Western Sydney University: Mental Health Case Study Report

This report analyzes a mental health case study involving a woman experiencing anxiety and depression related to a second pregnancy, financial stress, and past complications. The analysis includes a Mental Status Examination (MSE) to assess the patient's cognitive and psychological status, revealing symptoms consistent with depression based on DSM-V criteria. The report applies the stress vulnerability model and trauma-informed care to identify contributing factors, such as stress and past traumatic experiences during her first pregnancy. It then explores recovery strategies, emphasizing respect, hope, and empowerment to promote the patient's mental health recovery, highlighting the importance of therapeutic relationships and support systems. The report references various studies to support its findings and recommendations.

Running head: MENTAL ILLNESS
MENTAL ILLNESS
Name of Student:
Name of University:
Author’s Note:

1MENTAL ILLNESS
Answer number 1.
The case study is related to Lucinda Okiro, who was undergoing anxiety and depression
for which she was presented for a mental health assessment to perinatal mental health service
with her daughter Emily. The main area of concern for the Lucinda is the feeling of fear and
anxiety related to her second pregnancy. She is frightened that she will become pregnant because
they have a financial crisis and have to leave her studies for the sake of the unborn child. She is
also worried as her first pregnancy had many complications and she is facing many challenges in
the taking care of the Emil, and hence she does not have any idea how she manages the care plan
for her second child. Due to such circumstance, she is worried for her husband as he has to work
for the whole day in the supermarket along with his studies and the second child can create more
financial burden. Therefore, there is the need to assess the mental status of the patient, and for
this mental health, the examination has been employed. MSE is the most widely used test to
examine the cognitive and psychological status of the client.
The main component of the MSE are appearance and behaviour, mood, affects, thought
content, perception, judgement and insight (Srinivasan & Sembian, 2019). Looking at the
appearance of Lucinda, she appeared to be fine. Various indication related to the impairment of
mood was noticed in Lucinda as she felt lonely, anxious, frightened, worried and unhappy
because of her second pregnancy. The two-component of MSE that is found in the account of
Lucinda case are mood and affects. She was in the state of Dysphoric and showed signs of
depression. It is referred from the study of Grover and Kate (2017) that feeling of the anxiety,
lonely and upset are some of the common symptoms for the mental disorder and mood
impairment. She was in the state of the bad mood, which made her unmotivated to get out of the
bed, and she feels worse as she is not able to provide adequate care to her child. From the study

2MENTAL ILLNESS
of Gaviria et al. (2019), it is understood that women who score more than 9 in the EPDS are
suffering from depression or mental disorder. It is also evident from the case study that Lucinda
scored 12 in the Edinburgh perinatal depression, which itself proves that she is affected by
dysphoric.
It is noted that Lucinda has to drop her studies, and she is worried about her plan due to
second pregnancy; she is at the risk of developing depression which can be ensured with DSM-V
criteria. According to the criteria of DSM-V, the person with depression must show following
minimum five symptoms for more than one weeks, depressed mood, loss of interest, weight
loss/gain, insomnia, fatigue, psychomotor agitation, guilty, worthless, low concentration and
thought of suicide (Florence et al., 2015). Out of the above DSM-V criteria, Lucinda was found
to show poor interest in activities, depressed mood, guilty for being pregnant and feeling of
worthlessness. As she also felt lonely, and it is evident, it is the primary cause of fear and
anxiety, which confirms that she is at the risk of depression and dysphoric.
Answer number 2.
Stress vulnerability model is a useful model to recognize and treat relapse of the mental
illness. It is used to find the kind of stress and its impact on the life of the person concerning its
coping skills and daily social life which lead to mental illness (Ménard et al., 2017). Trauma-
informed care is a treatment framework and organizational structure that include understanding,
responding and recognize the impact of the trauma. It also takes into account the physical,
emotional and psychological safety of the client and caregiver (Raja et al., 2015). Therefore, to
assess the contributing factor for the status of mental health of Lucinda, these two models are
applied to understand the reason behind it.

3MENTAL ILLNESS
The first contributing factor which has led to a sign of depression is related to the stress
that Lucinda experience in her life. It is evident from the case study that she is stressed because
of the thoughts how she would be able to take care of her child, there is no external support to
assist her, and she also has a financial crisis. Due to the high-stress level of Lucinda, she has
become vulnerable to develop mental illness as it is also noted that she has lost interest in living
activities and felt loneliness. According to the study of Babenko, Kovalchuk and Metz (2015), it
is noted that stress is the one of the main potent reason for developing mental illness and disorder
as it impairs the cognitive thinking ability. As a consequence of this, the person can felt
worthlessness and become worried about the future life. Thus, stress can lead to mental illness.
Another contributing factor identified by the use of trauma-informed care is an episode of
trauma that Lucinda has experienced at her first pregnancy which proceeded to her second
pregnancy. It is witnessed in the case study that she had undergone a traumatic event in her life
when she had a complication during the first pregnancy. Lucinda has experienced prolonged
labour for 12 hours, and the birth of Emily was done with Forcep extraction method. This has
left her with pain, trauma and poor physical health. She needs time to overcome such episode of
trauma and to be physically ready for second child. It is evident from the study of Stramrood and
Slade (2017) labour pain in women is a traumatic experience which makes them frightened to
undergo the same process. She is worried and stressed for her second pregnancy which has
made her depressed and anxious. Therefore, there is a need to provide practical strategies to help
Lucinda overcome her traumatic experience.
Answer number 3.
Factors contributing to the mental health recovery of Lucinda.

4MENTAL ILLNESS
To promote mental health recovery in Lucinda three positive aspect of respect, hope and
empowerment can be utilised. As Lucinda is suffering from stress, depression and anxiety, it is
essential for her to give respect and hope so that she can better cope with the mental trauma.
When mental health care professional interacts with Lucinda, it is essential to show respect in the
way of communication. This will make her feel worthy and valued. It is evident from the finding
of Chadiha et al. (2017) giving respect to the client, makes them feels valued, which bring
positive outcome in both mental and physical health. Thus, when she expresses her area of
concern, it is crucial to listen and act non-judgementally and response positively. This help to
build a good therapeutic relationship with the client as he also gains trust in the process of
treatment (Rees et al., 2016). The caregiver needs to behave professionally in order to address
the concern and mental instability of the patient. Thus, through giving respect, Lucinda can
recover faster from the state of mental illness.
It is evident from the case study that she is frightened and fear for becoming pregnant for
the second time as initially, she has undergone massive trauma related to stress, pain and
complication. At this point in time, she has appeared to be mentally weak for giving birth to the
second child with a gap of only eight months. From the study of Grealish et al. (2017), it is seen
that empowering women is the most crucial factor that helps them to become mentally stable and
recover faster from mental illness. Thus, empowering Lucinda for second child, will make her
confident and develop self-esteem that will make her mentally ready and strong for the second
child. This can be achieved not only through the health care professional but also with the
support of family and friends. This will help to build positive thought for her second child and
release stress and anxiety related to future need (Read & Laschinger, 2015). The recovery model

5MENTAL ILLNESS
of mental illness also states that empowering the client help to build resilience and optimistically
handle the stress level.
Hope can also play a crucial role in lowering her depression level and promote faster
recovery. From the research of Anderson et al. (2015), it can be inferred that hope is such a tool
that helps to create a sense of responsibility for life. Lucinda is worried regarding how would she
care of her second child when she is unable to provide adequate care to Emily. There is no one to
give external support to Lucinda to ease her living and care for her family. She has to handle
alone the tough situation which has left her with a feeling of loneliness and depressed (Ekas,
Pruitt & McKay, 2016). Therefore, giving hope for a better life with the suggestion to cope with
stress can help her to recover fast from mental issue. It is the role of the nurse to provide positive
hope to the client that will help to build confidence and become self-reliant for a healthier future.

6MENTAL ILLNESS
Reference
Anderson, K. N., Jeon, A. B., Blenner, J. A., Wiener, R. L., & Hope, D. A. (2015). How people
evaluate others with social anxiety disorder: A comparison to depression and general
mental illness stigma. American journal of orthopsychiatry, 85(2), 131.
Babenko, O., Kovalchuk, I., & Metz, G. A. (2015). Stress-induced perinatal and
transgenerational epigenetic programming of brain development and mental
health. Neuroscience & Biobehavioral Reviews, 48, 70-91.
Chadiha, L. A., Ingersoll-Dayton, B., Dunkle, R. E., & Balestrery, J. E. (2017). Forms and
Meanings of Respect: Aging Mothers and Adult Daughters with Mental Illness. Families
in Society, 98(4), 319-327.
Ekas, N. V., Pruitt, M. M., & McKay, E. (2016). Hope, social relations, and depressive
symptoms in mothers of children with autism spectrum disorder. Research in Autism
Spectrum Disorders, 29, 8-18.
Florence, C., Emmanuelle, L., Florence, B. L., Mathilde, H., & Viviane, K. M. (2015).
Bereavement-related depression: Did the changes induced by DSM-V make a difference?
Results from a large population-based survey of French residents. Journal of affective
disorders, 182, 82-90.
Gaviria, S. L., Duque, M., Vergel, J., & Restrepo, D. (2019). Perinatal depressive symptoms:
Prevalence and associated psychosocial factors. Revista Colombiana de Psiquiatría
(English ed.), 48(3), 166-173.

7MENTAL ILLNESS
Grealish, A., Tai, S., Hunter, A., Emsley, R., Murrells, T., & Morrison, A. P. (2017). Does
empowerment mediate the effects of psychological factors on mental health, well‐being,
and recovery in young people?. Psychology and Psychotherapy: Theory, Research and
Practice, 90(3), 314-335.
Grover, S., & Kate, N. (2017). Unit-2 Steps In Mental Health (Status) Assessment. IGNOU.
Ménard, C., Pfau, M.L., Hodes, G.E. and Russo, S.J., 2017. Immune and neuroendocrine
mechanisms of stress vulnerability and resilience. Neuropsychopharmacology, 42(1),
p.62.
Raja, S., Hasnain, M., Hoersch, M., Gove-Yin, S., & Rajagopalan, C. (2015). Trauma informed
care in medicine. Family & community health, 38(3), 216-226.
Read, E. A., & Laschinger, H. K. (2015). The influence of authentic leadership and
empowerment on nurses’ relational social capital, mental health and job satisfaction over
the first year of practice. Journal of Advanced Nursing, 71(7), 1611-1623.
Rees, S. J., Tol, W., Mohammad, M., Tay, A. K., Tam, N., Dos Reis, N., ... & Silove, D. M.
(2016). A high-risk group of pregnant women with elevated levels of conflict-related
trauma, intimate partner violence, symptoms of depression and other forms of mental
distress in post-conflict Timor-Leste. Translational psychiatry, 6(2), e725.
Srinivasan, P., & Sembian, N. (2019). Knowledge on MSE (Mental Status Examination) Among
Nursing Students. Research & Reviews: Journal of Medicine, 6(1), 1-4.

8MENTAL ILLNESS
Stramrood, C., & Slade, P. (2017). A woman afraid of becoming pregnant again: Posttraumatic
stress disorder following childbirth. In Bio-Psycho-Social Obstetrics and
Gynecology (pp. 33-49). Springer, Cham.