Mental Health Case Study: Analyzing Munny Kaew's Condition

This case study examines the mental health of Munny Kaew, focusing on his presentation of depressive symptoms. The analysis begins with an assessment of his clinical signs, leading to a diagnosis of major depressive disorder based on DSM-5 criteria. The study then applies the Stress Vulnerability Model to understand the contributing factors to Munny's depression, including grief, work-related stress, and childhood trauma. Finally, the case explores recovery strategies, emphasizing the importance of respect, empowerment, and hope in the healing process, referencing relevant literature to support these principles. The paper highlights the need for a holistic approach to mental health care, considering the patient's unique background and experiences.

Running head: CASE STUDY 2: MUNNY KAEW 1
Case Study 2: Munny Kaew
Student’s Name
University

CASE STUDY 2: MUNNY KAEW 2
Case Study 2: Munny Kaew
Question 1
From the clinical signs that the patient is displaying, he seems to be suffering from
depression. This is a medical illness that negatively affects how one feels, thinks or acts. The
patient feels sadness and loss of interest in activities that he often enjoys. When assessing the
patient, it is important to rule out medical conditions like vitamin deficiency, brain tumor and
thyroid problems which also mimic depression. This is the reason why the DSM-5 criteria for
depression and the mental state examination are important in assessing the patient.
The mental state examination is a structured way of observing and describing the patient
current state of mind by focusing on appearance, behavior, attitude, mood, affect, speech,
thought process, perception, thought content and insight. According to Athanasos( 2017), MSE is
used to obtain a comprehensive cross-sectional description of the mental state which will be
combined with biographical and historical information that leads to a correct diagnosis and
formulation.
Athanasos( 2017) suggests that behaviour is a major element in establishing the mental
state of the patient. From the case the patient stares at the floor avoiding eye contact, and finally
asks the nurse to leave him alone. When at home, his wife indicated that he has lost interest in
the activities that he used to enjoy. This shows that there is something wrong since the behaviour
displayed here is not normal as per the explanations of the wife.
Mood and affect are also important elements that can be used to identify the mental
challenges faced by the patient. From the case his mood low since he has decreased interest in
activities that he previously enjoyed like caring for his children. His affect seems agitated as seen
in the way he asks the nurse to leave him alone. This shows that the patient is depressed and has

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some thoughts which may be affecting his normal life. The mood can also be seen from his use
of monosyllabic words. This is also seen in the loss of interest in his life activities like family
and work due to the changes in his mood.
The Diagnostic and Statistical Manual of Mental Disorders V (DSM V) requires that the
patient must have at least five or more symptoms before being diagnosed as having depression.
Tolentino & Schmidt (2018) argue that when using the tool, to assess the patient, at least five
symptoms have to be identified from the condition of the patient for the case to qualify to be a
mental disorder. Munny is displaying the following signs which can indicate the presence of the
depression that qualifies for depression. The first sign is loss of interest and pleasure in normal
activities like his job and children which have been the most things that he enjoys. This is also
seen from the fact that he has been frequently taking sick leaves which did not happen in the
past. The second symptom is sleep disturbances which are seen from the fact that he sleeps too
much and spends most of his time in bed. The third is reduced appetite and weight loss which are
seen from the fact that he has lost his appetite since the incident at work. The fourth is the feeling
of guilt from the bereavement of his mother and the past failures of not taking care of him.
Lastly, Munny seems to be progressing to angry outbursts based on the fact that he was speaking
less and finally tells the nurse to leave him alone. Therefore, Munny seems to suffer from a
major depressive disorder based on the clinical signs that he portrays. Klein (2018) adds that this
type of depression usually happens after the symptoms persist for at least two weeks for the
symptoms to qualify as depressive. Therefore, from the DSM-5 criteria, the five signs can be
used to quantify that the patient is depressed.
Question 2

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The Stress Vulnerability Model is used for identifying and treating relapses of mental
illness since humans are predisposed to mental illness and the mental conditions that relate to
their psychiatric disorders. Evans, Nizette, & O'Brien (2016) suggests that early life experiences
play an important role in the levels of stress that the individual experiences as important factors
for the development of mental disorders. From the model, stress is an important element of
depression that is the cause of the problem that Munny is having. Stress is the main cause that
the patient is facing which can be caused by many factors from his life. The environment that
patients live in has several stress factors that can create the mental health symptoms that the
patient experiences. This implies that the nature of events and the reaction of the individual
towards the events can be an important factor in determining how the patient manages stress to
avoid depression or increase depression.
Stressful events in the life of the patient vary from individual to individual. In the case of
Munny, the grief of losing his mother and the inability of him to be there for her seems to be
stressing him down. The fact that he used to be mostly preoccupied with his work as a way of
avoiding to experience the suffering and death of his mother is the major cause of the problem.
Zachar (2015) argues that during the time of bereavement and the grief process, people need
emotional support to assist them to overcome complicated grief. If the individual fails to travel
through the grief process at their own pace, they face the possibility of developing complicated
grief. Munny seems to be having complicated grief which is a result of him not going through the
grief process well which leads to the unresolved grief symptoms like inability to accept death,
enjoy good memories of the loved one self-blame for the death of the loved one. This is also seen
in the type of history that Munny has shared with his mother to overcome the childhood traumas
that he experienced while growing up.

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Another level of stress being experienced by the patient is the type of challenges being
faced at work. In this case, Munny seems to be having difficulty coping with the rising pressure
at work which has created the problem of him risking being sacked. This means that he has
difficulty dealing with work related challenges which are causing high levels of depression being
experienced by the patient. To deal with this problem he has chosen to take sick leaves which
and deviated from his normal life which is a reflection of the depression that he is experiencing.
Question 3
Respect entails viewing the recovery process as courteous, respectful and honest in all
interactions. This means that the professional is supposed to work with the while respecting his
feelings and being sensitive to issues that relate to his values, beliefs, and culture. The fact that
Munny has a history of living in a refugee camp means that he presents unique conditions that
need to be observed. The recovery process adapted needs to focus on and respect the needs of the
patient to increase recovery. Ziedonis, Larkin, & Appasani (2016) adds that respect and dignity
are important in the recovery process since they influence the ability of the patient to adapt to the
healing process.
The empowerment principle of health promotion and prevention of diseases since it gives
the patient a better understanding and control over life. According to Villaggi, et al. (2015) the
role of the empowerment process is to assist the patient to change the social and psychological
health-related life circumstances that lead to the mental health challenges being experienced. By
assisting the patient to take control of their lives, empowerment is developed on the dimensions
of self-reliance, participation in decision making, dignity and respect and belonging and
contributing to the wider community (Pictona, et al., 2018). Thus in the recovery process of

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mental health, empowerment is used to assist the patient to overcome the state of powerlessness
and thus gain control over life and the factors creating depression.
According to Acharya & Agius (2017), hope underpins the recovery process of mental
illness since it creates the desire that the patient wants to get better. This works by removing
despair which makes the patient feel that all is lost. This is seen in the positive response by
Munny when the nurse asks him whether he has ever considered meaningful things in life. The
role of hope is to push the patient through the difficult recovery process by ensuring that he
follows the designed recovery plan. This entails eating right, thinking right, exercising right and
even following all the medical treatment options given. Without hope, mental health recovery
becomes difficult since the patient fails to change the way of life which is essential in the
recovery process.

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References
Acharya, T., & Agius, M. (2017). The importance of hope against other factors in the recovery of
mental illness. Psychiatria Danubia, 3, 619-622.
Athanasos, P. (2017). Chapter 17 - MOOD DISORDERS, Psychiatric & Mental Health Nursing.
In K. Evans, & D. Nizette, Psychiatric & Mental Health Nursing (Vol. 25, pp. 370-390).
Evans, K., Nizette, D., & O'Brien, A. (2016). Psychiatric & Mental Health Nursing. USA:
Elsevier.
Klein, D. N. (2018). Classification of Depressive Disorders in DSM-V: Proposal for a Two-
Dimension System. Journal of Abnormal psychology, 117(3), 552–560.
Pictona, C., Pattersona, C., Moxhama, L., K.Taylor, E., Perlman, D., Brighton, R., & Heffernan,
T. (2018). Empowerment: The experience of Recovery Camp for people living with a
mental illness. Collegian, 25, 113-118.
Tolentino, J. C., & Schmidt, S. L. (2018). DSM-5 Criteria and Depression Severity: Implications
for Clinical Practice. Frontiers in Psychiatry, 9(450).
Villaggi, B., Provencher, H., Coulombe, S., Meunier, S., Radziszewski, S., Hudon, C., . . .
Houle, J. (2015). Self-Management Strategies in Recovery From Mood and Anxiety
Disorders. Global Qualitative Nursing Research, 4(1).
Zachar, P. (2015). Grief, depression, and the DSM-5: a review and reflections upon the debate.
Rev. Latinoam. Psicopat. Fund, 18`(3), 540-550.
Ziedonis, D., Larkin, C., & Appasani, R. (2016). Dignity in mental health practice & research:
Time to unite on innovation, outreach & education. International Jounral of Medical
Research, 144(4), 491–495.

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