CNA256 Mental Health: A Case Study Analysis of Mental Health Recovery

This case study analysis focuses on Annabelle, a 22-year-old suffering from mental trauma affecting her physical health and social life. The essay discusses the mental health recovery concept, emphasizing the primary issues related to her condition, including dropping out of university, social isolation, and hallucinations. It explores the Mental Status Examination (MSE) tool and its application in assessing Annabelle's speech, cognitive skills, and thought patterns. The analysis integrates the five domains of recovery and complementary approaches like WRAP, DREEM, and Recovery Star. The essay further analyzes issues such as anxiety, dietary status, emotional turmoil, and walkabouts, proposing interventions to reinforce mental health and wellbeing. The importance of understanding the severity of her mental health condition is emphasized to guide appropriate medical and mental interventions.

Running head: MENTAL HEALTH ASSIGNMENT
MENTAL HEALTH ASSESSMENT CASE STUDY ANALYSIS
Name of the Student
Name of the University
Author note

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Introduction
Mental health is the most integral part of a healthy human life, however, on account of
social stigma, it is still being ignored by people (Bockting et al. 2012). Mental health affects
more than one third of the world population and majority of these belong to younger generation
(World Health Organisation, 2018). As per the data collected from Australian Bureau of
Statistics (2018), every one in seven Australians within the age of 4-17 years suffer from mental
health condition and is the statistics from 2013 to 2014 is considered, more than 560,000 people
were found to combat of suffer from mental health condition. In this case study analysis,
discussion about Annabelle (22) who is suffering from mental trauma due to which her physical
health and social life both are being affected. Her continuous deterioration of health, social life,
and mental stability has evoked self-harm tendencies and she is unable to communicate even
with her parents to discuss about her mental and physical health. Therefore, this essay would be
discussing the mental health recovery concept with respect to condition of Annabelle and then
will emphasize the main issues related to her mental health condition. Further, discussion about
the assessment method of mental health for example the Mental Status Examination will be
discussed for Annabelle. Finally, using relevant and credible evidences, her mental state
recovery and strategies to engage with such patient so that recovery could be achieved.
Primary issues identified in case of Annabelle
Recovery in mental is different from the physical health recovery as in mental health it
does not refer to the complete recovery from the mental health issues (Moran et al. 2013). In
mental health recovery, it is associated with controlling the stress and tension related situations
of their lives so that they can overcome their environmental or situational stress without falling

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pray to it and hampering their physical health and mental peace (Williams et al. 2012).
Therefore, recovery is associated with Resilience of the patient from his/her mental health
condition and then provide them with supportive recovery and interventions so that such
stressors cannot affect their mental health condition (Matthias et al. 2012).
In case of Annabelle, her situation was uncontrollable by her parents and while
communicating with her mother, I was able to understand her situation while managing and
caring for Annabelle and her mental trauma. While communicating with Annabelle’s mother, I
was able to figure out the first stress or traumatic situation Annabelle faced when she dropped
out of her university in which she was studying as a nursing student. This could affect her mental
strength and made her vulnerable to forthcoming situations. She isolated herself from her
parents, her friends, her relatives and confined herself in her room with loud music as well as
refused every chance if discussion, her parents offered her so that she can overcome her stress.
Further, the second issue identified in her mental health condition was being aloof to social
norms and etiquettes which could be understood from her ‘walkabouts’. Annabelle’s mother
informed that she leaves her home very rarely, however when she leaves, she comes back after
days which indicates that she has lost her emotional connection to her parents and is careless
about social norms. The third issue identified was related to hallucinations which affected the
mental health of the patient badly and she was unable to come out of her hallucinated world.
While caring for patients with mental issues, it was mentioned that there are 5 domains of
recovery. According to which, the assessment of mental health and interventions are strategized
so that it could be applied on the patient (Moran et al. 2013). These 5 domains are as follows:
1. promoting language of hope and cultural optimism

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2. providing holistic care and keeping the person’s good first
3. supporting the patients personal recovery
4. understanding the workforce development and organizational commitment
5. acting for social inclusion and advocating about social determinants of health,
mental health as well as wellbeing (Williams et al. 2012)
It is an important step to implement these five domains in the care process for Annabelle
as it will help to develop an evidence informed, therapeutic, and psychosocial as well as
rehabilitation issues so that the aim of achieving the mental health and wellbeing for the patient
could be done (Killaspy et al. 2012). However, as Annabelle has lost all of her emotional and
mental connection to her family members and her relations, she should be provided with a
complementary approach of recovery so that achievement of positive results for the patient could
be obtained (Matthias et al. 2012). These approaches are WRAP or Wellness Recovery Action
Planning, DREEM or Developing Recovery Enhancing Environments Measures, Recovery Star
or Good practices. These tools are comprises of complementary approaches which determines
the application of interventions on the patients so that patients and her mental wellness could be
achieved (Moran et al. 2013). Within these, the Tool, WRAP is associated to program facilitatory
recovery which enables the patient undergo several activities which reinforces the critical
thinking and positivity in the patient that enables her to connect to the society and recover from
her stress and traumatic conditions. Whereas, DREEM is a complementary approach in which
the tool collects the patient data before and after the implementation of mental health
intervention is collected and depending on that the achievement of target is determined (Killaspy
et al. 2012). Further, Recovery star is the tool which enables the patients to assess their own
recovery from their previous state so that they can put more effort to achieve recovery for their

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wellness. However this tool only could be applied after successful implementation of WRAP and
DREEM. Therefore, if the recovery model is to be applied in case of Annabelle, it should be
applied from these three above-mentioned approaches so that goals for Anabelle could be
achieved (Williams et al. 2012).
Main issues in relation to MSE
MSE or mental status examination tool is a primary and essential tool which helps the
mental healthcare physicians to understand the psychiatric disorder by diagnoses process and
then evaluate it for the betterment of the patient (Cumming et al. 2013). This MSE report is
inclusive of past medication reports and the present observations made by the physicians while
encountering patient within mental healthcare facility (Feng et al. 2012). This assessment is
generally carried out when the case study of patient is not properly fit into standard cases and
when symptoms indicate more complexity (Sakamoto et al. 2012). In this case Annabelle is
suffering from sensory deprivation, isolation, and has lost her social and emotional connect to
society as well as her family and increased her rebellious tendencies by piercing her entire face.
Therefore, as per the MSE tool, the assessment should be inclusive of questions so that her
speech, cognitive skills, general principles, psychomotor behavior, level of consciousness,
thought patterns and mood and affect (Sakamoto et al. 2012). All these are the factors which
should be used in the MSE tools so that all the questions and regarding informations could be
gathered from the MSE form.as per this tool, my primary role will be observing the body
appearance, clothing, grooming and hygiene level of the patient as well as the facial expression
and eye contact she makes while communicating with me (Feng et al. 2012). Further, under
psychomotor behavior, primary observation will be related to her abnormal body movements,
postures, rate of movement, and gait so that her motor sensory could be assessed (van Steenoven

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et al. 2014). Along with this, under speech related aspect, her rate and flow of speech with clarity
and liveliness or the intensity of the volume will be used and assessed (Cumming et al. 2013).
Finally, the MSE tool will also assess the rate and attitude of the patient while communicating
with the nursing professional and the anxiety level she had while sharing her personal experience
she had while discussing about her health condition to the nurse (Feng et al. 2012).
There are several other aspects of the mental status examination tool which assesses the
patient’s thought patterns and level of cognition while discussing her health condition with the
healthcare physician or the nursing professional (J Larner 2012). Hence, I will also implement
both these in case of Annabelle. Presence of clarity in her thought, level of logic or relevance to
the practical world will be assessed and flow of these aspects will be noted, whereas, under
cognition level, her memory, attention and concentration while communicating her story,
judgment about any situation and orientation of mood will be assessed (van Steenoven et al.
2014). These aspects are helpful in determining the severity of her mental status which can affect
her physical wellbeing as well (Feng et al. 2012). In this aspect it should be mentioned that as
Annabelle is stressed and traumatized, reacting to every action or sound made by healthcare
professionals, undertaking MSE will be a difficult task in this case, however this will be
implemented in the case study of Annabelle so that the primary reason and the symptoms could
be assessed with clarity and relevance (J Larner 2012). Further this will be integrated in the case
of Annabelle after making herself comfortable in the environment of healthcare facility and if the
environment of the ward is distracting herself from answering all the questions, she will be
shifted to another ward where no such distractions will be present as in presence of distractions
her mental health could not be assessed properly (Sakamoto et al. 2012). Further, application of
MSE and gathered reports will be used to implement strategies and interventions so that the

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mental health and wellbeing could be reinforced in case of Annabelle (van Steenoven et al.
2014).
Analysis of issues relating to mental health
This is the step which determines the medical and mental interventions Annabelle
requires for her treatment and wellbeing. As per Zeidner, Matthews and Roberts (2012), prior to
implement the mental intervention on patient condition her severity of the mental health
condition should be properly understood. This helps the nursing as well as healthcare
professional to understand the degree of intervention and the duration of it requires to make the
patient recover from her stigmas and face her mental conditions with courage (Sakamoto et al.
2012). The first issue, which should be targeted as per the registered nurse, caring for Annabelle
is her anxiety and stress while communicating with people as she was continuously sweating and
wringing her hands. It determines that she is not confident about herself and fears to
communicate with people. Due to this fear she prefers to confine herself in her room, away from
people and voices that reminded of her connection with people such as her parents. This is an
important issue as if the healthcare physicians can increase the confidence within the patients
suffering from mental issues, the chances of recovery increases. The second issue which will be
chosen for analysis is her food and dietary status as her mother mentioned that she has no
appetite and does not consume food or fluid for days (van Steenoven et al. 2014). Besides her
emotional turmoil is another issue to be discusses as she suddenly breaks down into tears and
blames everything on herself. Further, her walkabouts and staying away from her home for days,
coming back with untidy clothes and appearance also indicated towards the severity of mental
state as Kapur, Phillips and Insel (2012) mentioned that such state indicate that people suffering
from mental health has lost their emotional connect to relationships and people who care for

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them which is an important pillar to live life. Therefore, all these aspects with respect to recovery
domains and mental state examination tool should be discussed in this case study of Annabelle.
Conclusion
Mental health is the aspect of health which creates a balance of physical health and
wellbeing and disruption of which severely affects the physical wellbeing and mental stability
making the person suffer from difficult situations. World health organization has also mentioned
that without achieving complete mental wellness, it is impossible to achieve complete holistic
wellbeing. In this case study, discussing about one such situation was conducted on which
Annabelle, a 22 year old girl was suffering from severe mental health condition, which made her
isolated and away from her friends, family, society and affected her mental state in such a way
that she started hallucinating voices and visualizing people. This essay identified the primary
issues in light of recovery concepts and domains and then discussed the MSE tools and aspects
which could be used to determine the effects of the mental trauma she was suffering from.
Finally conduced and presented issues which could be analyzed for interventions to recover
Annabelle from such mental condition.

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References
Australian Bureau of Statistics 2018. Mental Health - Australian Bureau of Statistics. [online]
Abs.gov.au. Available at: http://www.abs.gov.au/Mental-Health [Accessed 3 Jan. 2019].
Bockting, W.O., Miner, M.H., Swinburne Romine, R.E., Hamilton, A. and Coleman, E., 2013.
Stigma, mental health, and resilience in an online sample of the US transgender
population. American journal of public health, 103(5), pp.943-951.
Cumming, T.B., Churilov, L., Lindén, T. and Bernhardt, J., 2013. Montreal Cognitive
Assessment and Mini–Mental State Examination are both valid cognitive tools in
stroke. ActaNeurologicaScandinavica, 128(2), pp.122-129.
Feng, L., Chong, M.S., Lim, W.S. and Ng, T.P., 2012. The Modified Mini-Mental State
Examination test: normative data for Singapore Chinese older adults and its performance in
detecting early cognitive impairment. Singapore Med J, 53(7), pp.458-62.
J Larner, A., 2012. Mini-Mental Parkinson (MMP) as a dementia screening test: comparison
with the Mini-Mental State Examination (MMSE). Current aging science, 5(2), pp.136-139.
Kapur, S., Phillips, A.G. and Insel, T.R., 2012. Why has it taken so long for biological psychiatry
to develop clinical tests and what to do about it?. Molecular psychiatry, 17(12), p.1174.
Killaspy, H., White, S., Taylor, T.L. and King, M., 2012. Psychometric properties of the mental
health recovery star. The British Journal of Psychiatry, 201(1), pp.65-70.

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Matthias, M.S., Salyers, M.P., Rollins, A.L. and Frankel, R.M., 2012. Decision making in
recovery-oriented mental health care. Psychiatric Rehabilitation Journal, 35(4), p.305.
Moran, G.S., Russinova, Z., Gidugu, V. and Gagne, C., 2013. Challenges experienced by paid
peer providers in mental health recovery: a qualitative study. Community Mental Health
Journal, 49(3), pp.281-291.
Sakamoto, Y., Ebihara, S., Ebihara, T., Tomita, N., Toba, K., Freeman, S., Arai, H. and Kohzuki,
M., 2012. Fall prevention using olfactory stimulation with lavender odor in elderly nursing home
residents: a randomized controlled trial. Journal of the American Geriatrics Society, 60(6),
pp.1005-1011.
van Steenoven, I., Aarsland, D., Hurtig, H., Chen‐Plotkin, A., Duda, J.E., Rick, J., Chahine,
L.M., Dahodwala, N., Trojanowski, J.Q., Roalf, D.R. and Moberg, P.J., 2014. Conversion
between mini‐mental state examination, montreal cognitive assessment, and dementia rating
scale‐2 scores in Parkinson's disease. Movement Disorders, 29(14), pp.1809-1815.
Williams, J., Leamy, M., Bird, V., Harding, C., Larsen, J., Le Boutillier, C., Oades, L. and Slade,
M., 2012. Measures of the recovery orientation of mental health services: systematic
review. Social Psychiatry and Psychiatric Epidemiology, 47(11), pp.1827-1835.
World Health Organization 2018. Mental Health. [online] World Health Organization. Available
at: https://www.who.int/mental_health/en/ [Accessed 3 Jan. 2019].
Zeidner, M., Matthews, G. and Roberts, R.D., 2012. What we know about emotional intelligence:
How it affects learning, work, relationships, and our mental health. MIT press.

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