Healthcare setting for admitting Stephanie

Assessment Task 3

1. Current Care Context
The case under examination is a Mental Status Examination (MSE) for one Stephanie (not her real name), who has presented herself to the clinic with depressive symptoms. She has explained her present situation as having had suicidal ideation arising from her previous predicament, where she lost her job. Her condition is further aggravated by her family, where her parents are alcoholics and does not create a peaceful environment at home. Her boyfriend has also made her life a living hell through their constant arguments for the past two years. The current healthcare setting for admitting Stephanie is a mental hospital for mentally-ill patients like her. The admission type will be voluntary as she must agree first to be admitted before the psychiatrist goes on with the process. Stephanie has to decide whether she will get admitted to obtaining help under our care or undergo counseling sessions daily as she goes back home to her parents. For faster and better recovery, it is recommended that she undergo the treatment process in a hospital setting because getting back home might prolong the healing process because she is likely to encounter the same people who put her in her present condition.
The Australia Mental Healthcare Act (MHA, 2017) discusses the legal status of patients seeking mental healthcare help from practitioners in a healthcare setting. Their rights are in line with the fundamental rights of human beings as they belong to the vulnerable group from evaluation, treatment, and research viewpoints. Thus, the legal status demands healthcare personnel to remain ethical by ensuring such patients have respect for autonomy, the principle of non-maleficence, beneficence and justice, confidentiality and non-disclosure, violation of boundaries, and informed consent (Farkas, 2017). In this situation, Stephanie must give her approval before she gets admitted to the hospital or decides to go home.
Also, her condition and the information she presented to the psychiatrist have to remain confidential and can only be shared with a third party upon request and approval. The psychiatrist must act for her benefit and ensure she receives the best care and outcomes to speed up her recovery process.
2. Consumer’s Goals for Recovery and Future Plans
To help Stephanie recover fully and faster from her present condition, various goals must be set, and plans for achieving them must be. The goals have to be SMART (Smart, Measurable, Attainable, Realistic, and Time-bound). The first goal is to help Stephanie regain her former condition as she led a happy life. To achieve this, she will have to participate in sporting activities for the next two weeks to help her forget about her present condition. This goal is achievable because exercising will help improve her mental health by reducing anxiety, depression, and negative mood by improving her self-esteem and social withdrawal. As it stands, she has low self-esteem now that she has been dismissed from work, and her parents have never complemented her for anything since childhood. Also, it is evident that her self-esteem went down when she was abused sexually when she was 15 years old.
Another goal is to increase her positive relational interactions to help reinforce the support system by writing down at least one positive interaction she will have with someone each day for four consecutive weeks. Should she choose to be admitted to the facility, Stephanie has to record such interactions, which will help her improve her mood and reduce her anxiety level (Gureje et al., 2019). Another goal is to help her recognize anxiety symptoms and depression each day for the next six weeks and stop. She has to stop getting obsessed or worrying about a designated 15-minute “worry time” to happen before her dinner. This will help in her meditation and relieve anxiety issues.
For the future, the psychiatrist will help Stephanie challenge any negative thoughts she has had, such as suicidal ideation and trying to harm herself as she has done before, by having positive affirmations in 5 out of 5 instances for the next two weeks; she will be at the facility to help increase her confidence in coping with irrational thoughts. Currently, she has no one reliable to look up to, and she must tame negative thoughts to recover. Another plan for the future is to help Stephanie understand her depression and anxiety triggers by spending 20 minutes each night journaling about that day’s symptoms for the next three weeks. It is prudent that she has to understand her present condition before any help is offered to her.
3. Consumer’s Strengths and Resources For Recovery
As consumers are most likely to isolate themselves due to their situation, it is vital that their skills and resources at their disposal be explored to help them recover (Gureje et al., 2019). Our consumer has low self-esteem, compromised life quality, and poor psychosocial functioning. Consumer who exhibits such negative self-appraisals perform badly often in the community and are more likely to relapse and impede their recovery process (Donovan et al., 2017). Therefore, it is important that the traditional medical model focuses on pathology, problems, and failures in people with mental illnesses; the strength-based approach will allow the practitioner to acknowledge that each consumer has a unique set of strengths and abilities they can rely on to overcome their problems. For this case study, Stephanie, our consumer, has some strengths and resources she can employ for her recovery. For example, one strength can be derived from her motivation to have a better life in the future. Now that she is seeking help, she wants a quality life. This is one good strength the practitioner can capitalize on to help the consumer. Presenting herself before the health care facility is enough strength to have the courage and determination of the practitioner to help Stephanie.
Another strength and resource can be derived from the consumer’s family and community. The practitioner should partner with the local community organizations to identify and develop a formal support system for the consumer. The practitioner can also provide facilities for the consumer to hold meetings or activities. In this situation, the practitioner will collaborate with the community where Stephanie hails by developing a formalized structure that needs participation from her and her family and the community’s input (Cox, 2016). Stephanie can engage in meetings, interventional social gatherings, and educational sessions in leading and sharing success stories with others once she recovers.
Another resource and strength is developing a therapeutic relationship between the practitioner and the consumer. In this situation, the practitioner can establish this relationship with Stephanie by focusing on what she has. The practitioner will not blame her for her present condition but will discover how she has strived despite the adverse circumstances she has had, such as getting dismissed from her job, having unsupportive and abusive parents and a boyfriend, and careless society. The practitioner will focus on her desires, interests, aspirations, and knowledge, not her deficits, problems, and weaknesses (Xie, 2020). The therapeutic relationship will help identify the consumer’s autonomy as she has strengths vested in her personal qualities, such as the courage to speak up and seek help, virtues, and traits, such as being honest with her condition and revealing that she was once abused sexually while only 15 years old.
4. Priorities For Safety, Care, and Recovery for The Consumer
Once admitted with her consent, the practitioner has to look out for several things to ensure the patient is safe and her recovery process is on course. Brickell et al. (2019) says that the most common safety issues that must be prioritized and could arise in a mental health setting are falls, slips, missing patients, restraint use, self-harming behaviour, seclusion, suicide, reduced capacity for self-advocacy, and adverse medical events. In our situation, Stephanie has already shown signs of self-harm, as she did before coming to the facility. She is also likely to commit suicide, as she described having suicidal ideation before coming to the facility. She can also run away from the facility if she develops feelings of seclusion. Therefore, the practitioner has to maintain a closer watch on her and ensure she does not feel secluded and could self-harm.
Brickell et al. (2019) say that suicide is a serious problem and has led to death in many inpatient psychiatric settings. The practitioner has to assess the treatment environment to establish her behaviour characteristics and staff trust in no-suicide contracts. It is also found that patients who are depressed with abuse of alcohol and substances are at a high risk of being aggressive against staff and other patients. In our case study, Stephanie is under the influence of alcohol and has admitted to having taken five bottles of beer a day, a behaviour she has not done before. The abuse of alcohol is linked with the risk of harm or danger and explains the reason why she had to self-harm. It has affected the quality of her life, and such risky behaviours must be assessed for her speedy recovery.
Also, a well-secured environment is required to ensure a well-organized, safe environment for Stephanie and the staff in the psychiatric setting. Some safety measures include locking the washrooms from outside to prevent suicidal attempts. From our situation, Stephanie has suicidal thoughts and might attempt to kill herself again should she get an opportunity to do so. The security staff should constantly check belongings and take all potentially harmful gifts from visitors who might come to visit Stephanie. Doors should be electronically controlled to prevent her from escaping from the ward. Suicidal, homicidal, and violent patients should be placed in an observation room under close observation.
5. Strategies and interventions that could be utilized to address and support the identified priorities
The first priority is to stop Stephanie from self-harming as she has exhibited such behaviour. To do this, she has to be monitored closely by the practitioner and ensure there are no objects closer she can utilize to harm herself. Also, all doors and washrooms should be locked and controlled electronically, as she might try to escape from the facility unnoticed. The practitioner must ensure Stephanie is not lonely and does not feel secluded. The practitioner can do this by ensuring there is someone she can talk to so that she does not spend a lot of time lost in negative thoughts. Another intervention is to check all belongings coming to the facility from her friends and family members to ensure there are no potentially harmful gifts from them that can be used as self-harm objects (Business Bliss Consultants, 2018).Also, the practitioner has to ensure Stephanie gets fully involved in the goals established with her, such as taking part in physical exercises for the time she will spend at the facility.
She has to distract herself with sports activities to relieve the depression and anxiety that is rife within her. Her family has to get involved even though it appears they are the source of her trouble. Stephanie has to be part of the recovery process by following the advice from her practitioner at every stage of the treatment process. As already witnessed, she is already a strong woman because she has opened up and said whatever that was bedeviling her. The recovery process will be quick if she cooperates with the practitioner until when she shows signs of recovery.

References
Brickell, T. A., Cotner, B. A., French, L. M., Carlozzi, N. E., O’Connor, D. R., Nakase-Richardson, R., & Lange, R. T. (2019). The severity of military traumatic brain injury influences caregiver health-related quality of life. Rehabilitation Psychology, 65(4), 377.
Business Bliss Consultants FZE. (November 2018). Patient Safety Issues In Mental Health Care. Retrieved from https://nursinganswers.net/essays/patient-safety-issues-in-mental-health-care-nursing-essay.php?vref=1
Cox, K. F. (2016). Investigating the impact of strength-based assessment on youth with emotional or behavioral disorders. Journal of Child and Family Studies, 15(3), 278-292.
Donovan, S. A., & Nickerson, A. B. (20017). Strength-based versus traditional social-emotional reports: Impact on multidisciplinary team members’ perceptions. Behavioral Disorders, 32(4), 228-237.
Farkas, M. (2017). The vision of recovery today: what it is and what it means for services. World Psychiatry, 6(2), 68.
Gureje, O., Harvey, C., &Herrman, H. (2019). Self-esteem in patients who have recovered from psychosis: profile and relationship to quality of life. Australian & New Zealand Journal of Psychiatry, 38(5), 334-338.
Xie H. (2020). Strengths-based approach for mental health recovery. Iranian journal of psychiatry and behavioral sciences, 7(2), 5–10.