Components of the Mental Status Examination (MSE)
MSE helps caregivers to observe and describe the psychological functioning of the patient at a given time (Rollinger, Berres, Ehrensperger, & Monsch, 2015). The first component of the examination is the appearance of the patient. Mr. Chung’s posture indicates that he has clinical depression. He is slumped in his chair and has rounded shoulders.
The patient also stares at the floor for long periods of time. Behavior is another component of MSE. Chung has limited eye-to-eye contact with the health care specialist. The patient is less attentive to the questions as the interviewer has to repeat questions before getting an answer from him. Another aspect that indicates depression is the speech of Mr. Chung. His speech is slowed and purposeful.
The patient has a tearful and flat mood which has existed for six weeks. His unpleasant mood is due to the condition of his child and wife. The child’s (Charlette) birth was through a cesarean section due to complications at birth. Harriette (Mr. Chung’s wife) developed an infection due to operation at birth. The process left her with a lot of pain. The patient also has a sad and restrictive affect. The contents of his thoughts are also unpleasant as he has suicidal thoughts. Chung has been having suicidal thoughts for the last week. The patient is also delusional and thinks that he is the cause of his child and wife’s condition. He also blames himself for the drug error at the accident and emergency department.
MSD-V
Depression is also called the depressive order and makes the patient have a feeling of isolation, despair, and sadness for extended periods. Mr. Chung has clinical depression due to the symptoms of the disease that are evident in him. A depressed individual has a sad mood for days, weeks, or even months (Fried, & Nesse, 2015). The patient has had a tearful and flat mood for six weeks. The low mood is due to the long working hours; hence, he finds little time for his new daughter. The shift and the high pressure from the accident and emergency department are also responsible for the sad mood. Anxiety is another symptom of clinical depression. The patient has been anxious for the past two months due to the condition of the wife and child.
Depression makes a victim to lose weight due to loss of appetite or failure to take regular meals (Simmons et al., 2016). The case study indicates that Chung has lost five kilograms of weight due to reduced appetite and missing meals. Insomnia is also prevalent in patients with depressive disorder. Insomnia is the inability to fall asleep or to remain asleep (Manber et al., 2014). Chung has been experiencing sleeplessness which began as insomnia. However, he has also been experiencing early morning waking at 3 AM. Patients also feel worthless and guilty on a daily basis. Chung feels guilty due to the medical error and the conditions of the child and wife. Patients also have recurrent death thoughts. Chung has been having suicidal thoughts for the last week.
The Stress Vulnerability Model (S.V.M)
Question Two
Stress Vulnerability Model (S.V.M)
The vulnerability is the susceptibility of an individual towards a mental disorder (Calvete, Orue, & Hankin, 2015). The primary determinants of vulnerability are experiences during early life and genetics. Factors that affect susceptibility include the use of alcohol and medications. Challenges that an individual faces during a lifetime form the basis of stress. Persons with proper coping skills overcome stress easily than those without the skills. Individuals also need social support to counter stressful experiences. Therefore, the significant components of the SVM are biological Vulnerability, stress, and protective factors. The model assists caregivers to understand Mr. Chung’s condition and suggest a long-lasting solution to the problems.
Biological Vulnerability refers to the tendency or biological susceptibility t a mental disorder (Nixon et al., 2014). The susceptibility differs from one individual to the other. The intensity of depression and its symptoms also vary depending on the levels of a person’s sensitivity. Genetic factors are the first determinants of biological vulnerability. Persons who are from families with a history of depression have high chances of getting the mental disorder. However, the case study does not indicate the medical history of the patient. Biological factors also influence an individual’s vulnerability to depression. The elements are like a viral infection when an individual is at a young age.
Drug abuse and alcoholism increase vulnerability to stress and anxiety. However, the case study does not indicate whether Chung is an alcoholic or otherwise. Alcoholism increases the severity of depression symptoms. Depressed individuals have high sensitivity to little amounts of drugs and alcohol (Duman, Aghajanian, Sanacora, & Krystal, 2016). Stressful working environments increase the severity of depression symptoms. The long working hours at the hospital are stressful as Chung has limited time for his family. The drug-error at the accident and emergency department also worsened the symptoms of clinical depression. The shifts and going to school to earn a promotion further limit Chung’s time for his family.
Stress is any activity or occurrence that challenges an individual. The stressed individual requires urgent adaptation to deal with the condition (Yun et al., 2016). Severe stressful circumstances in the life of Chung involve long working hours at the hospital. The error in the medical administration that made the eight-year-old patient very sick is also a stressful event. Chung administered the medication intravenously instead of intra-dermal administration. The wife’s pain due to an infection during birth is also stressful. Chung also finds little time and space with his new daughter due to the nature of his job.
Components of the S.V.M
Protective factors decrease an individual’s stress and biological vulnerability. Medication is essential factors in dealing with depression (Williams et al., 2014). Relevant drugs reduce the severity of the symptoms of the conditions. Appropriate medication also prevents the reoccurrence of symptoms such as suicidal thoughts. Proper coping skills of relatives and the patients also help to reduce the impacts of medical disorders. The parents of Harriette should allow Chung to spend time with his daughter after work. The hospital management should reduce the working hours and ensure that staff members spend quality time with their families. Therefore, stress and biological vulnerability are essential components of SVM.
Question Three
Mental Health Recovery Model
The model explores factors that enable an individual to recover from a mental disorder such as depression. Recovery involves hope, empowerment, and respect for the victim of depression (Slade et al., 2014). An efficient recovery process reduces the symptoms of depression and also ends minor signs. The patient, family, stakeholders, and the government have the responsibility of supporting the patients with medical disorders. Chung should remain hopeful that his situation is not permanent. The wife and her parents should encourage the patient by making him believe that he can recover from the condition. The government should empower patients by building specialized mental health facilities. The treatment of depression should be cheap and affordable. Family members should respect the decisions of Chung despite his psychological status.
Hope is a belief that all is well despite a long list of challenges. The family members should help Chung to find hope of recovery from the mental disease. The health stakeholders should nurture the newly-found optimism by visiting the patient and acting as a source of encouragement. Chung should be optimistic and believe that he can recover from the clinical depression. The symptoms of the disease are many and severe in manifestation. Therefore, Chung should be ready to tolerate the setbacks and uncertainties due to the condition. Hope can begin at a given point or start and develop slowly. Hope should exist despite the general failure and disappointment due to the symptoms (Chen, Koller, Krupa, & Stuart, 2016). Every stakeholder has the responsibility of ensuring that mental health patients remain hopeful in life.
Empowerment is the second component of the recovery model. Empowerment involves the development of a positive healing culture in patients (Shahdadi, Rahdar, Mansouri, & Abdollahimohammad, 2018). The hospital administration should offer a competitive salary to enable Chung to treat his depressive condition. The government should build specialized mental health centers in every part of Australia. The health facilities should offer affordable treatment to psychological disorder patients. The parents of Harriette should support Chung by ensuring that he spends time with the daughter after work. Empowerment decreases the mental and social impacts of depression. Individual care practices and proper medication enable the patient to have a speedy recovery from mental disorders. The wife should ensure that Chung takes the appropriate drugs to reduce the symptoms of the disease.
The Mental Health Recovery Model
Respect is another component of the recovery model. The physicians should respect the decisions of the patients despite their mental conditions (Barth et al., 2016). Caregivers should explain the various remedies of depression to Mr. Chung and allow him to make an informed decision. Self-respect is also an essential path to recovery from mental diseases. Mr. Chung should take the depression drugs according to the caregiver’s prescription.
Drugs and alcohol are substances that increase the severity of depression symptoms. Chung should avoid the addictive substances to hasten the process of recovery. The hospital administration should respect Chung by asking him about his preferred working hours. The health facility should then obey the decision of the patient. Allowing Chung to spend time with his daughter is another component of respect.
References
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Calvete, E., Orue, I., & Hankin, B. L. (2015). A longitudinal test of the vulnerability-stress model with early maladaptive schemas for depressive and social anxiety symptoms in adolescents. Journal of Psychopathology and Behavioral Assessment, 37(1), 85-99.
Chen, S. P., Koller, M., Krupa, T., & Stuart, H. (2016). Contact in the classroom: Developing a program model for youth mental health contact-based anti-stigma education. Community mental health journal, 52(3), 281-293.
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Manber, R., Bernert, R. A., Suh, S., Nowakowski, S., Siebern, A. T., & Ong, J. C. (2014). CBT for insomnia in patients with high and low depressive symptom severity: adherence and clinical outcomes. Focus, 12(1), 90-98.
Nixon, N. L., Liddle, P. F., Nixon, E., Worwood, G., Liotti, M., & Palaniyappan, L. (2014). Biological vulnerability to depression: linked structural and functional brain network findings. The British Journal of Psychiatry, 204(4), 283-289.
Rollinger, H. K., Berres, M., Ehrensperger, M. M., & Monsch, A. U. (2015). Transformation formulae between scores of the mini-mental status examination (MMSE) and the Montreal cognitive assessment (MoCA). Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 11(7), P574.
Shahdadi, H., Rahdar, Z., Mansouri, A., & Abdollahimohammad, A. (2018). The effect of family-centered empowerment model on the level of death anxiety and depression in hemodialysis patients. Revista Publicando, 5(16), 470-482.
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Simmons, W. K., Burrows, K., Avery, J. A., Kerr, K. L., Bodurka, J., Savage, C. R., & Drevets, W. C. (2016). Depression-related increases and decreases in appetite: dissociable patterns of unusual activity in reward and interoceptive neurocircuitry. American Journal of Psychiatry, 173(4), 418-428.
Williams, J. M. G., Crane, C., Barnhofer, T., Brennan, K., Duggan, D. S., Fennell, M. J., … & Shah, D. (2014). Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: a randomized dismantling trial. Journal of consulting and clinical psychology, 82(2), 275.
Yun, S., Donovan, M. H., Ross, M. N., Richardson, D. R., Reister, R., Farnbauch, L. A., … & Eisch, A. J. (2016). Stress-induced anxiety-and depressive-like phenotype associated with a transient reduction in neurogenesis in adult nestin-CreERT2/diphtheria toxin fragment A transgenic mice. PLoS One, 11(1), e0147256.
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