Background

.Jan Novak, a 30 -year old patient with some suicidal tendencies admitted to the mental hospital.

.He had several fresh and older wounds on his forearms.

.He has lost a lot of weight because of a lack of interest in eating food and self-care.

.He also reported experiencing difficulty in sleeping for a few months.

.He had lost his father in his early childhood.

.He also stated that his mother was an alcoholic and did not look after him and his sister.

.He had never discussed the sudden demise of his father with anyone.

Identification of the Needs of Jan using Biopsychosocial Model

He is at risk of self-harm

He is at risk of self-neglect

Withdrawn from friends and family (self-isolation)

Risk of depression

Accommodation

Risk of health deterioration (Loss of weight and unkempt)

Self-harm

.Considering the patient’s behaviour of self-harm as he was cutting his forearms, he is suggested to be suffering from Self-injurious thoughts and behaviours or SITBs as he is trying harm himself without an intention of dying (Bettis, Liu, Walsh and Klonsky, 2020).

.This condition can be treated by incorporating family, emphasizing the development of skills, and understanding the triggers for their act (Hetrick et al., 2020).

Self-neglect

.According to a study, when a person is unable to maintain self-care as per the socially and culturally standards like in this case study is considered to be at risk of self-neglect (Touza and Prado, 2019).

.A conceptual structure and manifestations of self-neglect must be known to the therapist to initiate treatment appropriately (Pickens, Daniel, Jones and Jefferson, 2021) .

Withdrawn from friends and family (self-isolation and risk of anxiety)

.As the patient had withdrawn himself from family and friends and suffered from childhood trauma, he might be suffering from anxiety disorders (Takarangi, Moeck, Peters and Stirling, 2022).

.Anxiety disorders can be managed with the help of cognitive-behavioural and psychopharmacological interventions (Bystritsky, Khalsa, Cameron and Schiffman, 2013).

.As the patient had never talked about his grief with anyone, there is a possibility of depression, which is why his quality of life is deteriorating (Wang et al., 2017).

.The most effective method of treating depressive symptoms is the utilization of talking therapies (Cuijpers, Stringaris and Wolpert, 2020).  Identifying And Treating The Biopsychosocial Needs Of A Mentally Ill Patient Essay Paper

.Mental health disorders like depression lead to the deterioration of the health as observed in this case study (Dewa et al., 2018).

.As per a study, Childhood Maltreatment is directly related to the development of depressive disorder like in the case of Jan, he was not cared by his mother properly that resulted in his mental health deterioration like loss of weight (Gerke et al., 2018).

• According to Shephard, all healthcare procedures require the consent of the patient, which would be a legal, moral, and ethical necessity for health providers. An emerging body of research indicates conflict and heterogeneity in practice in assessing decision-making ability and consent processes. Patient decision-making capacity is likely the most important aspect of all healthcare consent, and a consent that lacks decision-making capacity is not legally binding (Shepherd, 2016). Increasing research reveals the occurrence of dissonance and diversity in practice among healthcare practitioners in the evaluation of patient decision-making capacity, which has an influence on following consent and treatment frameworks. Therefore, as a care professional, I have a legal and ethical obligation to get proper permission for all healthcare interventions with Jan.

• On the surface, assessing decision-making capacity and gaining Jan’s consent may be a specific aspect of healthcare involvement, including discussion, transparency, and agreement. In actuality, especially in this case of acute care, it may be a complicated process impacted by various idiosyncratic and contextual circumstances. When poor cognition is present, the difficulties in assessing decision-making consent are exacerbated (Shepherd, 2016); hence, the quality of Jan’s consent in this setting is of the utmost importance, both legally and morally. Since Jan has the ability to make decisions about his bodies, he also has the right to decide what may and cannot be done to them: This implies individuals have the option of consenting to or refusing medical care. Adults with capability are considered to be competent and so do Jan.

• Jan would be placed at the centre of the operation and treated as such in an individual approach. The focus would be on Jan and his abilities, rather than his mental condition. Person-centred care, according to Moon and Rice (2012), comprises treating people as equal stakeholders in the experience of healing; it is customized, integrative, and collaborative. It is not a medical model and should be viewed as multidisciplinary, with the understanding that Jan may require the aid of more than one professional (Coulter & Oldham, 2016). Jan’s assistance will be tailored to his specific needs and situations needed to aid him to reach his objectives.
  

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• I would urge Jan, who works in the repair centre, to be active in making life decisions. The method takes into account an individual person’s life experience, age, gender, culture, origin, language, beliefs, and identification, and requires flexible services and support to match the person’s desires and objectives. It is a competency approach in which Jan will be regarded as the expert in his life, with a concentration on what he can do first and whatever assistance he needed. In addition, Jan’s mental health resources are included as partners. Notably, therapists employ this strategy to try to create the conditions for their clients to change. This requires establishing a flexible, considerate, and empathic treatment environment.

Annotated References

Bettis, A., Liu, R., Walsh, B. and Klonsky, E., 2020. Treatments for Self-Injurious Thoughts and Behaviors in Youth: Progress and Challenges. Evidence-Based Practice in Child and Adolescent Mental Health, 5(3), pp.354-364.

Through this research, researchers had compared several case studies that presented the implementation of evidence-based psychotherapy for individuals with SITBs. This study also stated the challenges and new developments in this field. It has been observed that skills-based psychosocial interventions and family support worked effectively in improving the behaviour of the patient. This research is helpful in initiating the skills -based psychosocial therapy of Jan to improve his condition. The involvement of mental-health caregivers and psychiatrists may enhance the quality of life and reduce the self-injurious thoughts of the patient. Considering this approach, it is important to talk to the patient about his thoughts.

Identification Of The Needs Of Jan Using Biopsychosocial Model

Bystritsky, A., Khalsa, S., Cameron, M. and Schiffman, J., 2013. Current Diagnosis and Treatment of Anxiety Disorders. National Library of Medicine, 38(1), pp.30-38, 41-44, 57.

The researchers in this study have conducted a research using the ‘ABC’ Model of Anxiety to understand the impact of emotional reactivity, coping strategies, and core views on diagnosis and management of anxiety. According to this study, stress and biological factors play a significant role in the onset of this disorder. As per this study, pharmacological therapy can be utilized to manage this condition and reduce stress. As Jan was withdrawing himself from his family and friends, it can be said that he was dealing with anxiety disorders that can be managed utilizing the approach suggested in this research study. As concluded in this study, it is significant to understand the emotions and feelings of the patient to enhance the care of the patient.

Coulter, A. & Oldham, J. (2016). Person-centred care: What is it and how do we get there? Future Hospital Journal, 3(2), pp.114–116.

This study was conducted by Coulter and Oldham in 2016 that focusses on the approach of person-centred care at three different levels including service, consultation, and system. The researchers had explained a better way of delivering healthcare to the patients and what exactly needs to be done to reach there. This study is helpful in the case of Jan Novak as he will be cared personally as per his specific requirements.

Cuijpers, P., Stringaris, A. and Wolpert, M., 2020. Treatment outcomes for depression: challenges and opportunities. The Lancet Psychiatry, 7(11), pp.925-927.

Through this research study, it has been observed that depression is very common and strongly affects the quality of life of the patient. In this study, the researchers have discussed ten key statistics about depression treatment. According to these statistics, 54% of the patients have shown improvement after starting medications and 62% of the patients have shown improvement in their condition after psychotherapy. This research is useful for the case study in respect of the treatment of the patient. The initiation of psychotherapy with an experienced professional may improve his condition after a given time-span.

Dewa, L., Cecil, E., Eastwood, L., Darzi, A. and Aylin, P., 2018. Indicators of deterioration in young adults with serious mental illness: a systematic review protocol. Systematic Reviews, 7(1).

In this case study, the researchers have utilised seven databases that include MEDLINE, CINHAL, Health Management Information Consortium, Embase, Cochrane databases, PsycINFO, and Web of Science to get information on five main aspects including serious mental illness, age, deterioration, sign, and patient. Through this systematic review, a recognisable contribution to the mental health field is more likely to be made that assists in managing deteriorating patients. This review can be used to keep the patient safe from harm and identify the major triggers of the health deterioration of the patient. Using this study, the patient will know when his symptoms start deteriorating and when he requires help.

Engel, G., 1980. The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137(5), pp.535-544.

Interventions For Jan Needs

This research was conducted by George L. Engel for the clinical application of the biopsychosocial model. As per this study, the consequences of this model for understanding and care of the patient are presented with a critical myocardial infarction. According to this model, every patient’s need is influenced by several biological, psychological, and social aspects. The current case study is considered and approached on the basis of this research. The needs of Jan are identified based on this model and interventions are also made considering the biopsychosocial model by Engel.

Gerke, J., Koenig, A., Conrad, D., Doyen-Waldecker, C., Pauly, M., Gündel, H., Wilker, S. and Kolassa, I., (2018). Childhood maltreatment as risk factor for lifetime depression: The role of different types of experiences and sensitive periods. Mental Health & Prevention, 10, pp.56-65.

The researchers have conducted five studies on a large group of patients of different age groups to understand the exposure of age and its impact on the development of a lifetime of Major Depressive Disorder due to Childhood Maltreatment. Through this research, it has been concluded that the negligence and abuse by parents during adolescence leads to the risk of lifetime major depressive disorder. A Similar case can be observed in the case study of Jan where he was neglected by his mother after the sudden death of his father. This carelessness of his mother resulted in the onset of depressive disorder in the patient. This can be treated with the help of a psychotherapist by discussing his life events.

Hetrick, S., Subasinghe, A., Anglin, K., Hart, L., Morgan, A. and Robinson, J., (2020). Understanding the Needs of Young People Who Engage in Self-Harm: A Qualitative Investigation. Frontiers in Psychology, 10.

This study was conducted by the researchers on seven young people by engaging them in interviews. These interviews were made in a way to learn about the immediate triggers that urge them to self-harm. Also, these interviews help participants to understand strategies that can be utilised to manage this urge. A similar procedure can be used for Jan to learn about his immediate triggers that urge him to harm himself. Also, he may be asked to use the strategies to manage his condition by reducing his urge of harming himself. This study can be helpful in managing his self-harm disorder.

Moon, K.A. & Rice, B., (2012). The nondirective attitude in client-centered practice: A few questions. Person-Centered & Experiential Psychotherapies, 11(4), pp.289–303

This research study was conducted by Moon and Rice in 2012. This research study was focused on the ethical essentials of the non-directive attitude, which is closely related to person- centred therapy. Through this study, the researchers have questioned about the practices of counsellors and therapists. This study is helpful in the case of Jan Novak to focus on his abilities instead of his mental health.

Pickens, S., Daniel, M., Jones, E. and Jefferson, F. (2021). Development of a Conceptual Framework for Severe Self-Neglect (SN) by Modifying the CREST Model for Self-Neglect. Frontiers in Medicine, 8.

Annotated References

This study focuses on the development of a strategical method to manage the condition of severe self-neglect. As per this study, this condition results in more than one condition in the future including poor sleep, dementia, frailty, and depression. Using this study, healthcare professionals can identify severe cases of self-neglect. This research study can also be used to learn more about the condition of Jan Novak and the severity of his condition. This will help in improving the health condition of the patient by collaborating with other health professionals. It may reverse his health deterioration.

Shepherd, V., 2016. Research involving adults lacking capacity to consent: the impact of research regulation on ‘evidence biased’ medicine. BMC Medical Ethics, 17(1).

This study was conducted by Victoria Shephard to explain the issues of the capacity and consent for the individuals who lack capacity of making decisions. With the utilization of this paper the standard of healthcare can be improved. This research study is helpful in understanding the issues of capacity and consent for Jan Novak. As he was not in proper state of mind, it cannot be concluded that he was providing the correct information about his health and hygiene. Additionally, he was not ready to give consent for the initiation of his appropriate medical treatment.

Takarangi, M., Moeck, E., Peters, J. and Stirling, N. (2022). Posttraumatic stress disorder symptom severity and functional impairment in the education domain. Journal of Anxiety Disorders, 88, p.102573.

Through this research study, the researchers have examined the relationship between the objective and subjective measures of functional impairment in the domain of education and posttraumatic stress symptoms. This research was conducted on around two hundred and sixty participants. Their average grades have been assessed at the end of the semester. It was concluded that Posttraumatic Stress Disorder affects the daily life activities of the participants. Similarly, Jan Novak’s childhood trauma affected his daily life events. Hence, it is important to start talk therapy with an expert medical professional to improve his condition and reduce posttraumatic stress symptoms.

Touza, C. and Prado, C., (2019). Detecting Self-Neglect: A Comparative Study of Indicators and Risk Factors in a Spanish Population. Gerontology and Geriatric Medicine, 5, p.233372141882360.

This study was conducted on 269 social service clients in the Spanish population. They were divided into three groups that include presumed adequate treatment, at increased risk of self-neglect, and at increased risk of abuse. It was observed that elders of the group that was at increased risk of self-neglect showcased major issues in reference to personal appearance and hygiene. This study is useful to understand the risks and factors associated with self-neglect and how important it is to improve this condition. The patient must start his medical therapy to improve his condition and quality of life.

Wang, J., Wu, X., Lai, W., Long, E., Zhang, X., Li, W., Zhu, Y., Chen, C., Zhong, X., Liu, Z., Wang, D. and Lin, H., (2017). Prevalence of depression and depressive symptoms among outpatients: a systematic review and meta-analysis. BMJ Open, 7(8), p.e017173.

Through this study, the researchers have conducted a systematic review to deliver a particular estimate of the occurrence of depressive symptoms among outpatients in a large number of medical specialties. The researchers have used eighty-three cross-sectional studies to study 41344 individuals. It has been observed that the prevalence of depression was higher among the patients in developing countries in comparison to the patients in developed countries. Using this study, it can be concluded that the health care providers must use effective management strategies for Jan Novak for the early identification and treatment of his health condition.  Identifying And Treating The Biopsychosocial Needs Of A Mentally Ill Patient Essay Paper