OMPLEX NEEDS: ADVANCING MENTAL HEALTH NURSING

1. Describe the chosen individualas background and history to date.
2. Provide a formulation of the individualsa current psychological, physical and social needs at this time by selecting and using published therapeutic/theoretical approach/s.
3. Utilise the formulated assessment data from section 2 to provide a structure or guide the nursing care provided in :-
a. Critically determined identification of aims/goals
b. Appropriate and critically selected therapeutic nursing interventions
c. Exploration of the evaluation of care and clinical MDT review
4. Discuss the therapeutic efficacy of the current clinical environment or service where care is being provided. Analyse possible alternative service provision options and discuss whether they may or may not be more beneficial for the individual.
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Added on 15.12.2014 07:07
THIS IS A LEVEL 6 ESSAY AND REFLECTION ACADEMIC WRITTING.
THIS ASSIGNMENT IS BASED ON A PATIENT SCENERIO AND YOU WILL HAVE TO DO AN EVIDENCE BASED CARE PLAN IN MENTAL HEALTH NURSING FOR THIS PATIENT.
YOU WILL ALSO HAVE TO DO A CASE FORMULATION THAT WILL USE A PSYCHOLOGICAL APPROACH TO DIAGNOSE THE PATIENT PROBLEM AND USE THE SAME APPROACH TO PLAN INTERVENTION.
IT IS A 1250 WORDS COUNT AND PLEASE DO USE HAVARD REFERENCING WITH MINIMUMOF 15 REFERENCS.
FIND THE SCENERIO HERE;


Case study 3  Musti s case study (Forensic)

PRESENTING SITUATION
Musti is a 23 year old Turkish Cypriot man who is currently admitted into a forensic unit. This is his first contact with the mental health services and he is currently being place on section 2 of the mental health act (MHA, 1983) amended (2007). The situation leading to the current admission is mainly because of aggressive and violent behaviour as it was reported that Musti was initially arrested by the police for a public order offence as he was seen punching a glass of panel at a bus stop. Officers thought that Musti was under the influence of alcohol or drugs, so he spent the night in custody on constant observations. Musti was due to be released and picked up by his uncle the following day and when his uncle arrived Musti became agitated and aroused and tried to punch him, according to his uncle who had seen him one week before reported this was was entirely new behaviour. Whilst Musti was in the cell, he was observed to be behaving bizarrely by standing to attention, crying, pacing up and down his cell and attempting to hug female officers and this presentation led to a mental health act assessment.
During the assessment Musti appeared agitated and perplexed seemingly to be responding to external stimuli. On occasions he would appear to be preparing to fight by expanding out his chest, breathing heavily and giving prolonged stares  he seemed to be distress by something. Following the assessment, Musti started to kick the wall and punch himself in the face. A police officer attempted to de-escalate the situation but this initiated a scuffle and resulted in him being physical restrained by six officers. It was reported that just after this incident, Musti was shouting out  shoot me and kill me , currently presents as floridly psychotic.
He was considered to be suffering from a mental illness with the risk of violent and aggressive behaviour so he was detained under section 2 of the mental health act (1983) for assessment. Musti was transferred to a triage ward where he was assessed but his behaviour became unmanageable he was presenting as aggressive towards other patients and staff and this was why he was subsequently referred to forensic services.
Patient s Family Background
Musti grew up in Cyprus and has an older sister who is engaged and lives with her fiance. Both parents are still together and report good health. There was no report of first degree relatives with any mental illness but his mother s sister had an acute psychotic episode twenty years ago but had fully recovered and had not had an episode since.
Past Psychiatry History
Musti reported a happy child hood and had no contact with mental health services in Cyprus.
Although, Musti has a history of aggression including uncharacterised aggression toward his uncle. Vandalising property and threatening behaviour.
Medical History
There were no reports of any prenatal complications or delays in reaching his developmental milestones. No physical health problem reported.
Social History
Musti did well academically; he went to university to study computing but could not cope with the work load and failed the course and he is due to attend military service in Cyprus.
Employment and financial History
Musti worked with his mother and father in their restaurant business which was said to have been under some financial stain. This prompted Musti to leave Cyrus and come to the UK in January 2012 to find employment. He initially stayed with an uncle and a cousin for 6 months then found work in a kebab shop working 11 hours per day at ?3 per hour. He left the job after one month after reporting that the employers were threatening him with a knife.
Alcohol and Drug History
Musti admitted he drinks occasionally but very little, denied any substance misuse and is a non-smoker.
Activities of Daily living
Some evidence of self-neglect as uncle reports he has lost weight.
Accommodation
Musti is renting a one bedroom flat in south east London and reports ?600 in savings.
Relationship
Has contact with an uncle and a cousin (father s side) who live in the UK..
Risk
Denied suicidal thoughts/ideation, but risk of harming others is high due to his paranoid beliefs.

HERE ARE THE GUIDELINES
Assessment guidelines
1. Describe the chosen individual s background and history to date.

Guide There should be a brief but thorough description of the facts, events and reasons that brought the services user into the mental health services. This will include the information normally collected in an initial assessment but also subsequent and on-going intervals. It will include demographic details, recent history, past history, family set up, social networks, risks. It will provide an overview of how the service user came into the MH services and what or if they have used the MH services previously, what was efficacious on those occasions.


2. Provide a detailed formulation of the individuals current psychological, physical and social needs at this time by selecting and using published therapeutic/theoretical approach/s.

Guide Each of the cases can be understood in the context of a theoretical position which can help us as Mental Health nurses to understand, be able to explain and therefore be in a better position to assist our patients. You must consider what may have been happening in the service user s life that has resulted in their present condition. This may have been in the distant past or recent past or currently happening. Once you have established this, look at the various theories that have been proposed that offer an explanation for why the service user may be in their current position. You will then be required to offer a theoretical perspective to explain what is happening with the individual in question.

E.g. A person with: -
” An acute anxiety state may be a result of unresolved separation anxiety in their development or faulty cognitive evaluations of situations.
” Self-harming tendencies may be still affected by childhood sexual abuse issues.
” An eating disorder may have altered cognition regarding their body image.
” Someone who is misusing alcohol or illegal drugs may be suffering from an addiction.

3. Demonstrate how the therapeutic/theoretical approaches chosen in part two can provide a structure or guide the nursing care provided in :-
a. Assessment of needs.
b. Identification of aims/goals
c. Therapeutic nursing interventions
d. Clinical review
Guide 
a. All mental health care takes place in the context of the Multi-disciplinary team, but