Components of the Mental State Examination (MSE) related explicitly to the case study and the DSM V
1.As mentioned in the clinical case study, Chung is suffering from changing mental health conditions and this transition is hampering his positive thoughts and critical thinking (Cokley et al., 2013). from the case study, it is evident that Chung is suffering from depression as his professional and personal lives are making him feel alone and weak. due to his professional engagements, he is unable to spend time with his newly born daughter and her wife as well as sleep deprived working hours are pushing him to make errors, affecting his professional life as well. If discussed critically, as per the mental health status examinations or MSE, there are two domains of the assessment that is reflected prominently from the behavior of Chung, his thought process and his speech and behavior (American Psychiatric Association, 2013).
As per American Psychiatric Association (2013), in MSE assessment, thought is judged by three simple aspects, tempo, quality and form of thoughts however, it is not possible to infer that without the help of the patient. The thought content of Chung starts from him being unable to follow his tradition for his marriage, altered behavior of his wife Harriet’s parents. His inability to spend time with his daughter and unwell wife to suicidal thoughts, and consumption of high dose of critical medication were also the reason of his sorrow. On the other hand, difference in his speech and behavior was noticed by me when I tried to find out the reason for his quiet mood and restrictive nature. I observed his eyes were tearful, his speech was low and purposeful and not spontaneous (Frith, 2014). His replies were depending on the thought process and thought content. His behavior was also influenced by guilt as he was making eye contact while talking. Moreover, if the mental health of Chung is assessed with the DSM-5 or the Diagnostic and Statistical Manual of Mental Disorders, then the mental condition of Chung falls into the depressive, sleep-wake and food related disorders. This should also be mentioned that Chung was also suffering from elimination disorder as he used to feel excluded and alone in his own family (Whitcomb, 2013).
As per Cokley et al. (2013), these disorders identified by the MSE and DSM-5 are important to determine the intensity, reactivity, and mobility of the thoughts and behavioral attitudes of the patient. in this case study, the mental health was suffering from loneliness, depression, low-self esteemed and confidence. In a research article by Frances (2013), it was determined that people generally feel lonely and isolated when they do not receive the same attention and importance from people they expect. Chung felt that Harriet’s parents were so busy in taking care of his daughter that he was unable to spend time with her. Further, his ability of being awake for 20-24 hours made him attempt an error due to which he had to suffer an enquiry and observational practice for one year that affected his confidence. As per Krueger et al. (2012), it is difficult for passionate people to accept their defeat and move ahead. Therefore, this was the mental health condition
Factors which have contributed to the development of the client’s current mental health status
2.The stress vulnerability model is the study of the psychological theory that depends on the life experiences of the person due to which, he develops vulnerability and stress (Drake, Pillai & Rothm, 2014). The contributing factor or the predisposition of this situation can be psychological, environmental, genetic or situational that forces people to think, act and behave in a certain way (McEwen & Morrison, 2013). Further these vulnerabilities are increased due to persisting stress that the situation or the environment puts of the person. In this given case study of Chung, within several life events, two primary events that affected his mental health condition was, his inability to bring his parents in his wedding and his inability to spend enough time with his daughter (Scharf & Schmidt, 2012).
Chung moved to Australia to work as a health professionals and unable to visit his family, his parents, brother and sister because of his long working hours. His workplace, a busy accident and emergency department of a hospital in Australia demands maximum determination and devotion which stopped him from visiting his own country. Despite these, he was unable to bring his family in Australia so that they can attend his and Harriet’s wedding because the travel cost was higher and her mother’s health condition did not allowed her travel to Australia. This event was responsible in affecting his identity as he felt that his traditions and cultures were not followed in the wedding rituals as well as none of his family member was present in his wedding. Further he also felt that he was unable to take part in planning and other important functions of his own wedding due to his long working hours.
On the other hand, the second situation that affected Chung the most was his inability to spend time with her. As Chung made mistakewhile medicating a patient, he was kept on supervision practice that made him busy in his profession. Further, Harriet was also suffering from surgical site infection due to which Harriet’s parents used to take care of their child. However, Chung is unable to take of his child as Harriet’s parents are so much involved in the care process. This was another factor that affected the mental health of the Chung as it affected him emotionallyand the situation made him feel worthless. Due to these he also noticed a sharp decrease in his health condition as well as made him affected with insomnia and early wakening. It also mentioned that his professional and personal responsibilities and their overlapping made him suffer from anxiety that ultimately affected his appetite, his weight. Further, due to the feeling of letting his family down, he also had the feeling of cardiac arrest. These two events affected the self-esteemed and confidence of Chung as he was unable to balance his personal and professionals life, which is important to provide stability to the life and therefore in the absence of this, Chung developed his current mental health condition (Hruska & Delahanty, 2012).
Positive aspects of mental health recovery, Respect, Empowerment and Hope
3.As mentioned by Schrank et al. (2012), mental health is a condition, which can easily be treated if the person is provided with respect, empowerment and hope in his care process. Respect is one of these factors that focuses on the individual and his uniqueness so that their self-esteem can be boosted. Corrigan, Druss and Perlick (2014) mentioned in the research article that recovery is associated with regaining strength, hope and belief in the life and for that purpose, the people around the patient need to be supportive and respectful to the decision and actions of patient, as it will help them to understand their worth in life. The patient should be placed in an environment where his actions will not be judged and he will not be blamed for any negative event happening. This sensitive and respectful behavior will help him to overcome the emotional and personal barriers (Naparstek, Biegel & Spiro, 2012). As in this case study, Chung has the feeling that he has let his family down and is unable to provide them the time they deserve, the family members should support him and provide him enough dignity and respect so that he can overcome his guilt and spend time with them
Empowerment is also an important aspect as mentioned by the World Health Organisation; empowerment is an important pillar for health promotion and development that help people taking care of their own health in adverse conditions (Castro et al., 2016). Chung is suffering from stress and depression that has evoked suicidal behavior in his thoughts. Being a clinician, he also has access to different life threatening drugs which he could take to end his life (Wong & Laschinger, 2013). Therefore, empowerment is an important step in recovery from mental health. For Chung, this empowerment will be provided by his family, his wife and his colleagues, who will support him in his weakness and provide him with power so that he again can gain in his life. His family should take part in this process so that he can develop a stronger sense of belongingness to the family again (Castro et al., 2016).
In a research article by Schrank et al. (2012), the researchers used hope as one of the alternative interventions for treating patients with mental health condition. In that article, researchers mentioned that providing the patient with hope provides them positive energy that helps them to withstand negativity and self-doubts. Further, being hopeful provides them with confidence so that they can lead their own path to overcome depression, stress and sorrow (Naparstek, Biegel & Spiro, 2012). In this case study of Chung, his depression, sorrow and stress is associated with his family, his daughter and to some extent his professional life. In this situation, Harriet and her parents should provide Chung with hope that he is able to take care of his family and is able to balance his personal and professional life (Drapalski et al., 2012). Therefore, in this way, respect, empowerment and hope can help Chung to overcome his mental health condition.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Castro, E. M., Van Regenmortel, T., Vanhaecht, K., Sermeus, W., & Van Hecke, A. (2016). Patient empowerment, patient participation and patient-centeredness in hospital care: a concept analysis based on a literature review. Patient education and counseling, 99(12), 1923-1939.
Cokley, K., McClain, S., Enciso, A., & Martinez, M. (2013). An examination of the impact of minority status stress and impostor feelings on the mental health of diverse ethnic minority college students. Journal of multicultural counseling and development, 41(2), 82-95.
Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest, 15(2), 37-70.
Drake, C. L., Pillai, V., & Roth, T. (2014). Stress and sleep reactivity: a prospective investigation of the stress-diathesis model of insomnia. Sleep, 37(8), 1295-1304
Drapalski, A. L., Medoff, D., Unick, G. J., Velligan, D. I., Dixon, L. B., & Bellack, A. S. (2012). Assessing recovery of people with serious mental illness: development of a new scale. Psychiatric Services, 63(1), 48-53.
Frances, A. (2013). Saving normal: An insider’s revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma and the medicalization of ordinary life. Psychotherapy in Australia, 19(3), 14.
Frith, C. D. (2014). The cognitive neuropsychology of schizophrenia. Psychology press.
Hruska, B., & Delahanty, D. L. (2012). Application of the stressor vulnerability model to understanding posttraumatic stress disorder (PTSD) and alcohol-related problems in an undergraduate population. Psychology of addictive behaviors, 26(4), 734.
Krueger, R. F., Derringer, J., Markon, K. E., Watson, D., & Skodol, A. E. (2012). Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychological medicine, 42(9), 1879-1890.
McEwen, B. S., & Morrison, J. H. (2013). The brain on stress: vulnerability and plasticity of the prefrontal cortex over the life course. Neuron, 79(1), 16-29.
Naparstek, A. J., Biegel, D. E., & Spiro, H. R. (2012). Neighborhood networks for humane mental health care. Springer Science & Business Media.
Scharf, S. H., & Schmidt, M. V. (2012). Animal models of stress vulnerability and resilience in translational research. Current Psychiatry Reports, 14(2), 159-165.
Schrank, B., Bird, V., Rudnick, A., & Slade, M. (2012). Determinants, self-management strategies and interventions for hope in people with mental disorders: systematic search and narrative review. Social science & medicine, 74(4), 554-564.
Whitcomb, S. A. (2013). Behavioral, social, and emotional assessment of children and adolescents. Routledge.
Wong, C. A., & Laschinger, H. K. (2013). Authentic leadership, performance, and job satisfaction: the mediating role of empowerment. Journal of advanced nursing, 69(4), 947-959.
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