Mental State Examination Case Study: Munny's Depression

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Contents
Question 1............................................................................................................................................1
Question 2............................................................................................................................................2
Question 3............................................................................................................................................3
References..........................................................................................................................................5
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Question 1
Mental state examination is the tool used to assess the mental state of the individual.
Li et al (2016), suggested that mental health examination is the tool can be used to
evaluate the mental health of the individual suffering from any of the mental issues or
illness. In given case Munny is being assessed for mental health issues as reported
by his wife. Recent interview with the employer and significant loss of mother in past
may have triggered some behavioural changes in the individual that has led to
mental sickness. Mental state examination consist of assessment of different
parameters that influence and impact mental health of the patient (Hungerford et al.,
2018). It is defined that mental health is the total expression of the person’s
emotional responses, mood, personality and cognition. The chief components of the
mental state examination include general appearance and behaviour, speech, mood
and affect, perception, thought, cognition, judgment and insight. The given case was
evaluated using this examination and the general appearance of Munny portrayed
different findings. The physical appearance of the patient including body build was
normal but the clothes that the patient was wearing were loose that indicated recent
loss of weight. Clothes appeared to be well maintained and appropriate, physical
health of Munny was reported to have been deteriorated since last some months. He
showed some disinterested mood by nodding the head and shooing his shoulders
when asked of certain things. Other factor that can be evaluated using mental state
exam includes speech. The speech of the individual determines his thought process
and comfort level with the clinician. In this case Munny used very short sentences
and monosyllabic in nature with use of single words. Speech is not spontaneous and
rapid in nature and the tone is also slurred. He also hesitates while speaking and
portrays discomfort while communication.
DSM-V is the guidelines for the diagnosis of different mental issues. This tool is
highly helpful in diagnosis of different issues that are related to human mental and
emotional health. The given case resembles the diagnostic criteria for depression
where Munny lost his mother 6 months ago and the recent insecurity regarding his
job has triggered her concerns and depressive moods. Depression is a common
serious mood disorder where the person may develop serious behavioural changes.
According to DSM V depression includes symptoms such as chronic pain, digestive
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issues, loss of interest and continuous feeling of sadness (Elder et al., 2011).
According to the guidelines to be diagnosed as clinical depression Munny must have
these symptoms for more than two weeks. The criteria involves experience of patient
including at-least five symptoms of depression listed in the guidelines and one of it
should be loss of interest or depressed mood for about two weeks period. To confirm
depression Munny has to have these symptoms for more than two weeks with its
impact of house, work, occupation, interest and daily routine. The symptoms may be
the result of significant life events or habits like substance abuse. In this case the
patient may be diagnosed of depression due to significant life events.
Question 2
Different situations cause individual’s mental health status to be significantly
impacted and this leads to mental issues and diseases. Stress, trauma and
significant events in past life can have a crucial impact on the vulnerability of the
individual to develop mental illness. The given case of Munny had certain aspects
that were identified as the triggers for development of the mental issues in his life
(Warner., 2010). The death of his father during the Roog and recent loss of his
mother to cancer plays important role in development of any mental sickness.
According to stress vulnerability model human carry some genetic and other
predisposition of mental issues. The model describes how stress impacts and
influences the development of mental issues. Stress is defined as the human
response to a disturbing factor in the environment and as a consequence of such a
reaction. Zannas & West (2014), indicated that stress vulnerability model shows how
the two areas of concern including biological vulnerability and stress are influenced
by several other factors that makes the individual vulnerable to mental issues. These
factors are alcohol, drugs, medication, coping skills, social support and activities.
The model briefly described how stress plays a major role in development of mental
issues. In case of Munny stress was evident as the job was of odd timing and was
stressful. Also recent loss of mother was well hidden by him in this course using
additional work as a point to divert him from the events. This excessive stress
caused Munny to develop certain behavioural issues that can be diagnosed and are
indicative of depression. Zubin (1977), described that the new parameter of mental
issues aetiology was identified to be vulnerability to stress and this was illustrated by
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the exogenous and endogenous challenges that elicit all the humans including
intensity to tolerate stress and threshold that if surpassed can lead to disorders.
Hence, in given case Munny also has existing past trauma of his father being shot
during the roog war and the images of losing his mother has produces the
cumulative effects on his mental state.
This model also suggests how the individual has a certain threshold towards stress
and different tolerability towards stress (Warner., 2010). Depending on this once this
threshold is broken the individual can undergo development of various mental
disorders and behavioural conditions. Residing in the refugee camp and thriving to
earn his living made Munny highly depressed and stressed in past with still not
surpassing his stress vulnerability threshold. Loss of his mother triggered this limit
and the recent interview with the employer that made him insecure regarding his job
in-spite of working hard and with passion made him loose his threshold and develop
some changes in behaviour and mood leading to mental disorder. Hence, it can be
concluded that in given case, father’s death at an early age, trauma due to
experiences of refugee life and recent loss of mother has altogether triggered his
emotional and mental state and caused some significant changes in his regular
mood and behaviour that is reported by his wife.
Question 3
Mental health recovery model is a holistic approach that is person-centered and
family oriented care model. This model has come into existence in recent past
decad4e and has gained momentum in mental health and care field. The model
wisely explains two important criteria that includes 1) it is possible to be recovered
from mental health issue and 2) the most effective recovery in mental health is
patient directed. The aim of this model is to ensure that people can recover from
mental illness to lead a fully satisfied life. Carpenter (2002), suggested that mental
health recovery should include four dimensions while supporting mentally sick
individual. Health, home purpose and community are the four aspects that need to
be addressed while providing mental health care. The mental health recovery
framework also includes principles of care which illustrated following guiding aspects
that are- self-directed, person-centred, empowerment, holistic, non-linear, strength
based, respect, responsibility and hope.
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Empowerment in mental health recovery model refers to giving control to the
individual. The model helps in recovery by empowering the individual in making real
choices and has control over their life. The model supports individual to make
decision based on their strengths and helps in taking responsibility of their lives as
much they can. It also maintains an adequate balance between duty of care and
support for the individuals to take positive risks and helps in making use of new
opportunities. Munny needs to be motivated to take up therapy and treatment to
enhance his decision making ability and allow him to be empowered for his own
decisions of life.
Dignity and respect is another crucial aspect of recovery model in mental health
care. This practice involves being courteous, respectful and honest in all interactions.
It indicates sensitivity and respect for every individual with compassion and empathy
in service delivery (Slade., 2009). The values and beliefs of the individual are
secured. Munny requires to be respected as his recent interview with employer
somewhere instigated his trauma and depressive mood that turned into mental issue
and behaviour changes. Respect and dignity are considered as main principles of
recovery model. The mental health patients are mostly deprived of respect and care
from society and others. Little effort to provide care and respect that fosters their
dignity and allows positive recovery of the patient.
Hope according to Leamy (2011), is considered as another crucial element in mental
health recovery model. When a person is not having any hope to life his mental
health starts to deteriorate further but with some sense of hope and ability to have an
optimistic vision for life helps in recovery of the mentally sick individual. Murry also
has experienced certain events in his life that has affected his vision for living and
hope that life is a better choice. These aspects will help in delivery of patient centred
and family oriented care for this patient.
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References
1. Carpenter, J. (2002). Mental health recovery paradigm: Implications for social
work. Health & Social Work, 27(2), 86-94.
2. Elder, R., Evans, K., & Nizette, D. (2011). Psychiatric & Mental Health
Nursing-E-Book. Elsevier Health Sciences.
3. Hungerford, C., Hodgson, D., Bostwick, R., Clancy, R., Murphy, G., Jong, G.,
& Ngune, I. (2018). Mental Health Care.
4. Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2011).
Conceptual framework for personal recovery in mental health: systematic
review and narrative synthesis. The British Journal of Psychiatry, 199(6), 445-
452.
5. Li, H., Jia, J., & Yang, Z. (2016). Mini-mental state examination in elderly
Chinese: a population-based normative study. Journal of Alzheimer's Disease,
53(2), 487-496.
6. Slade, M. (2009). Personal recovery and mental illness: A guide for mental
health professionals. Cambridge University Press.
7. Warner, R. (2010). Does the scientific evidence support the recovery
model?. The Psychiatrist, 34(1), 3-5.
8. Zannas, A. S., & West, A. E. (2014). Epigenetics and the regulation of stress
vulnerability and resilience. Neuroscience, 264, 157-170.
9. Zubin, J., & Spring, B. (1977). Vulnerability: a new view of schizophrenia.
Journal of abnormal psychology, 86(2), 103.
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