NURS20150 Contextual Foundations: Mental Health Nursing Case Study

This essay examines the mental health of a 65-year-old man from a marginalized group, using Bronfenbrenner's ecological model to analyze the impact of culture, history, mass media, and organizations on his well-being. The essay highlights the increased risk of mental illness in marginalized populations and emphasizes the importance of considering cultural factors, historical context, media influence, and organizational support in addressing mental health challenges. It identifies key lessons, including the significant influence of culture on mental health decisions and the need for tailored support systems to improve mental health outcomes for older adults. The essay concludes by advocating for greater awareness and understanding of the unique challenges faced by marginalized groups in accessing mental health care.

NURS20150 Contextual Foundations of
Mental Health Nursing

Table of contents
INTRODUCTION ..........................................................................................................................3
MAIN BODY ..................................................................................................................................3
Introduction of the person............................................................................................................3
Bronfenbrenner’s (1979) ecological model.................................................................................3
Take home lessons from the essay...............................................................................................7
CONCLUSION................................................................................................................................8
REFRENCES...................................................................................................................................9

·INTRODUCTION
The health conditions that change in the thinking, behaviour and emotion of person is called
mental illness. The mental illness is linked with the social functioning and problem in the
functioning of the individual at the work and family activities. The mental health is important
part of the personal, relationships, emotional well-being as well as the contribution to the society
as well as community. The essay discusses the marginalized people who have the increased risk
towards the mental health as compared to the non-marginalised people. A 65-year-old
grandfather is taken The impact of the culture, history, organization and mass media is discussed
using the Bronfenbrenner’s ecological model. The essay also consist of the four major take home
lessons that are evident to the report.
·MAIN BODY
·Introduction of the person
The marginalised people have increased risk of mental illness as well as mental disorders as
compared to the people who are not from the marginalized population. One such person was
encountered during the clinical practice. He is a 65-year-old man. He is my grandfather. He is
having difficulty in the remembering things, and he gets angry when he did not get the things he
likes. He has his own certain way of remembering things. He is unable to understand the things
he used to earlier and the ageing is increasing the risk of mental illness as well as the disorders
for him. This is due to the fact that the older people are experiencing with loss of the capabilities
as well as declining ability to function (Quarmby and et.al, (2021).
He is at increased risk of mental illness due to the reduced mobility chronic pain and other health
problems for which he is required long-term care. He is retired from his job and is feeling drop
from his socio-economic status. He is also feeling alone after the death of his wife six month ago
that has caused isolation, loneliness and psychological distress, and they require a long term care
for recovering from this and it they are not given the care they are at high risk of the mental
illness.
l壱Bronfenbrenner’s (1979) ecological model
The Bronfenbrenner’s model is about the development of the individual relationships within the
society as well as the communities. The theory is also called the ecological/systems framework.
The environmental systems are explained in which an individual is able to interact in the model.
Five environmental systems are identified that are:

Micro-system- It is the first level of the Beronfenbrenner’s theory and this includes the things
that are directly linked with the individual in their immediate environment, like spouse, peers
and social group. The relationships in this environmental system are bi-directional that is, the
individual can get influenced by the people in the environment as well as the individual is also
capable of changing the actions and beliefs of the other people as well (Liu and et.al, (2019).
The way the individual treat the other people in this system may depend upon the reactions of
the individual to the other people in the micro system. The interactions made in the micro system
are very important as well as personal for the individual that help in developing the individual
and fostering. The positive impact of the surrounding people has positive effect on the individual
while the negative and affectionate behavior will have negative effect on the individual.
Mesosystem- This system encompasses the individual’s interaction between the microsystem
that is the interaction between the individual’s family member and the social group, the peer
along with the office peers and siblings. In the Mesosystem, the microsystem of the individual is
not functioning independently and have asserted as well as interconnected influence on one
another (Hayes, O’Toole, and Halpenny, (2017). A Mesosystem is a system of microsystems.
When the doctors and the family member of the individual work together they are able to have
the positive impact on the development of the individual.
Exosystem- This is the system of ecological systems theory and this incorporates the informal as
well as formal structures. The structures do not have the individual but deal with the systems that
impact the individual indirectly. For example, the Exosystem include the family member’s
workplace, neighbourhood, mass media and family member’s friend. These are the external
environment to which the individual is not involved but it will be impacting the development of
the individual (Fearnley, (2020). If the family member is having a bad day they can have short
temper and this can have negative impact on the individual.
Macrosystem- This is the system in which the element of the culture are focused upon for the
development of the individual like wealth, ethnicity, socioeconomic status and poverty. The
culture in which the individual is immersed is capable of influencing their perception as well as
beliefs about the events that comes to be known in life. The macrosystem is different from the
above discussed ecosystems as it does not refer to the specific environment of the developing
individual but refer to the specific culture as well as society in which the individual is

developing (Vélez-Agosto and et.al, (2017). This can also include the ethnicity, ideologies,
socio-economic status and geographic location of the system.
Chronosystem- This is the final ecological system of the model. In this system the
environmental changes are included that occur in a lifetime that influence the development; it
also includes the major historical as well as life transitions event (Edelen and et.al, (2020). This
system can include to the normal life transition and non-normative life transition.
The four elements that impact the 65 year old man and his mental illness experience are:
Culture- The researcher has found that the elderly people are less likely to get the treatment or
they have to wait until their symptoms becomes severe. The regular healthcare provided to the
elder people is very less. Different culture has different way of looking at the mental health and
the 65 year old grandfather has to face the challenge as many culture stigma is that mental health
is a weakness and it should be kept hidden that can increase the risk for the adult (Buser and
et.al, (2020). The culture also influence the way people discuss about the mental health and
choose to recognise as well as talk about the symptoms.
The community support is one of the factors that determine that how the elderly grandfather will
be getting the support for their mental health. Due to the existing stigma the elder people are left
alone to find the treatment for their mental health. This increases the risk for the elder people for
getting the best treatment for the mental illness. The cultural factors and needs are considered for
finding the treatment options for the elderly people and that can be time-consuming as well as
difficult at sometimes (Soule, (2021). The elderly people are impacted with this badly as they
want resources for their mental health treatment that are able to understand the concerns and
experiences of the elder people, but if they are not provided with one of the resources like that it
can be devastating for their health.
History- The history of the adult in their earlier life can impact the risk of the mental disorder, if
the adult has gone through much during their earlier days then it can impact the mental health.
The elderly people can be suffering from dementia at a very young age and as it is known that
the syndrome is progressive in nature that minimizes the thinking, memory and behaviour of the
person with the passing time. The person become incapable of doing the everyday activities and
this becomes severe for the older people. This increases the challenges for the old grandfather as
well as increases the risk of the mental health disorder (Fancourt, and Steptoe, (2019). The
depression due to prolong suffering leads to issues that are in the daily life like impaired

functioning. The older people are suffering from the unipolar depression and that is for the
people above the age of 60. Thus, the grandfather has increased risk for this depression as he is
been lonely after the death of his wife six months ago.
Mass media- Mass media is the primary source of public for getting the information about the
mental health; it is considered the most significant source. The television is considered the most
powerful medium for the framing the consciousness of the public. The mass media rarely even
go by a week without discussing the mental health (Johnson, and Rogers, (2020). The
representations of the mental illness at the mass media are so powerful that then personal
experiences of the people are override on how they view the mental health. The mass media
makes and breaks the stigma in the society for the people that indirectly impact the 65year old
grandfather in his mental illness. The mass media is outer source that is not linked with the
elderly person in the mental health condition directly but influence the health inconsiderably.
The mass media is very powerful as it is able to set norms for the health and the illness for the
people that will be having great effect on their lives. The society treats the mental health the
same way they believe and see it.
The mass media is able to promote the false as well as negative images and stereotypes. The
negative stereotypes on the mass media can cause negative impact on grandfather’s mental
health as the people surrounding him will act according to the false image and that will have a
negative impact on the grandfather which might worsen the condition for him (Johnson, and
Rogers, (2020). The grandfather can also be impacted positively by the mass media if it helps
the people suffering from the mental health by spreading the real cause and resources that can
help along with things that can be done by the people surrounding them need to do for the
people with mental illness.
Organisations- The older adults of the Australia are under utilizing the mental health services of
the organizations. This is due to the lack of the services that specialized in the mental care for
the elderly people, the poor health literacy in older adults and stigma that is associated with the
mental illness (Besschetnova and et.al, (2021). The research showed that mental health issues
with the ageing process are normal. The normalization of the fact that the mental health
degradation with the ageing is normal acts as a barrier for the identification and recognizing for
the need of help by the older people. The professional at the healthcare organization feel this as

a barrier for the identification of the treatment and assessment of the mental health. This makes
the elderly grandfather to suffer from many challenges in day to day life.
The normal ageing process in the organization has not highlighted the increased mental illness in
the normal profile of ageing and that is acting as a barrier (Cogburn, (2019). This is making it
difficult to differentiate the signs of the grief and loss from the mental illness for the older
people. These factors are making it difficult to identify the mental health in the elderly people by
the professionals. The organisations can help in positively impacting the lives of the people with
the mental health when they are good at understanding the barrier to the mental health.
l壱Take home lessons from the essay
The essay was about the older people and the four major take home lessons from this can be:
First, the culture of the individual impact the mental health significantly. The decision taken by
the adult regarding the mental health is totally depended upon the cultural they are surrounded
by if the culture believe that mental illness is a weakness and should be hidden from everyone
then the adults will be very suspicious while taking about their health concerns to anyone
(Haddon, (2018). This impact the elderly individual severely as the treatment of mental health is
possible and not being aware of the resources will make them face difficulties. The impact can
be reduced if the adults are put into the culture where they can easily talk about their mental
health.
Second, the elder person can be suffering from the healthcare due to the depression and due to
the loss of their closed ones that can also lead to the increased mental health issues. The older
individuals are left lonely after the death of their closed ones, and they can be depressed for long
time that can increase the risk of the mental health (Stella, (2020). The elder people can also
have dementia that can cause memory loss, incapability in doing certain things and change in the
behaviour that can cause increase mental concerns.
Third, the mass media has an impact on the health of the elder people, for example, newspaper is
the source of information for many people, and they believe and act according to the beliefs that
the newspaper is serving as it is showing the perception of thousands of people worldwide. If the
newspaper put a great impact on the people so if the newspaper is making the mental health in
good view then people will find it easy to get healthcare. When the newspaper talk about the
mental health like any other health issue that can be cured then the people will be talking more

about it and it can be helpful for the people who are suffering from it (Steinman, Perry, and
Perissinotto, (2020).
Fourth, the organizations of the mental health need to be specific about what they do the study
about. They have make the people more aware about the facilities and benefits of the treatment
for the mental health care as the healthcare are being underutilized. It is necessary for to make
the people aware that they are being cared, and they need help and support for their condition.
The mental health should not be looked as one of the factor of the old age. The elderly people
need not be facing the challenges as they are getting old they need to be giving the appropriate
support for their grieve, depression and loneliness.
·CONCLUSION
It can be concluded from the essay that the mental health is a condition where the individual
losses the ability to behave, mange their emotions and thinking. The marginalized people are
more likely to have the mental illness as compared to the non-marginalised people as they are
not able to use the healthcare facilities fully due to the differences. The 65-year-old grandfather
in the essay and people like him are not brought to the healthcare until they are in very serious
condition because mental health is still considered a taboo in many cultures and it is kept
hideous from the people. Bronfenbrenner’s ecological model is used in the essay for the
understanding the development of the individual and how different environments influence the
individual's life. The five ecological systems are discussed that are micro-system, exosystem,
macrosystem, chronosystem and mesosystem. The four factors like culture, history, mass media
and organisation are discussed on how they impact the life of the individual suffering from
mental illness.

·REFRENCES
Books and Journals
Quarmby and et.al, (2021). Narratives and marginalised voices: Storying the sport and physical
activity experiences of care-experienced young people. Qualitative Research in Sport,
Exercise and Health. 13(3). 426-437.
Liu and et.al, (2019). Association between frailty and incident risk of disability in community-
dwelling elder people: evidence from a meta-analysis.Public Health. 175. 90-100.
Hayes, O’Toole, and Halpenny, (2017). Introducing Bronfenbrenner: A guide for practitioners
and students in early years education. Routledge.
Fearnley, (2020). Becoming a reflexive and reflective practice educator: Considering theoretical
constructs of Bronfenbrenner and Bourdieu for social work student field placements.
Social Work Education. 1-13.
Vélez-Agosto and et.al, (2017). Bronfenbrenner’s bioecological theory revision: Moving culture
from the macro into the micro. Perspectives on Psychological Science. 12(5). 900-910.
Edelen and et.al, (2020). Moving toward shared realities through empathy in mathematical
modeling: An ecological systems theory approach. School Science and Mathematics.
120(3). 144-152.
Buser and et.al, (2020). Operationalization of the Ecological Systems Theory to Guide the Study
of Cultural Practices and Beliefs of Newborn Care in Rural Zambia.Journal of
Transcultural Nursing. 31(6). 582-590.

Soule, (2021). A virtual art therapy curriculum for high school students during the COVID-19
pandemic: Informed by Bronfenbrenner’s Ecological Systems Theory.
Fancourt, and Steptoe, (2019). Cultural engagement and mental health: Does socio-economic
status explain the association?. Social Science & Medicine. 236. 112425.
Johnson, and Rogers, (2020). “We're the Normal Ones Here”: Community Involvement, Peer
Support, and Transgender Mental Health. Sociological Inquiry. 90(2). 271-292.
Johnson, and Rogers, (2020). The impact of COVID-19 on the lives and mental health of
Australian adolescents. European child & adolescent psychiatry. 1-13.
Besschetnova and et.al, (2021). The effect of digital mass media on mental health of children
and youth. Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsiny. 29(3).
462-467.
Cogburn, (2019). Culture, race, and health: implications for racial inequities and population
health. The Milbank Quarterly. 97(3). 736-761.
Haddon, (2018). The impact of employees’ well-being on performance in the workplace.
Strategic HR Review.
Stella, (2020). Multiplex networks quantify robustness of the mental lexicon to catastrophic
concept failures, aphasic degradation and ageing. Physica A: Statistical Mechanics and
its Applications. 554. 124382.
Steinman, Perry, and Perissinotto, (2020). Meeting the care needs of older adults isolated at
home during the COVID-19 pandemic. JAMA internal medicine. 180(6). 819-820.