Mental Health Nursing Report: Chung's Case Study and Recovery Plan

This report presents a comprehensive analysis of a mental health nursing case study involving a 35-year-old medicine practitioner named Chung. The report applies the Mental State Examination (MSE) and the DSM-V to assess Chung's mental state, identifying symptoms of depression and anxiety stemming from work-related stress, insufficient sleep, and changes in his familial environment after the birth of his daughter. It further utilizes the stress vulnerability model to explain the underlying causes of his mental health issues. The report also explores mental health recovery strategies, including the mental health recovery model, and proposes interventions such as counselling for Chung and his family, and adjustments to his work and home life to promote his well-being. The report emphasizes the importance of early intervention and support to prevent the progression of Chung's condition and promote his overall mental health.

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

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Answer 1:
Relating MSE with the client in the case-study:
According to the case-study, 35 year old Chung is a struggling medicine practitioner
who is striving hard to become an emergency medicine consultant, however has been
subjected to a number of events that has led to the occurrence of mental and emotional
turmoil in him, leading to the manifestation of the initial symptoms of mental unrest (Admon
et al.,2013). In compliance with the standards of the mental state examination, a number of
factors can be held accountable that depict the degrading mental stability of Chung. Typically
it can be said that the thought content and the behaviour of the subject significantly points out
to the development of depression and anxiety. The case study clearly states Chung to be
feeling low most of the times and preoccupied with disturbing thoughts. On proceeding with
the interview, the midwife could perceive suicidal thoughts and continuous frustration.
Chung also explains himself as a worthless father that proves that he feels incapable and
possesses a pessimistic attitude. In context to his behaviour, Chung is seen to be extremely
fatigued and tired and in dire need of sleep. He is also seen to be resting with rounded
shoulders and is seen to be detached from the interview. He finds it difficult to focus on the
questions and is found to struggle with his responses. These features can be linked to the
thought content and the general behaviour category of the MSE guidelines and it can hence
be inferred that Chung is at a high risk of developing a mental disorder.
Relating DSM-V with the client in the case study:
According to the American Psychiatric Association, in the year 2013, the diagnostic
and statistical manual of mental disorder that has been updated pertaining to the current
trends prevalent in the critical diagnosis of the psychological disorders, it can be commented
that Chung is on the verge of steeping into depressive disorder that would ultimately lead to
the development of the initial phase of neurodegenerative disorder such as communication
disorders (Von Gontard,2013). This is evident from Chung’s inability to perceive and quickly

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respond to the questions asked by the midwife and the midwife having to repeat her questions
in order to derive a ‘one-word’ substantial answer from Chung. In addition to the above
stated fact, Chung’s persistent feelings of anxiety, stress and concomitant sadness pertaining
to the fact that he is not being able to devote ample amount of time to his dear wife and his
new born baby Juliette and his absence due to the bizarre long hours is ultimately leading to
an emotional turmoil. These factors can hence be correlated to the guidelines of mental
disorders as highlighted by the DSM V and can be tagged as the precursor symptoms that
would lead to the development of bipolar disorder. This would involve episodes of intense
depression and feelings of hopelessness and irritation over every minute instance (Briere &
Scott, 2014). It is important to identify the initial symptoms as early as possible and seek
counselling interventions so as to combat with the ongoing emotional trauma (Regier et al.,
2013).
Answer 2:
Applying the stress vulnerability model:
The stress vulnerability model has been conceptually designed in order to provide a
framework to the patients and their family members to understand the underlying reason
behind the occurrence of various mental disorders and the associated complications and also
the exposed vulnerability in these conditions that lead to taking up substance-abuse (Simon et
al.,2013). It is critical to note here that the vulnerability factor differs from individual to
individual and it can be said to be dependent on two factors broadly, mainly the genetic
susceptibility to develop a mental disorder and the physiological stress exerted by the familial
environment or the work environment (Slade et al.,2013).
Contributing factors eliciting mental stress:
Many factors can be co-related with the generation of the effect of stress in Chung. As
identified by the case study, it can be inferred that prolong work hours, insufficient sleep and
unable to cope with the change in the familial environment can be said to directly affect the

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thought process of Chung. Research studies reveal that prolong hours of duty in healthcare
lead to the cause of excessive physical exhaustion that drains the energy unit of the body and
as a result it causes reduced performance output and also mental fatigue that in turn leads to
feeling of emotional breakdown (Sonnentag & Fritz,2015). Studies also reveal that,
insufficient sleep or disruptive sleep pertaining to waking up and finding it difficult to get
peaceful sleep for a long period of time leads to the development of feelings of anxiousness,
hallucinations and due to the inadequate amount of sleep, feelings of irritation and mental
fatigue are reported to persist in patients which lead to the damage of mental health (Trzepacz
et al.,2013). Another important factor that can be co-related as a degenerative effect of stress
would include, change in familial structure. In the case study, it can be perceived that Chung
is extremely affected with the birth of his daughter Charlotte and the over-involvement of his
in-laws in taking care of the new born baby. This makes him detached from his baby and his
wife and he is not able to spend quality time with them, which leads to the trigger of stress
and frustration.
Answer 3:
Mental health recovery:
The mental health recovery model is primarily based on two broad principles which
include the fact that it is possible to dispense mental health treatment to a disturbed patient
and the approach adopted focuses mainly on the patient. It is important to understand the fact
that the mental health recovery model focus on the mental health improvement of the patient
pertaining to the maintenance of a holistic care giving approach (Mellor et al.,2013). In the
context of the case study, Chung can be provided aid based on the mental health recovery
model which would involve several characteristics ranging from the behaviour of the family
members to Chung to the language used by the people who stay in close association with
Chung throughout the day could help him in dealing with the mental stress and emotional
turmoil in a convenient manner. According to the guidelines laid down by the substance

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abuse and mental health administration (SAMHSA) the intervention to help the patients with
mental stress has been categorised under four following heads, that critically comprise of the
factors such as, community, home, purpose and health (Zannas & West,2014). Each of the
above mentioned domains are considered for promoting mental wellness to the patient
dealing with stress. Approaches that could be taken up in order to plan a quick recovery of
Chung would include administering care on the basis of the Developing Recovery Enhancing
Environments (DREEM) that would include, accessing the level of the recovery service and
carry out extensive research so as to develop better methodologies to improve the treatment
procedure. It must be also highlighted that thorough counselling sessions can be undertaken
in order to ensure that both Chung and his family members are enlightened about the
complexities that Chung is facing with regards to the status of his mental health and also
empowering them with the drastic effect of the prolonged manifestation of the symptoms.
Chung can be counselled by the Midwife on the basis of the specific information gathered
about his condition and accordingly mould his family members to be more compassionate
and understanding towards him so that he is able to cope up faster with the scenario and heal
at a speedy rate. Interventions could also include counselling the in-laws of Chung and
making them aware of the critical situation faced by their son-in-law and they could adapt
minimalistic changes in their daily activities by handing over Charlotte to her father after
Chung arrives home from duty and ensuring that Chung plays with his baby girl to his heart
content. This would ensure that Chung is satisfied with the quality time that he gets to spend
every day with his wife and his daughter. In addition with the above said, Chung could also
participate in certain mind-refreshing activities such as reading to his baby daughter or going
out with his family that would help him deviate his mind from work related stress and help
him in achieving mental satisfaction. Chung is at risk and it is important to prevent him from
entering into terminal depression and for that it is necessary to prevent his mind from

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developing suicidal thoughts and consequently instil the feeling of optimism and hope in him
so that he is able to overcome the feelings of being a worthless husband and an irresponsible
father and at the same time work on hope in order to feel loved and provide security to his
family. Depression or any other disorder related to mental instability is highly sensitive and
patients going through the process are unable to comprehend the scenario based on their
analytical ability and hence end up harming their own-self or developing suicidal tendencies,
hence it is important that appropriate steps are taken in order to focus on the mental health
well-being of patients like Chung who are stressed on grounds of many factors pertaining to
personal life or even professional life and are unable to voice their expressions and end up
feeling more miserable (Zannas & West,2014). It is important to ignite in them a feeling of
hope so that they are able to lead a decent standard of living.

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