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Primary Health Care Principles Applied to Mental Health Care Assessment and Management

Word count/duration: There is a word limit of 1500 words. Use your computer to total the number of words used in your assignment. However, do not include the reference list at the end of your assignment in the word count. In-text citations will be included in the additional 10% word count. If you exceed the word limit by more than 10% the marker will stop marking at 1650 words or plus 10%. 

Your assessment should be submitted in .doc, docx. format Double space your assessment using a 12 point font such as Ariel or Times New Roman Please ensure your answers are typed using Word. Your work should not be hand written. 

Aim: Students will apply primary health care principles to show their understanding of how they would meet the healthcare needs of individuals and their families/ significant others in the community. They will demonstrate their knowledge of principles related to stress, mental health assessment, risk assessment and management in promoting mental health and wellbeing. They will show their understanding of the lived experience of mental illness and recovery for individuals with mental health concerns and/or illnesses. 

There are two case studies for Assessment 1 and Assessment 2. Students enrolled in the Bachelor of Nursing can choose to focus on either case study. This case study must be used for both assessments. Students enrolled in the Bachelor of Midwifery will focus on Case Study 1 only. 

All students will answer the (3) three following questions in relation to their chosen case study:

 Question 1 - 500 words - 10 marks Using relevant literature critically discuss the mental health status of the client in the case study. Your work should make reference to two (2) components of the Mental State Examination (MSE) related explicitly to the case study and the Diagnostic and Statistical Manual of Mental Disorders V (DSM V) relevant criteria for Depression. 

Question 2 - 500 words - 10 marks Critically discuss two (2) factors which have contributed to the development of the client’s current mental health status. You should demonstrate your knowledge of the Stress Vulnerability Model and demonstrate how any history of trauma may impact on the person’s mental health. Your work should clearly identify the contributing factors; make reference to the case study and relevant literature. 

Question 3 - 500 words - 5 marks Respect, empowerment and hope are three (3) positive aspects of mental health recovery. Using relevant literature and the case study, critically discuss how these three (3) principles could positively contribute to the client’s journey of recovery. You should demonstrate your knowledge of recovery orientated mental health theory and practice. 

Case Studies 

Case Study 1: Lucinda Okiro Lucinda Okiro presented to the perinatal mental health service today for a mental health assessment with her daughter Emily (aged eight months). She and Emily were both well-groomed but Emily was wearing a short sleeved onesie on a cold day. Lucinda was referred for an urgent appointment by her midwife at her antenatal clinic. Lucinda complained of feeling frightened and very unhappy since she found out she was pregnant with her second child. She has known about this pregnancy for one month and is now ten weeks pregnant. 

Lucinda is a 22-year-old woman who gave birth to her first child, Emily, eight months ago. There were complications when Emily was born as she was a posterior presentation and labour was prolonged (12 hours). Eventually, Emily was born by a forceps extraction because although the head could be seen, the labour was not progressing. It 5 took Lucinda a long time to feel physically ready to care for Emily. She also said she is exhausted caring for Emily and is still having difficulties sleeping even though Emily was now in a better routine. When speaking about her difficulties caring for Emily, Lucinda becomes tearful and stares at the floor, wringing her hands.

 Lucinda immigrated to Sydney from Ghana in 2017 to study accounting and met her partner, Jerome (aged 24 years) who is also from Ghana, at her church. Jerome works in the local supermarket and is also studying accounting. Although he is very happy to share the care of Emily when he is at home, he has to work long hours as he is the only person who is able to bring in a wage. Lucinda hoped that her mother, who she misses very much, might come to Sydney to help her but there was not enough money to pay for her mother’s air ticket. Lucinda says she has no other family in Australia and although Jerome’s family are supportive, they live in Port Macquarie.

 At the beginning of her second year at university, Lucinda was shocked to find she was pregnant but continued studying up until she gave birth. She realised after Emily was born that she would have to defer her studies for one year. She says that she feels guilty that she can’t help Jerome more by working. Lucinda is now very upset that she will have to take more time off studying and working because she is having another baby. She is also very worried and scared about the birth.

 When she thinks about the birth, Lucinda starts to feel very anxious and finds that she has trouble breathing and when she told the midwife about this, the midwife referred her for further assessment. She is also finding that she feels very unmotivated and that she really doesn’t want to get out of bed in the morning. This makes her feel worse because she believes she is not being a good mother to Emily. Lucinda says that if she feels like this with one baby, she has no idea how she could cope with another baby.

 Sometimes Lucinda wonders whether Emily and Jerome would be better off if she was not around but knows that she must try to keep going for the sake of her unborn baby. Today she scored 12 on the Edinburgh Perinatal Depression Scale. She denied thinking about harming herself on question 10. However, she believes that she just feels a little bit worse every day and worries that when the baby is born, she may think differently about whether she needs to remain with her family as the wife and mother. Lucinda says that she feels very lonely and really doesn’t know where to turn to get help. 

Case Study 2: Munny Kaew Munny is a 45-year-old Cambodian man who lives in Western Sydney with his wife, Ary, and their three children, a girl Chan aged 10, and twin sons, Prak and Rith, aged 6 years. He has presented at the community centre with his wife. Ary is very worried that Munny has not been his usual self since he was interviewed by his employer six weeks ago.

 Munny has worked in a large bakery for the last five years that supplies bread for large supermarket chains. He finds this job stressful because he has to start work at 1 am but he says that he enjoys his work once he gets there. However, when his employer spoke to him, he was very surprised to learn that his employer was not satisfied with his work and that if it did not improve, Munny would lose his job. 

Since that incident, Munny has become less and less communicative at home. He is taking increasing amounts of sick leave and when he is not at work, he spends most of his time in bed. Now he rarely takes notice of his children, who were previously the centre of his attention, and no longer does anything around the house.

 Ary is also worried because Munny is not showing any interest in food and believes he has lost a significant amount of weight. Ary says that she has tried to talk to Munny but he only speaks in one word answers and says that he is fine and to leave him alone. Ary tells you that Munny’s family were forced to move from their home into the countryside during the Khmer Rouge period in Cambodia in 1975. His father was shot by the Khmer Rouge. After that, Munny and his mother escaped but had to live in a refugee camp in Thailand until they received a visa to Australia in 1985. After finishing school in Australia, Munny started a degree in law but soon dropped out and started an apprenticeship as a baker. He was always very proud that he could support his family, including his mother. 

Munny was always very close to his mother, but she died after a long battle with cancer 6 months ago. Although Munny visited his mother every day during her illness, Ary worries that he did not take time off work after she died. She says that Munny just wanted to keep going so he did not have to think about losing his mother.

 When Munny comes to the centre, he was well dressed but his clothes are loose fitting. He is slumped in his chair and staring at the floor. When he is greeted by the nurse, he does not make eye contact and only gives monosyllabic answers to any questions saying ’fine’ or ’no problems’. However, when the nurse asks if Munny has ever thought about whether life was worth living, he shook his head. When asked how his family might feel if anything happened to him, Munny simply shrugs his shoulders. Munny then asks the nurse to leave him alone because he doesn’t want to talk about anything anymore. 

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