Mental Health: Case Study of Depression and Nursing Care Plan

This report presents a detailed case study on a 41-year-old woman named Mary, who is experiencing symptoms of depression. The report begins with an introduction to mental health and the context of Mary's situation, including changes in her behavior observed by her family. Part 1 of the report includes a mental status examination, a clinical formulation table summarizing Mary's presenting, precipitating, predisposing, and perpetuating factors, along with protective factors. A nursing care plan is then provided, detailing non-pharmacological interventions such as establishing communication and educating Mary about her condition, and also includes SMART objectives. Additionally, Part 1 includes a clinical handover summarizing Mary's situation. Part 2 focuses on therapeutic engagement. It identifies and discusses a strategy to develop a therapeutic relationship with Mary using positive body language, justifying its importance. The report then describes how this strategy relates to the Recovery Model in Mental Health. The report concludes by identifying a challenge in working with Mary, which is convincing her to discuss her issues, and suggests a strategy to overcome this challenge.

MENTAL HEALTH:
Self and Others

Contents
INTRODCUTION.......................................................................................................................................3
PART 1.......................................................................................................................................................3
1. a. The Mental Status Examination.......................................................................................................3
1. b. Clinical Formulation Table..............................................................................................................5
1. c. Plan for Nursing Care......................................................................................................................5
1. d. Clinical handover.............................................................................................................................6
PART 2.......................................................................................................................................................6
2. a. Identify and discuss one strategy that you would use to develop a therapeutic relationship with the
(selected person) and justify why this strategy is important for this person?...........................................6
2. b. Describe how the specific nursing strategy relates to the Recovery Model in Mental Health..........7
2. c. Identify one challenge that you may encounter when working with this person..............................8
2. d. Discuss one strategy that you can use to overcome the challenge....................................................8
CONCLUSION...........................................................................................................................................8
REFERENCES............................................................................................................................................9

INTRODCUTION
Mental health is considered as level of psychological well being or situation related to the
absence of mental illness. Moreover, it also considered as situation when an individual is
functioning at the satisfactory stage of behavioral as well as emotional adjustment. There are
several situations which a person experience due to difficulties related to mental health disorder
such as depression, risk of suicide, schizophrenia and so on (Bao and et.al., 2020). The respective
report is based on case study related to the depression; the case is based on Mary who is at
responsible position in a large accounting organization. She lives with her husband Jim and three
children currently her family is noticing some huge change in behaviour and leaving condition
due to depression. The respective report include evaluation related to the holistic assessment and
planning in which they include mental status examination, clinical formulation table, plan related
to nursing care and clinical handover. On the other hand it also explains about therapeutic
engagement as well as clinical interpretation.
PART 1
1. a. The Mental Status Examination
Mental State Assessment
 Appearance & behaviour
 Appearance
 Motor behaviour
 Attitude to situation and
interviewer
Mary appears tidy and clean, she dressed in the
fashionable t-shirt and jeans along with sandals. Her
dark hair is brushed but in greasy and lank looking as
well as she is wearing no makeup. According to her
attitude she is feeling low and quiet at the situation.
 Speech form
 Rate
 Volume
 Quantity of information
 Speech content
 Disturbance of meaning
The speech form of Mary at the situation is low and she
sits quality with hands clasped in her lap as well as her
eyes are downcast (Chen and et.al., 2020). The speech
content of respective person is low and less confident as
compare to the normal days as she not like to interact

 Disturbance of language with others.
 Mood and Affect
 Mood
 Affect
 Congruency
Mary is not in the good or happy mood as she sits
quietly on the side as well as her also not conduct
interaction with the other or family (Gao and et.al.,
2020). In addition to this, she also not likes to
communicate to his family and she also not get engaged
in household work.
 Form of Thought
 Excess, absence, quality of thought
 Continuity of ideas
The form of thought of respective person Mary is
absence as she sit quietly as well as not much interact
with the others. Moreover, from several days she is
avoiding meeting people at any place.
 Content of Thought
 Delusions
 Suicidal thoughts
 Other
Mary is feeling thought related to that she didn’t want to
talk as well as meet any person and she also did feeling
well due to which she not able to contribute in house
hold activities.
 Perception
 Hallucinations
 Illusions
 Depersonalisation/derealisation
Mary perception is based on the depersonalization
according to which she not wants to interact any person
within the family or outside the family (Lai and et.al.,
2020).
 Sensorium and Cognition
 Level of consciousness
 Memory:
 Orientation.
 Abstract thinking
In this respect Mary is experiencing abstract thinking
situation because she not able to interact with others
properly.
 Insight & Judgement
 Extent of individual’s awareness
In respect of Mary situation she not able to take

of the problem
 Can they make rational decisions
decisions properly as she not interactive with others.
Risk Assessment
 Potential for harm to self
 Potential for harm to others
 Potential for absconding
The Mary risk assessment is related to the potential for
absconding (Li and et.al., 2020).
1. b. Clinical Formulation Table
Clinical Formulation
Summarize the pertinent information from case study
Presenting factors Mary is experiencing situation related to the depression due to which she
did not interacting with others as well as she is also not getting involved in
their daily activities like going church and so on.
Precipitating factors The precipitating factor in Mary case is related to her organization situation.
Predisposing factors In case of Mary predisposing factor is related to the family history of mental
health as her mother also end her life due to depression.
Perpetuating factors The perpetuating factor of Mary is that she is avoiding interacting with
others (Liu and et.al., 2020).
Protective factors In order to protect Mary it is essential to properly interact with her and
involve her in day activities.
1. c. Plan for Nursing Care
For treating a patient it is essential to opt nursing interventions because through that
professional person able to conduct treatment practices in effective manner as well as it also help
in healing the mental issues in effective manner. In respect of Mary she is experiencing
depression so there are several nursing interventions which are non pharmacological for an

individual such as professional assume active and effective role in the initiating communication
so that patient or Mary feel comfortable with the person and effectively share her condition to
them according to which they provide treatment without medicines. According to this strategy
professional need to conduct observation of Mary behaviour so that they can conduct another
step of analysis accordingly (Pfefferbaum and North, 2020). The next strategy related to it is to
educate Mary about the depression situation by this a professional person able to motivate Mary
to be normal and be normal. The long term intervention which can be adopted in Mary case is
related to communication because through it medical professional able to take decision properly
in order to cure Mary. The SMART objective is to conduct interaction with Mary in order to
understand her situation and provide treatment facilities accordingly in next 1 year.
1. d. Clinical handover
From the above examination of the mental health it can be determined that Marry who is
41 year old married women leaving with her husband and three children. She is working at the
responsible position at the big accounting company. From few time her family noticed that she is
not dressing properly as well as she seat at her dressing room hours and hours. Moreover, her
husband says that she is also not taking proper sleep as well as not interacts with others. In past
time she goes to the church but from some day she is not visiting to the church for prayer which
is improper for her family. According to Mary she is perfectly physically well but she diagnosed
with a mental issues i.e. depression as well as at that time she is treated with citalopram but from
last 1 year she is not taking the medicines as she think she is ok or good. Family of Mary think
that she is again experiencing or going through depression so they want to consult to the doctor
or medical professional so that her treatment will conduct properly as well as effectively.
PART 2
2. a. Identify and discuss one strategy that you would use to develop a therapeutic relationship
with the (selected person) and justify why this strategy is important for this person?
The therapeutic relationship is considered as relationship among healthcare professional
as well as its client. Moreover, it is determined as the way that therapist and client are expected
to engage with one another as well as impact the beneficial changes at the client (Ryle and Kerr,
2020). There are main five components of the therapeutic relationship are professional power,

intimacy, empathy, trust as well as respect. The respective components are always present in the
therapeutic relationship even if nurse is primary or secondary care provider, length of interaction
and many more. There are several benefits of adopting therapeutic relationship such as it
enhance the patient satisfaction, professional fulfillment, enhance compliances along with
prescribed medication, save time and many more.
In respect of Mary who is 41 year old women lives with her husband and three children
as well as she hold a responsible position at the large accounting organization. They have a large
and comfortable home in the Clayfield as well as her children attend private schools. From some
time her family is experiencing that Mary is tearful as well as has little or no energy that she
move from her bed as well as she started becoming burden to her family. In respect of her the
strategy which can be take for therapeutic relationship is using of positive body language in
order to demonstrate care of Mary (Xiang and et.al., 2020). In this medical professional will use
positive body language so that Mary will feel comfortable with them as well as it will also
encourage Mary to discuss her situation with the professional person that why she is feeling low
as well as behaving differently. The respective strategy is essential for the Mary condition
because she is not discussing her situation to any person that why she is feeling low and wanted
to be lonely. Moreover she also not getting proper sleeping as well as food which make her fell
weak and due to this she not able to dressed proper and takes care of her family. So by using
respective method, profession able to make Mary comfortable and encourage her to explain what
happen to her that make her feel low and demotivated. This will also help professional to
understand the best treatment as well as medicines so that Mary get recover fast as well as
quickly.
2. b. Describe how the specific nursing strategy relates to the Recovery Model in Mental Health.
The recovery process provides a proper holistic view of a person who is with the mental
illness as it focuses on person but not only on its symptoms. According to the recovery model it
argues that a person recovery is possible and it is a journey not a destination which is very far.
According to the case of Mary the specific nursing strategy is using of positive body language in
order to demonstrate care (Zandifar and Badrfam, 2020). This will be help full for the recovery
model in the mental health because through it Mary feels motivated as well as comfortable with

the professional which help in understanding proper health condition and it also motivate a Mary
to again start her medicines which she is taking 3 years back.
2. c. Identify one challenge that you may encounter when working with this person.
While working with a person who is going through mental issues another person
experience several challenges which impact on their working situation such as issues in
communication, encouraging them, motivating them, convincing and so on. In respect of Mary
she is also experiencing situation related to the depression so in case of this the main or primary
challenge which is experienced by professional person is related to convincing her to discuss her
issues or medical situation to them. This will generally take place because at the starting Mary
was not feeling comfortable with the professional due to which she not likes to share her
situation to them.
2. d. Discuss one strategy that you can use to overcome the challenge.
For medical professional it is essential to overcome challenge properly because through
that they able to provide proper services and care to the patient which improve their condition. In
respect of Mary, her medical professional may adopt conduct counseling session first because
that will help in developing effective relationship between the client and profession (Zandifar
and Badrfam, 2020). This will also aid in delivering quality as well as effective services to Mary
so that they get recover from depression fast and effectively.
CONCLUSION
By analyzing above mentioned point it can be conclude that for every person and their
family it is essential to take of the mental health because through that they able to ensure that
everyone at the family is mentally as well as physically sound. At a family if a person seem
different from some day like change in their behaviour or leaving condition then it is essential for
family members to take step as well as conduct consultancy with the medical profession who
will examine that person and their condition. In addition to this it is also essential to determine
the best strategies which can be practice according to the person’s condition.

REFERENCES
Books and Journals
Bao, Y. and et.al., 2020. 2019-nCoV epidemic: address mental health care to empower
society. The Lancet. 395(10224). pp.e37-e38.
Chen, Q. and et.al., 2020. Mental health care for medical staff in China during the COVID-19
outbreak. The Lancet Psychiatry. 7(4). pp.e15-e16.
Gao, J. and et.al., 2020. Mental health problems and social media exposure during COVID-19
outbreak. Plos one. 15(4). p.e0231924.
Lai, J. and et.al., 2020. Factors associated with mental health outcomes among health care
workers exposed to coronavirus disease 2019. JAMA network open. 3(3). pp.e203976-
e203976.
Li, W. and et.al., 2020. Progression of mental health services during the COVID-19 outbreak in
China. International journal of biological sciences. 16(10). p.1732.
Liu, S. and et.al., 2020. Online mental health services in China during the COVID-19
outbreak. The Lancet Psychiatry. 7(4). pp.e17-e18.
Pfefferbaum, B. and North, C.S., 2020. Mental health and the Covid-19 pandemic. New England
Journal of Medicine.
Ryle, A. and Kerr, I.B., 2020. Introducing Cognitive Analytic Therapy: Principles and Practice
of a Relational Approach to Mental Health. John Wiley & Sons.
Xiang, Y. T. and et.al., 2020. Timely mental health care for the 2019 novel coronavirus outbreak
is urgently needed. The Lancet Psychiatry. 7(3). pp.228-229.
Zandifar, A. and Badrfam, R., 2020. Iranian mental health during the COVID-19
epidemic. Asian journal of psychiatry. 51.