Assignment Task
Learning Outcomes Assessed
1. Discuss the concepts of contemporary mental health nursing practice, inclusive of a recovery-focused approach.
2. Identify the rights-based principles approach in mental health with respect to the Victorian Mental Health and Wellbeing Act and explore the importance of person and family participation and self-determination for recovery
3. Promote Rights-Based principles for people living with mental illness to reduce stigma and discrimination.
4. Conduct a mental health status examination through a comprehensive and systematic nursing assessment.
5. Use a recovery-based approach to assess, plan, implement, evaluate, accurately document and communicate evidence-based nursing care for the person living with a mental illness
Task Instructions
This task is focused on creating a recovery plan for Ben’s mental health, considering his transition from inpatient care to a community setting. This assignment will help you demonstrate your understanding of recovery planning, mental health interventions, monitoring and collaboration. Please carefully read and follow the instructions provided below.
Task Overview:
You are required to create a recovery plan for Ben, a 25-year-old individual who was discharged from an inpatient unit to a community setting after a recent aggressive episode and psychotic episode. Your recovery plan should address Ben’s mental health history, substance use, and recovery goals, considering evidence-based interventions and a include collaborative approach involving Ben, healthcare providers, family, and support network.
Step 1: Read Case Study Ben’s Mental Health Recovery Plan
Note: This is information is a continuation of Ben’s story from Task 1, all previous information and video still applies
Ben, a 34-year-old qualified builder, was brought into the Emergency Department by the Police three days ago following an aggressive episode involving his girlfriend outside their house. Ben’s behaviour raised concerns, leading the Police to believe that he was mentally unwell and posed a risk to himself and/or others. As a result, Ben was detained and taken to the local health service, this service is located in rural Victoria. Eg, Grampians Region, Wimmera or Gippsland (You may designate this if relevant to your recovery plan).
Ben has a history of depression and borderline personality disorder, with known suicide attempts. His depression has been ongoing since he was 21 years old. Additionally, he has been using substances since the age of 14. His girlfriend informed the police that his substance use had become “much worse” in recent months and that he had “started acting strangely.”
Upon admission to the Emergency Department, Ben was found to have a mixture of alcohol, ice (methamphetamine), and cannabis in his system. He was also experiencing a psychotic episode. The healthcare professionals managed his acute symptoms and determined that he is now stable enough to be discharged from the inpatient unit to a community setting. However, given his complex history and current mental state, a comprehensive recovery plan is necessary to support his transition and rehabilitation.
Your previous MSE and Risk Assessment contributed to his care and after 4 days, he is to be discharged in the community.
You have just started in the community and have requested to continue working with Ben at the Community Mental Health Service. Ben has agreed to this as he is comfortable with you, having previously met you in the Inpatient Unit.
He has also been taken off the Mental Health and Wellbeing Act (2022) and is now not subject to any treatment orders.
Ben’s Current presentation and information:
Ben’s symptoms of psychosis seem to be resolved he was given the diagnosis of drug induced psychosis, the psychiatrist also questioned his previous diagnosis of borderline personality disorder as this was from mentioned from previous admission history but didn’t fit his current presentation and would like this reviewed.
On discharge from hospital he is currently prescribed Olanzapine 10mg BD for the psychotic symptoms, is also prescribed Diazepam 5mg TDS relating to Ben’s withdrawal from his methamphetamine and cannabis whilst he was in hospital. Ben previously was on Diazepam at much larger doses due to his withdrawal symptoms. The psychiatrist would like this to be reduced and will review these medications with a view to discontinuing when appropriate, Ben stated he was worried about this request.
When in hospital, Ben also started a SSRI called Escitalopram 10mg Daily. The psychiatrist would like this to be monitored with an increase to 20 mg if tolerated, Ben was previously on other antidepressants before admission and stated, “they did nothing for him”. He has not had Escitalopram before.
Ben still presents as low in mood at times; he states his girlfriend will leave him and he will lose his job and is embarrassed about how he was brought into hospital. While his girlfriends comments and other information gathered don’t support this, these statements maybe related to his mood and do not fit delusional content.
In conducting a risk assessment he has stated that he has no plans to take own his life, but he does on occasion think about if he could just go to sleep and not wake up as his thoughts “don’t stop” sometimes and he just wants to get away.
Overall, Ben still reports he isn’t feeling like he is withdrawing from his substance use anymore He currently feels he cannot miss any doses of the Olanzapine and Diazepam, otherwise he may “lose it”. He has also stated he is done with “this drug S#@%” and just wants to get on with his life, but worries as he still has urges to use again here and there and he might relapse and wants to know what he can do about it.
Ben has discharged, back to his home with his girlfriend. She has been very supportive during his inpatient stay. but she very is worried about future relapse and what she can do if he does. His mother Cathy has also been supportive to Ben during this time and has volunteered to help where she can, Ben and his mother have a strained relationship in the past, due to his aggressive interactions when unwell.
Ben’s workplace has organised him some sick leave. Ben’s girlfriend has discussed with you that his employer is very supportive around mental health issues and wants him back at work when he is ready, Ben has discussed with you that he is worried about going back to work as he doesn’t think he can do his normal fulltime job with the medications he is on as they make him drowsy at times and he doesn’t want to have a workplace accident because of it.