which can be implemented for the identification of the depression includes, Decreases
energy, fatigue, pain, aches, gastrointestinal complications, loss of appetite and insomnia
(Bernstein, 2018). Apart from these, other symptoms which are experienced by the patient during
depression are loss of interest, sadness, hopelessness, anxiety, anger and thought of suicide. In
anxiety also some of these symptoms are prevalent such as, fatigue, insomnia, muscle tension,

6
MENTAL HEALTH- NURSING
increased heart rate, irritability, worry and loss of concentration. In the case of Jane, some of
these symptoms are observed such as worry, fear of small things, insomnia, loss of appetite, lack
of motivation and anxiety. According to Jane it is just because of anxiety, however after
analyzing the symptoms of depression and anxiety disorder it can be stated that, Jane is either
suffering from anxiety disorders or depression which can be evaluated by conducting an Early
diagnosis.
For the proper assessment of the mental illness, physical exam is performed in which the
underlying medical complaints are evaluated. Apart from this depression risk assessment and
anxiety risk assessment are performed. In the risk assessment test the risk factor which are
responsible for the medical conditions are evaluated with the aid of open end questionnaire.
After interviewing the patient, the response of the patient is evaluated with the aid of score from
1 to 15. If the score of the patient is assigned over 5, the person is stated to have at the risk of
getting affected with the mental illness and if after evaluation of the response, the assigned score
is 12, an individual is stated to have at high risk of getting into depression and anxiety disorder
(Yates, Cohan & Goharian, 2017). Early diagnosis helps in the appropriate evaluation of the
disease within the time so that the care plan is formulated accordingly.

7
MENTAL HEALTH- NURSING
References:
Bernstein, C. N. (2018). Addressing Mental Health in Persons with IBD.
Bester, P., & Van Deventer, Y. (2015). Holistic care for patients living with chronic wounds:
nursing. Wound Healing Southern Africa, 8(2), 78-81.
Bolton, J. M., Gunnell, D., & Turecki, G. (2015). Suicide risk assessment and intervention in
people with mental illness. Bmj, 351, h4978.
Cramer, R. J., & Kapusta, N. D. (2017). A social-ecological framework of theory, assessment,
and prevention of suicide. Frontiers in psychology, 8, 1756.
Cummins, N., Scherer, S., Krajewski, J., Schnieder, S., Epps, J., & Quatieri, T. F. (2015). A
review of depression and suicide risk assessment using speech analysis. Speech
Communication, 71, 10-49.
Davis, D. E., Ho, M. Y., Griffin, B. J., Bell, C., Hook, J. N., Van Tongeren, D. R., ... &
Westbrook, C. J. (2015). Forgiving the self and physical and mental health correlates: A
meta-analytic review. Journal of Counseling Psychology, 62(2), 329.
Feinstein, A., Brochet, B., & Sumowski, J. (2019). The cognitive effects of anxiety and
depression in immune-mediated inflammatory diseases.
Ferro, M. A., & Boyle, M. H. (2015). The impact of chronic physical illness, maternal depressive
symptoms, family functioning, and self-esteem on symptoms of anxiety and depression in
children. Journal of abnormal child psychology, 43(1), 177-187.

8
MENTAL HEALTH- NURSING
Lindquist, R., Tracy, M. F., & Snyder, M. (Eds.). (2018). Complementary & alternative
therapies in nursing. Springer Publishing Company.
Parker, G., & Brotchie, H. (2017). Pancreatic cancer and depression: a narrative review. The
Journal of nervous and mental disease, 205(6), 487-490.
Rumpold, T., Schur, S., Amering, M., Kirchheiner, K., Masel, E. K., Watzke, H., & Schrank, B.
(2016). Informal caregivers of advanced-stage cancer patients: Every second is at risk for
psychiatric morbidity. Supportive Care in Cancer, 24(5), 1975-1982.
Schaefer, J. D., Caspi, A., Belsky, D. W., Harrington, H., Houts, R., Horwood, L. J., ... &
Moffitt, T. E. (2017). Enduring mental health: prevalence and prediction. Journal of
abnormal psychology, 126(2), 212.
Triguero-Mas, M., Dadvand, P., Cirach, M., Martínez, D., Medina, A., Mompart, A., ... &
Nieuwenhuijsen, M. J. (2015). Natural outdoor environments and mental and physical
health: relationships and mechanisms. Environment international, 77, 35-41.
Wolanin, A., Gross, M., & Hong, E. (2015). Depression in athletes: prevalence and risk
factors. Current sports medicine reports, 14(1), 56-60.
Yates, A., Cohan, A., & Goharian, N. (2017). Depression and self-harm risk assessment in online
forums. arXiv preprint arXiv:1709.01848.
Zamanzadeh, V., Jasemi, M., Valizadeh, L., Keogh, B., & Taleghani, F. (2015). Effective factors
in providing holistic care: A qualitative study. Indian journal of palliative care, 21(2),
214.