Mental Health Case Study in Rural Australia Order Instructions: This case presents the issues of Peter, a man living with his wife, Gail on the edges of a regional town.
Read the scenario then respond in your assignment to the following questions.
Peter is a 35-year-old man who lives with his wife and two children, aged 10 and 7 years, on a small property just outside a large regional town. Peter grew up on a farm three hours’ drive north but is now well established in the regional town. He works as a middle-level manager in a construction business. He consults a local general practitioner, Dr. Mercedes, for a first visit because he has been experiencing insomnia and loss of energy. Peter adds that one of his workmates has recently been diagnosed with leukaemia. Dr Mercedes has only ten minutes allocated to see Peter and performs a quick physical examination and takes some blood. She asks Peter to return in one week. At the second visit to Dr Mercedes, Peter is told that no physical problem was found on his blood tests. The doctor is at pains to rule out the possibility of leukaemia. Peter appears relieved. The doctor prescribes a short-acting benzodiazepine, temazepam for his sleep. She asks Peter to return in a month if things have not improved.
A fortnight later, Peter goes to see his old family GP, Dr Bill Holden, who practices in a town close to his parents’ farm, where Peter is staying for a visit. Peter explains that he has felt much worse in the last fortnight. His sleep pattern has deteriorated considerably and although he gets off to sleep fairly easily, he wakes every night staring at the clock at 2am and then can’t get back to sleep for hours. The mornings are his worst time but as the day goes on things gradually improve. In the evenings Peter has felt tense as the time to go to bed comes closer and he knows his night will again be difficult. On questioning from Dr Holden, Peter says, “life has always had its ups and downs’, but that he has never felt like this before. He says he has lost his taste for food and has lost 5kg in weight. His wife had told him that he seemed to have lost interest in all his normal hobbies and appeared to get no pleasure from anything. After further questions from Dr Holden, Peter went on to say that his sex drive had dropped away totally. Bill Holden also checks whether Peter has any significant suicidal thoughts and is relieved to find that Peter has no active suicidal plans at present.
Peter went on to explain that lately his wife had tried to cheer him up. He was unable to react to her efforts and constantly felt down. Subsequently Peter’s wife, Gail complained that he always rejected her and was spending more and more time at work. Peter had told her that he was under considerable pressure at work, as his company was trying to secure more building contracts despite difficult economic times. Things had got really difficult between them and last Friday night she had accused Peter of having an affair. He admitted to her that he has sought support from his secretary at work, but denied that a relationship has developed. Gail was very upset and asked him to leave.
The next morning Peter packed his things and drove home to the family farm to stay with his parents. He decided he needed help and that is why he had come to see Dr Holden, whom he had known all his life. After listening to Peter for twenty minutes, Dr Holden tells him he believes Peter is suffering from major depression and that a combined approach of tablets and talking therapy is indicated. Dr Holden tries particularly hard to educate Peter about “depression as an illness” since there is a particular stigma about mental illness in his local community. He informs Peter about the good chance of a recovery from this episode with appropriate treatment.
Suggested structure for assignment is;
Introduction: state briefly what you intend to do in the assignment (150 words).
Body: Briefly describe the nature of Peter’s problem. Reference any material you have used (200 words).
In a regional area such as the one where Peter lives, what are the barriers to mental health care? Give an account of the local scene for someone with a mental health problem. You may pick the area you are currently working, or research an existing area and use this (200 words).
What do you think are his most pressing concerns? Provide a list of both Peter’s and Gail’s concerns. Also suggest the strengths Peter may already bring to help overcome his problem. Give brief explanations of each concern and identify any interventions that may help him. Ensure you identify the level of evidence of the interventions and provide examples from the literature of research that has demonstrated this evidence (800 words).
Examine the different disciplines that may be able to help Peter and Gail and give examples of the way in which these disciplines could work together (300 words).
Conclusion: Tie all of your findings together and give a concise summary of what you have found (350
Mental Health Case Study in Rural Australia Sample Answer
Mental Health: Case Study in Rural Australia
Mental health encompasses psychological stability and absence of psychiatric abnormalities. It also involves emotional well-being and ability to control one’s behavior. Other concepts constituting mental health include self-dependence, autonomy, and intellectual competence. Mental illnesses include critical clinical conditions such as Alzheimer’s syndrome, dementia, psychopathy, obsessive disorders among others. There are also other conditions that occur more frequently such as anxiety, depression, addiction, mood swings, grief, stress and others. When such conditions present with a certain threshold of severity, clinical intervention is necessary. Psychiatric and psychological interventions are particularly helpful in avoiding outcomes such as suicide and tendencies to harm one-self. This paper refers to the case of Peter who visits two doctors and is diagnosed with depression. The paper describes the condition of Peter, looks into societal perception of mental conditions, points out the patient’s major concerns, and offers interventional recommendations to help the patient manage depression.
Peter’s Problem
Peter’s clinical complication is depression. Smith, Saisan, and Segal explained that symptoms of depression include hopelessness, loss of interest in one’s daily encounters, sleep abnormalities, irritability, fatigue, and inability to concentrate among others (2010). Peter experiences most of these problems, and in addition to that, he has fears of having acquired leukemia. Blood tests revealed that Peter was not suffering from leukemia, and his fears were probably motivated by a sensation of hopelessness often associated with depression. Again, Peter presents with occurrences such as loss of appetite and unintended weight loss. Both experiences are symptoms of depression as research findings show (University of Michigan, 2014). Peter is also unable to have fun and interact lively with his family. The condition has worsened with time and patient inability to sleep has aggravated even after treatment with temazepam. Peter also pointed out that life has both good and bad courses. His assertion was motivated by sadness and despair which often occur during depression. Actually, depression is a real disease, and it is best explained from the feelings of patients (University of Michigan, 2014). Possible causes of depression in Peter’s case include fear of having leukemia, work-related emotional stress, and being too self-critical. The condition is worsened by accusations of infidelity placed by Gail against him and his subsequent dismissal from home.
Barriers to Mental Health Care
Peter’s local setup presents significant barriers to his access to mental health care. First, the community expresses unwelcome perceptions about mental diseases. It stigmatizes patients of mental disorders making them feel uncomfortable when seeking psychiatric and psychological care. So as to avoid social consequences, patients may not readily accept that they have mental illnesses. This may interfere with their tendency to seek care and also cooperate in management of these conditions. In Peter’s case, Dr. Holden takes caution when informing his patient about depression as an illness of the brain. The strategy worked effectively in avoiding misunderstandings with his client. Additionally, mental diseases such as depression involve diagnostic questions that patient may not readily answer in the locality. These include one’s interest in activities such as sex as seen in the case of Peter. Other local determinants of care accessibility include adequacy of medical and psychiatric personnel to handle patient concerns effectively. In some situations, patients would require in-depth evaluation that would cost health institutions considerably large amount of time. In cases where hospitals would not have adequate personnel, institutions would limit the length of patient appointments so as to attend as many clients as possible. On the same point, small towns may not sustain medical specialists such as psychiatrists, and patients would have limited access to specialized mental health care (The Royal Australian and New Zealand College of Psychiatry, 2015). In Peter’s case, Dr. Mercedes only had ten minutes to diagnose and evaluate the clinical condition of her client.
Peter’s and Gail’s Concerns
Peter’s concerns included his current and future health, safety of the job environment, economic gains for his company, as well the well-being of his family. On the other hand, Gail’s concerns are about health and social condition of her husband. Gail worries about Peter’s loss of interest in different aspects including interactions with his family, eating, engagement in sex, as well as his long stays at work. However, Gail does not expect Peter to suffer from a mental condition, and so, she does not relate Peter’s condition to disease. Instead, she worries that Peter’s behavior is associated with an affair with his secretary.
On his side, Peter worries about a possibility of experiencing severe health complications in the future. The instance of one of his workmate being diagnosed with leukemia makes him worried about his possibility of suffering from the same condition. The patient is probably dissatisfied with his current job and he feels a need to take early measure of avoiding leukemia. It is for this reason he suggested that Dr. Mercedes examine him for cancer. However, peter’s condition does not improve even after being proved not to have leukemia. Most likely, the middle-level manager still feels predisposed to the disease and he fears continuing with the job. Peter has a considerably young family and the thought of acquiring cancer could be causing severe mental disturbance to him. So as to overcome these worries, Peter should purpose to resolve the ambiguity regarding his working place and predisposition to disease. Wahrenberg explained that when people have misunderstandings about issues that cause them to worry and become anxious and depressed, they should seek direct answers to such concerns for them to overcome them (2014). Therefore Peter would need seeking assurance from health agencies and his company that he would not be placed at the risk of diseases by the working environment.
Peter is also concerned about his currently deteriorating health status. The patient expected that his health status would have improved after his first visit to Dr. Mercedes. His expectations were unmet, and instead of having improvements, Peter experienced worse sleep disturbances. When patients fail to improve after taking medications, they have high tendencies to question their diagnoses and they may end up experiencing increasing worries. If their doubts are high, they may not feel improvements. Research indicates that patients can heal from placebo effects on the basis that patient beliefs play significantly in determining treatment outcomes (Miller, Colloca, & Kaptchuk, 2009, p. 518). Likewise, it is possible for patients not to recover from illnesses if they continue to belief that they are sick. Since depression is a disease of the mind, Peter’s thoughts of not healing would have counted remarkably in causing his health deterioration. So as to settle the above concerns, Peter would require psychological boost. Psychotherapy would be necessary in boosting his mentality and overcome the impact of negative feelings. There are various professionals who could administer psychological therapy to Peter. They include health care specialists such as psychologists and nurses, as well as social professionals such as spiritual leaders and counselors. Research shows that morale boost facilitates patient healing and recovery from diseases (Miller, Colloca, & Kaptchuk, 2009, p. 518). However, there are certain standards that psychotherapy should meet for it to work for the case of Peter. First, the therapist needs having updated information concerning depression and its management. This would see to optimal effectiveness of recommendations offered by the therapist. Again, the patient must feel free to interact with his therapist. It is recommendable that Peter uses a therapist whom he likes. Additionally, psychotherapy should be time-limited, and it should be reconsidered if the patient does not improve within the first six sessions (Clinical Depression.co.uk, 2015). Again, the intervention should entail interpersonal, behavioral, and cognitive types of therapy. Cognitive therapy would particularly improve patients’ perception of self and their future, and it also helps them to overcome behavioral challenges such as inability to sleep (Hofmann, Asnaani, Vonk, Sawyer, & Fang, 2012, p. 427). Therefore, it would be effective for the case of Peter considering his situation and concerns. Other approaches that could work effectively in managing depression include engagement in exercises. The intervention would boost both his physical and mental health. However, Peter would still need motivation to engage in exercises as adherence to the practice could be hindered by his current condition. Peter experiences fatigue, loses interest in most activities, and has considerably high chances of poor self-esteem. Research shows that the above experiences often compromise the effectiveness of exercise as a measure to manage depression (Blumenthal, Smith, & Hoffman, 2012, p. 18). Peter may also consider approaches such as using appetizers to boost his poor appetite. He may also consider taking a short leave from his job so as to regain his health.
Generally, Peter expresses strengths that would facilitate implementation of various management strategies. For instance, he is willing to seek medical help to handle his condition. Therefore, he is likely to cooperate with his health care providers and adhere to recommendations. Additionally, Peter has a family that would be a source of support for his recovery. It is most likely that his wife would offer necessary physical and psychological support if she understands the health situation of her husband. Lastly, Peter is employed and it is most likely that he has an insurance cover that would cater for his treatment and therapy.
Relevant Disciplines and their Coordination in Managing Peter and Gail’s Situation
Depression is a significantly complex disease owing to its association with other conditions such as aging, physical ill health, grief, dementia and so on. Different health care disciplines should share knowledge and guide one another in its management. Relevant disciplines in the case of Peter and Gail include a psychologist, psychiatrist, nurse, therapist, nutritionist, and family members. Each member of the team would play a role that matches their specialization for efficiency. For instance, a psychologist may head the team and communicate the needs of the patient to the rest of the team. The psychiatric would carry out the role of prescribing medications, while the nurse would constantly monitor the patient. A physical therapist would help Peter engage in exercises, while the nutritionist would help the patient recover his appetite. Family members would work together with the team in supporting their patient by offering a peaceful environment and helping him physically and emotionally. Novotney reported that depression management works best with the integration of multiple strategies such as exercise, stress management, and pharmacological interventions (2010, p. 40). There are numerous benefits associated with a multidisciplinary approach to disease management. Novotney reported that the approach is cost-effective and it is cheaper than the traditional forms of care that involved minimal integration (2010, p. 40). Such a strategy would also save time for the patient as he would receive holistic type of care at the same time. Again, the move is associated with a high degree of efficiency. Professionals would first share their knowledge, discuss options, settle their differences, and offer recommendations that are verified from multiple perspectives. The strategy would also promote patient satisfaction in that Peter would not have to strain to have his needs addressed. Instead, professionals would work closely with one another, identify patient needs, and make necessary arrangements and hence act on behalf of their client. An inert-disciplinary approach would also enhance interactions between the patient and care providers as professionals would gain a deep understanding of their customer.
Mental Health Case Study in Rural Australia Conclusion
Mental health is a broad term describing people’s psychological status as well as their lack of psychiatric disorders. Diseases of the mind are varied with some being critical and complex while others are barely severe. Conditions such as depression, addiction, anxiety, loss of moods, and stress may be mistaken for insignificant clinical conditions, but in most cases, they impact undesirably on people’s health and life quality. A critical evaluation of Peter’s experiences suggests that the middle-level manager is depressed. He has been experiencing fears of having leukemia but diagnostic test revealed that he did not have the condition. Even after receiving the good news and receiving treatment to depression, Peter did not improve, and instead, his condition worsened. His depression is severe to an extent that it affects the outcomes of its treatment. His failure to respond positively to treatment was influenced by his depressed status and a conviction that he was facing a severe threat to health. It is important to note that some localities pose significant barriers to accessibility of mental health care to patients. For the case of Peter, the society stigmatizes mental health patients. Such situations make it hard for patients to comfortably seek treatment for mental diseases. Other factors affecting the accessibility of mental health services expressed by specific local regions include inability to sustain psychiatric specialists. In most cases, diseases make patients and their families to worry. At the same time, diseases such as depression could result from worrying. Major worries that Peter held included the fear that he could be at the risk of getting leukemia. The middle-level manager was probably concerned about the safety of his job environment considering the recent occurrence of his workmate being diagnosed with leukemia. Psychotherapy, exercises, medication, and an approach to address his causes of depression such as seeking assurance about the safety of his working environment were recommendable approaches toward depression management for Peter. A multidisciplinary team would be crucial in implementing such strategies. It would involve clinical professionals as well as non-clinical staff. Gail and the rest of Peter’s family would also be important as they would offer physical and emotional support to Peter and promote his recovery from depression.
Mental Health Case Study in Rural Australia References
Blumenthal, J. A., Smith, P. J., & Hoffman, B. M. (2012). Is exercise a viable treatment for depression? ACSM’s Health & Fitness Journal, 16(4), 14–21.
Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.
Miller, F. G., Colloca, L., & Kaptchuk, T. J. (2009). The placebo effect: illness and interpersonal healing. Perspectives in Biology and Medicine, 52(4), 518.
Novotney, A. (2010). Integrated care is nothing new for these psychologists. American Psychological Association, 41(1), 40.
Smith, M, Saisan, N., & Segal, J. (2015). Depression symptoms and warning signs. Retrieved from http://www.helpguide.org/articles/depression/depression-signs-and-symptoms.htm
The Royal Australian and New Zealand College of Psychiatry. (2015). Delivering mental health care in rural areas. Retrieved from https://www.ranzcp.org/Publications/Rural-psychiatry/Delivering-mental-health-care-in-rural-areas.aspx
University of Michigan. (2014). Depression. Retrieved from http://www.depressiontoolkit.org/aboutyourdiagnosis/depression.asp
Wahrenberg, M. (2014, July 8). Worry and anxiety in depression. Psychology Today. Retrieved from https://www.psychologytoday.com/blog/depression-management-techniques/201407/worry-and-anxiety-in-depression
