Case Study: Mental Health Nursing Analysis of Lisa's Substance Abuse

This case study examines Lisa's situation, focusing on her drug abuse and the underlying factors contributing to it. The analysis highlights the significance of mental illness, loneliness, and family conflicts as key issues. It explores the need for a multidisciplinary approach, involving psychiatrist nurses, clinical psychologist nurses, social worker nurses, and therapist nurses. The paper emphasizes the application of trauma-informed care principles, such as safety, trustworthiness, choice, collaboration, and empowerment, in Lisa's treatment. The case study provides insights into how these principles can be implemented to create a supportive and effective treatment plan. The paper also looks at the role of different nurses in addressing Lisa's complex needs, from diagnosing mental health conditions to providing therapy and social support. It underscores the importance of a holistic approach that considers the individual's mental, emotional, and social well-being. Furthermore, it provides a comprehensive understanding of Lisa's case, outlining how various healthcare professionals can work together to help her overcome her challenges and achieve recovery.

Running Head: MENTAL-HEALTH NURSING 1
Mental-Health Nursing, Case Study of Lisa
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Mental-Health Nursing, Case Study of Lisa
In order to help people with drug-related issues, understanding the reasons behind their
drug use habits is very important. The reasons behind some people getting into drug abuse are
called risk factors while the factors which protect others from drug abuse are called resilience
factors. The reasons why people abuse drugs vary greatly from one person to another. More
often than not, people get into drug abuse as they try to fix some issues within their lives. For
instance, a depressed person finds himself into drug abuse when trying to get a solution out of
the depressed condition while a teenager may find himself into drug abuse trying to fit with peers
and viewing drug abuse as a way of feeling “a part of them”. Other people abuse drugs as a way
of self-medication. From mental health disorders to chronic pain, many people find themselves
into drug abuse with the aim of alleviating ailment symptoms. This paper has identified three
issues which have contributed to drug abuse in Lisa’s case as presented in the video
https://youtu.be/83i2MWMqph8. The three issues are mental illness, loneliness, and family
conflicts.
According to research by the National Bureau of Economic Research, there is a close
connection between the use of addictive substances and mental illnesses and that large
percentage of common drug users are patients with mental health disorders (Sousa-Poza, 2018).
Further research has indicated that people going through a mental illness such as anxiety,
depression, Post-traumatic stress disorder (PTSD) and others stand at a higher risk of becoming
drug addicts. These people usually get into drug and substance abuse in an attempt to cope with
difficult feelings they usually undergo. In the case scenario of Lisa, it comes out clearly that she
has been seeing her counselor from the local drug service for some time after her first admission
in a psychiatric hospital where she was diagnosed with some mental illness. She was then

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discharged on anti-psychotic medication. However, from her interaction with Jenny during the
counseling session which was displayed in the video, Lisa after moving in with her boyfriend
took a couple of weeks not using the medication. This is true because she attests not to be aware
of where the drugs where. From a healthcare approach, for any kind of medication to work
effectively, a patient must complete the dose as prescribed by the doctor. In the case of Lisa, that
was not the case and hence the mental illness which had been diagnosed earlier might be back
and hence making her abuse drugs with an aim of alleviating the symptoms of her condition.
This issue relates to the first principle of the trauma-informed approach which advocates for the
safety of an individual.
Another issue which comes out clearly from the storyline is loneliness. After moving in
with Jonah from her parent’s house, Lisa is staying alone in the house whereas she was used to
living with her parents. This might be affecting her to the extent of abusing substances to cope
with the feeling of loneliness. In addition to being alone in Jonah’s house, Lisa must also be feel
isolated by the family especially in consideration to the fact that she confessed of her mother not
talking to her anymore after her decision to move in with Jonah. To her, turning into drug abuse
fully must have been facilitated by the urge to fill the void she was living in. This relates to the
fourth principle of the trauma-informed approach (collaboration and mutuality) which advocates
for both physical and psychological support (Evans, Nizette & O’Brien, 2017).
The third issue which might be facilitating the problematic substance abuse by Lisa is the
family conflicts. From the case study, Lisa narrates that her parents were not happy with her
moving in with Jonah but she decided to move in with Jonah. According to Lisa, her parents got
angry with her for moving in with Jonah and that had broken their communication with her.
When the narration is phrased in line with the confession by Lisa that she has not been able to

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see her medication since she moved in with Jonah which was being administered by her mother
while living in their house, it comes out clearly that there is an ill relationship between her and
her parents. This is in consideration of the fact that people who lack positive daily interaction
with their family members may choose to start abusing drugs with the aim of feeling happy and
contented. The feeling that her parents might have had noticed that Jonah was not a good person
before she moved in with her might be haunting her to an extent of associating Jonah with evil
practices like having inserted a transmitter into her stomach. This issue relates to the second
principle of the trauma-informed approach which advocates for trustworthiness and transparency
(Goldacre, 2012).
Based on the three issues which have been identified as the key contributors of Lisa’s
problematic substance use; mental illness, loneliness, and family conflicts, it is clear that her case
will have to be handled by different professionals (Maddock, 2015). For instance, the video has
clearly demonstrated that Lisa has had mental illness before and was under medication until she
moved in with Jonah when she stopped the medication. It is also clear that Lisa has an ill
relationship with her parents and that might be affecting her psychologically as she attests that
she has not been communicating with her parents since she moved in with Jonah. Finally, the
video has portrayed Lisa as a lonely person who is staying alone most of the times in the new
house she moved to Jonah. Considering the fact that she was used to staying with her parents
before moving out, the loneliness aspect might also be affecting her well-being to the extent of
feeling afraid to sleep inside the house. All these issues won’t be handled by single mental
healthcare but a collaboration of more than one nurse in order to handle her different issues
(Miller & Rollnick, 2013).

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Considering her mental health issue which has been identified as a problem she had and
was under medication until the time she moved in with her boyfriend Jonah, Lisa will need the
services of a psychiatrist nurse. Psychiatrist nurses usually specialize in the diagnosis, treatment,
and prevention of mental illnesses. They typically deal with people with significant mental
health problems although in extreme cases they also see a broad spectrum of patients. Just like
other physicians, psychiatrist nurses have been trained to prescribe medications to mental health
patients (Dowdy, et al., 2015). They are also responsible and qualified in ordering and
performing full range tests that are coupled with patient discussions to assess the patient’s mental
and physical conditions. They are experts in providing psychotherapy and prescribing other brain
treatment approaches such as electroconvulsive therapy. These services will be highly demanded
in the case of Lisa whose mental illness seems to have reappeared after she stopped using the
drugs (Moxham, Hazelton, Muir-Cochrane, Heffernan, Kneisl & Trigoboff, 2018).
Lisa also appears to have funny behaviors in the video. In order to be understood, a
clinical psychologist nurse will be required. Psychologist nurses are specialists in the field of
psychology who have undergone specialized training in the provision of mental health treatment.
They have three specializations; clinical, counseling and developmental psychologists.
Specifically, clinical psychologists provide psychotherapy to clients or patients either in person
or in a group (Psychotropic Expert Groups, 2013). They achieve this by performing detailed
batteries of assessments which measure specific mental behaviors and functions. For Lisa’s
behavior to be understood and receive treatment, a clinical psychologist nurse will play an
important role
Lisa’s interaction with Jenny in the video has revealed an ill relationship between her and
her parents as a result of moving in with Jonah. This might be impacting her socially and hence

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will require a social worker nurse to help her out of the situation. Social worker nurses are
specialists in understanding social factors that affect the emotions and behaviors of people.
Through a social worker nurse, any impacts of the ill relationship between her and the parents
which might be affecting her emotions and behavior will be understood and assisted out of the
situation (Slade, 2009).
The fact that Lisa’s dependency on drugs seems to be increasing was confirmed during
the session she had with Jenny calls for a therapist nurse. These kinds of nurses provide
interventions such as therapy and counseling. Talk therapy is the main approach used by these
nurses in their interactions with patients. A therapist nurse will dig deep to know the reason
behind her increasing trends of drug abuse and advise her accordingly (Skinner, 2015). The nurse
will also work with the rest of the specialist nurses identified above in order to come up with a
solution to help Lisa out of drugs. A therapist nurse is important in this scenario because the first
step in dealing with drug addicts starts by making the addict accept there is a problem, which can
only be realized through talk therapy (Muir-Cochrane, Barkway & Nizette, 2018).
The nurse in charge will be guided by the principles of Trauma-Informed care in various
ways when engaging with Lisa. For instance, the safety principle will be applied in the
counseling process by ensuring her that her information will be confidential. This will create a
space for her to feel cultural, physically and emotionally safe as well as the awareness on her
discomfort and unease (Dudgeon, Milroy & Walker, 2014). Lisa’s discussion with Jenny has
revealed that she stopped using the mental illness drugs she had been prescribed by her
counselor. The principle of transparency and trustworthiness will be applied in this scenario to
provide full and accurate information about the consequences of not using the drugs as

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prescribed and what is expected to happen on her mental health in future as a result of further
negligence.
Although Lisa might have been wrong by failing to heed to her parent's advice not to
move in with Jonah, the nurse will stand on his side and not against her. This is in respect to the
third principle of Trauma-Informed Care, Choice, which advocates for the recognition and the
need for an approach that honors patient dignity (Paris, 2013). Also, Lisa is expected to deny the
fact that her ill relationship with parents doesn’t play any role in her current mental condition.
The nurse in charge will, therefore, apply the fourth principle of Trauma-Informed care,
collaboration, to make her understand that healing in relationships and partnerships can only be
achieved through shared decision-making. Finally, Lisa attested of the voices which she could
hear demeaning her abilities and appearance (Elsevier Nizette, McAllister & Marks, 2013).
Through the fifth principle of Trauma-Informed care, empowerment, the nurse will be able to
restore her self-esteem by recognizing her strengths. The nurse will work closely with a clinical
psychologist; this is because Lisa has been displaying some behavioral aspects which can only be
understood by a clinical psychologist.

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References
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