Mental Health Case Study: Justin O'Dowd's Journey and Analysis

This case study analyzes the mental health journey of Justin O'Dowd, an Aboriginal man, exploring the impact of his cultural background, life events (including the loss of his uncle and the onset of T2DM), and social implications on his mental well-being. The study examines the student's personal perceptions of mental illness, the knowledge and skills required for effective nursing interventions in an emergency department setting, and the importance of self-awareness in nursing practice. It further discusses the cultural safety considerations, the application of mental health assessment tools, and the development of a culturally competent care plan. The assessment also covers the care pathway from initial assessment to discharge, reflecting on the student's professional development as a future Registered Nurse and emphasizing the significance of patient-centered care and holistic approaches to improve patient outcomes.

Running Head: CASE STUDY ON MENTAL ILLNESS
CASE STUDY ON MENTAL ILLNESS
Name of the Student
Name of the University
Author Note

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1. I’m born in a typical Chinese family where my great grandparents who originally came from
China but migrated to Malaysia years ago. Due to my parent’s failure in their relationship, my
mom had to raise my siblings and me without the support of her husband because he was a
violent, alcoholic and selfish person. Therefore, all the burden and stress are often on mom. My
eldest brother and I were raised by our strict mom, which runs in the family for generations,
while my youngest brother was raised by a nanny which spoiled and turned him into a stubborn
child. In most Chinese cultures, younger generations aren’t allowed to reply defiantly to elder
people. They believe it’s a sign of challenge and disrespect because they think that elder people
have survived with tougher experiences than we do. From my memory, my eldest brother and I
were often being blamed and caned by mom whenever our youngest brother had done something
wrong which triggered mom’s temper and stress. Thus, we couldn’t deny and escape mom’s
assumption because the punishment will be doubled if we were being disrespectful. The only
way we could think to calm her is by taking the blame of our youngest brother and admitting that
it was ours. Furthermore, mom has high expectations in her children in terms of academic and
co-curricular activities. At some point, she sometimes contradicts herself and denies the
statement she’d made depending on her mood. Therefore, my siblings and I must always observe
her mood before starting a conversation with her. From my experience, I somehow believe that
her symptoms are most likely linked to bipolar disorder.
2. The similarities of Justin’s and my perception of mental illness towards my mom is that both
mental illnesses come from excessive stress. In Justin’s case, he limits himself because he feels
hopeless whenever he believes that he will have the same outcome of complications from T2DM
like his dad. However, my mom has no limitations to herself in pursuing her goals in life.
Instead, she seizes the opportunity to transform and allow herself to enter a whole new level of

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achievement. Furthermore, the next similarity of both developments of stress which leads to
mental illness is related to the family. Mental Illness had occurred in my mom because she hasn’t
got any financial and mental support from her spouse, in raising her children and allowing them
to have the best in life. Justin had indicated that he had too many concerns when he mentioned
he’s “constantly thinking how bleak his future is” and what hope he has if his aboriginal health
worker parents cannot handle his dad’s diabetes.
3. Knowledge and skills that are required to effectively work with Justin to de-escalate the risk if
he was present in the Emergency Department are to keep calm and keep patients and families
informed of the reason of waiting or delaying, listen and talk to patient to seek clear contribution
to their care, explaining actions and providing reassurance, involve their trusted friends or family
and anticipate their needs, stated (Mental Health for Emergency Department, 2009).
Every healthcare professionals including nurses must involve the patient in effective
communication in order to communicate with them and understand their concerns. According to
the Nursing and Midwifery Board of Australia standard, a nurse must communicate effectively
with the patient to facilitate patient centered approach to care (Nursingmidwiferyboard.gov.au,
2019). Nurses and other health professionals working in this area often finds it a challenge to
communicate with the Aboriginals because of the language barrier. To eradicate the possibility
of such challenges faced by both the Medical professionals and the patients, an interpreter can be
hired with the responsibility to interpret the words said both by the patient as well as the doctor
in order to facilitate an effective communication.
The nurses and the medical professions must be culturally competent and have skills and
knowledge about the culture to ensure cultural safety of the patients. Every nurses and medical

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professionals must be aware of the patient’s cultural concerns and treat them by accessing their
need and the treatment they are expecting or seeking for.
Considering the current health status of Justin, nurses should conduct health assessment,
especially mental health examination (MHE) by recording his mental capacity and analyze his
cognitive capacity to interpret his condition. Nurses and other health professions must possess
the appropriate skill set required to manage these patients. The vital signs recorded should
clearly and comprehensively understood by the professionals to access his current health
condition and carry out the necessary intervention strategies to treat his condition and deliver
quality care.
4. Development of self-awareness can impact on nursing practice because it is known as a
therapeutic tool to develop a relationship between the nurse and the patient (Subia, 2015). To
intensify a therapeutic environment of caring, nurses would have to increase their self-awareness.
Self-awareness could influence us in different ways and reflect on how our attitude and belief
impact others. To understand and analyze the similarities and differences of another individual, it
is important to first comprehend awareness of our own life (Subia, 2015). Moreover, caring for
people with mental illness is about promoting positive relationships with patients who are
different. (Eckroth-Bucher, 2010).
5. Throughout my readings, I have noticed a life event that had remarkably impacted on Justin’s
mental health which was the loss of Uncle Reggie and the presence of T2DM in him. Justin had
certainly looked up to Uncle Reggie when he described his uncle as his father and teacher in the
“Aboriginal way”.

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Depression is one of the most prevalent health comorbidities involved in diabetes (Ducat
Philipson & Anderson, 2014). Diabetes causes serious mental distress like depression, anxiety
and stress. Patients with diabetes face a number of challenges both in terms of physical and well
as mental aspects. Studies have shown that individuals with diabetes both type 1 and 2 are at an
increasing rate of depression and also eating disorder. Mental health comorbidities of diabetes
increases the risk of both short term as well as long term complications leading to severe
conditions like stroke, heart diseases, decreased quality of life, impaired kidney function, and
also premature death (Ducat Philipson & Anderson, 2014).
6. The social and cultural implications for Justin is that he will be leaving his home and
community to proceed for the assessment and treatment in the city that restricts him from being
able to meet and speak to his family and community who shares common values and belief,
while the examination is in progress. Justin then felt that he misses his family and wishes to
return home as soon as possible.
Justin also reported that he must have done something wrong for what he is always told
that he is depressed and must be admitted to a medical ward for crazy people. He stated that he
has feelings of guilt and admitted that he had done something bad in an Aboriginal way and that
is why he has been punished. He grieves about Uncle Reggie’s death and also has feelings of
anger as his uncle left his family. Upon diagnosis, when he was found to have diabetes, he felt
bad as he cannot care for his family who were dependent on him. Justin, was found to be silent
most of the time during an interaction and he mentioned concepts from an Aboriginal
perspective.

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7. Nurses must ensure that Justin receives an enhanced and quality care irrespective of his culture
and socio economic status. The nurses and medical professions must carry out an effective
communication to address and access both physical as well as mental needs of Justin.
Communicating effectively with patients helps in comprehensive analysis of the patient’s health
condition to aid in the delivery of quality care services to get an improved health outcome. Justin
must be given culturally competent care to ensure cultural safety and lead to an improved health
outcome. Intervention strategies to enable an effective delivery of cultural competent care
includes involving patient and family in the care service planning, person and patient centered
care, holistic approach to care, involving multidisciplinary team in the care process and by
aligning with the ethical considerations and nursing standards in order to facilitate the delivery of
an enhanced and quality nursing care. Nurses and healthcare professionals should respect the
patient’ autonomy by respecting his or her concerns, preferences, beliefs and culture and should
no way involve in any action that will breach these standards and guidelines.
8. From the information in the Mental Health Assessment and Mental State Examination, the
identified areas of concern include withdrawal of social activities which requires encouragement
and suicidal thoughts which requires counselling and attention to talk about his feelings and
prevent reoccurrence.
Through Mental Health Examination, Justin’s current mental state was accessed by a
comprehensive cross sectional analysis to understand and analyze his domains of behavior,
mood, appearance, perception, cognition, speech, thought process and insight by accessing a
combination of historical, biographical and psychiatric history thereby allowing the clinician to
make an accurate and appropriate diagnosis of the condition. The objective data identified were
unwilling to communicate, not feeling to participate in anything, pessimism, depression, suicidal

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thoughts, feeling of guilt and hopelessness. The subjective data recorded and analyzed were poor
eye contact, a low involvement of psychomotor movement and slow and cumbersome gestures.
9. From the initial assessment to discharge back to Justin’s community, I can identify that the
care pathway was effective as I have observed a major change in Justin’s behavior. Justin’s
mood was improved and he denies any suicidal thoughts. He wishes to return back to his home
and hopes to return to his old job. His appetite was improved and he appeared to be realistic in
his outlook and future planning.
10. From Justin’s scenario, I have covered more in-depth in approaching cultural safety, mental
health, values and beliefs of the Indigenous that will subsequently reflect on my professionalism
as a Registered Nurse in the future. I have learnt that the Aboriginals patients, who are suffering
from mental illnesses like that of Justin, must be given quality care by understanding and
accessing their issues and concerns in order to deliver an enhanced care. Every healthcare
professionals must practice within the framework of patient centered care and holistic approach
to enable the delivery of high quality care and hence improved patient’s health outcome (Durey
et al., 2016).
I believe that every health care professionals including nurses must possess the core
competencies while delivering quality care to the patients. Cultural competent nurse can access
both the physical and mental needs of the patients through comprehensive analysis to lead to an
improved health outcome and eventually increase patient’s satisfaction.

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References
Ducat, L., Philipson, L. H., & Anderson, B. J. (2014). The mental health comorbidities of
diabetes. Jama, 312(7), 691-692.
Durey, A., McEvoy, S., Swift-Otero, V., Taylor, K., Katzenellenbogen, J., & Bessarab, D.
(2016). Improving healthcare for Aboriginal Australians through effective engagement
between community and health services. BMC health services research, 16(1), 224.
Eckroth-Bucher, M. (2010) Self-Awareness: A Review and Analysis of a Basic Nursing
Concept. Advances in Nursing Science Vol. 33, No. 4, pp. 297–309
Mental Health for Emergency Departments (2009). A Reference Guide. NSW Department of
Health, Sydney. Retrieved from
http://www.cena.org.au/wp-content/uploads/2014/10/pub-emergency.pdf
Muir-Cochrane E, Levett-Jones T, Rudd C, Barkway P, O’Kane D, McAllister M, Gillham D,
Edmondson W, Rigney D. (2014). ‘Justin O'Dowd’. Flinders Learning Online. Retrieved
from https://flo.flinders.edu.au/course/view.php?id=19785
Nursingmidwiferyboard.gov.au. (2019). Nursing and Midwifery Board of Australia - Registered
nurse standards for practice. Retrieved 31 August 2019, from
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards/registered-nurse-standards-for-practice.aspx
Subia, P. (2015). Self-awareness as a Therapeutic Tool for Nurse/ Client Relationship.
International Journal of Caring Sciences. Retrieved from
http://www.internationaljournalofcaringsciences.org/docs/24-%20Review-Parveen.pd

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CRITERIA FOR ASSESSMENT 1 – Short Questions- Case World
NURS1007 Dimensions of Physical and Mental Health
The following is an itemised rating scale. Some aspects rate more highly than others. There is no
set formula for the grade relating to the ticks.
Grading Criteria* E AE ME BME
Professionalism – 20%
Clarifies own attitudes and
values and their potential
impact on clinical
practice/communication.
x Unclear about values and
attitudes and/or unable to
clarify how they might impact
on clinical
practice/communication.
Demonstrates insight and
self-awareness into how the
content from the online case
could transform future
thinking and practice.
x Little or no reflection on how
the content from the online
case study may influence
personal beliefs, skills or
behaviour. Implications for
future practice non-existent or

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CASE STUDY ON MENTAL ILLNESS
limited.
Analysis – 30%
Includes and applies
relevant topic concepts and
materials correctly with
online questions being
addressed and
corresponding answers
critically analysed.
x Does not use evidence or topic
contents to support answers.
Answers are superficial and
lack developed critique.
Information is accurate with
developed answers
supported by suitable
literature/evidence and an
excellent integration of
others’ ideas.
x The main questions have not
been addressed or inaccurate
with inappropriate or
anecdotal supporting
literature.
Application to Practice –
30%

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CASE STUDY ON MENTAL ILLNESS
Clearly recognises the
priorities of care based on
the clinical evidence
provided.
x Unable to identify the
priorities of care for the
person using the clinical
materials/evidence provided.
Articulates implications for
recovery focused care based
on specific cultural needs
x Neglects to consider the
specific cultural needs of the
person.
Recognises and responds to
the health needs and
recovery of the identified
person from a culturally
diverse background.
x Poor understanding of the
health needs or recovery
focused care of the identified
person. Generalisations are
made without supporting
evidence.
Demonstrates a clear link
between theory and
practice.
x Little or an absence of links
between theory and practice.
Anecdotal arguments or
inappropriate use of evidence.

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CASE STUDY ON MENTAL ILLNESS
Presentation – 10%
High level of clarity of
expression and answers are
presented clearly using
the questions advised in
the online materials.
x Main ideas are vague and
answers are confusing or
incomplete. Incoherent and
difficult to follow. Poor
presentation.
Clear and well-constructed
sentences and paragraphs.
Well set out format. Correct
grammar, spelling and use
of academic language. A
pleasure to read and easy to
follow.
x Poor grammar, spelling and
paragraph structure. Errors
cause meaning to be unclear
and confuse the reader.
Referencing – 10%
Thorough appropriate use
of the referencing style.
x Inadequate evidence of
sources. Significant incorrect
referencing in text. Collusion
or breach identified. Any
suspected failure to meet

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academic integrity process
will warrant investigation.
Reference list is accurate
and in alphabetical order.
x Frequent errors in reference
list.
*E= exceptional; AE = above expectations; ME = meets expectations; BME = below
minimal expectations
The total mark will be rounded up to the nearest percentage point in multiple of 5’s for
example, if a student receives 66% the grade will be 65%. If a student receives 74%, their
grade will be 75%.
Student Name: Xiao Xian Yii
Marker: Raymond Tini Date: 15/08/2019
GRADE:40%
Comments/Feedback :
 Thank you for submitting Assignment 1 of Nurs 1007. Word count is correct. Turnitin
did not show evidence of plagiarism. There were a few good points in some sections of

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the discussion, however overall, main answers lacked enough detail to demonstrate
understanding of looking after a person of diverse cultural background. There were issues
with academic writing which impacted on your work. I recommend that you seek SLC
services for assistance in these areas. I have provided further comments in your
discussion. Minor issues with APA referencing which will require attention.