The Neuman’s assessment model provides a framework to identify the potential stressors in the environment of the mental health consumer and develop measures to better deal or prevent the stressors to restore equilibrium to the individual. The Driscoll reflective model uses three essential questions: “What?”, “So what?”, and “Now what?” to complete the reflective activity. This reflective model has been widely used by nurses to enhance their decision-making abilities (Ashoorian and Davidson 2021). This essay seeks to critically reflect on the person-centered mental health assessment carried out by the author by using Driscoll reflective model (Snowdon 2018) on a mental health consumer (Esterhuizen 2019). The author aims to reflect on the use of the Neuman’s assessment model as a means of intervention to understand the case of Gary (Lawson 2021). Additionally, the essay reflects upon clinical decision-making ability of the author for the management of complex cases in mental health nursing settings.

The person-centered assessment was centered on Gary, using the pre-defined questions of the Neuman’s assessment model tailored to suit the consumer’s circumstances (Symonds et al. 2020). Gary is a 20-year old, male consumer who is currently unemployed. During his teenage, he had started to become distant from his mother, had very limited friends and engaged in abusing drugs like marijuana with local young males. Gradually his behvaiour started becoming erratic and bizarre, followed by an event of fire setting which Gary indicated was done on the commends of a voice as a part of bombing campaign to signal his other brothers. He had been admitted to CAMHS mental health unit under the Mental Health Act (1983, Section 2). He was diagnosed with dug induced psychosis and was prescribed with Olanzapine (Citrome et al. 2019). Since the discharge at age thirteen, he remained a threat to his sister and began inflicting oneself with cuts on his arms and legs. On assessment, the author found that there were various stressors in his environment, which makes him susceptible to another psychotic episode. The stressors identified are: lack of contact with one’s family members (in intermittent contact with Nan, no contact with mother) (Aggarwal and Patton 2018), living in a temporary accommodation, unemployment, absence of father, inability to accept his mother’s relationship with her current partner, and lack of adequate social support. Reflective Analysis Of Person-Centered Mental Health Assessment Paper  It is conceptualized that he engages in inflicting self-injury as a way to cope with the stressors described above (Lockwood et al. 2017). The supports available to Gary are a reasonable relationship with his youth worker, his Nan, a supportive friend named Tor and the support of the community mental health team.

The social Care Institute of Excellence (SCIE, 2021) states that it is imperative to use a person-centered assessment model before the development of a personalized intervention plan that considers the unique needs, goals and health aspirations of the consumer. A person-centered approach promotes the role of the consumer as the agents of their own health and wellbeing. The role of the service provider is to actively engage the consumer in the decision making of their care plan. This enables the consumer to completely engage, commit and determine the course of the recovery plan and additionally instills hope, direction, and self-determination to carry out the care intervention (Lim et al. 2017). The person-centered approach assists and enhances the information gathering process as it considers the unique narrative of the consumer and centers on the abilities and strengths of the consumer rather than on the philosophies of the healthcare practitioners.

Stressors Identified In Person-Centered Assessment

In this context, the author has effectively used the principles of the Neuman’s assessment models in creating a warm and empathetic therapeutic relationship with Gary to elicit important information that is pertinent to the development of a tailored intervention plan to enhance the patient outcome (Gerace 2020). The author had used strength based interview technique to gather the relevant data relating to his experiences of the mental health issues, how he coped with the challenges, thereby, helping him reflect on his available resources and the resources and support that he additionally requires from the community services to recovery from his mental health issues. Through the collaborative encounter with the consumer, the author has been successful in respecting the preferences of Gary while developing the finest intervention to help Gary deal with his issues. Gary’s belief system, his insight about his mental health issues (Ma et al. 2018), understanding of the services available to him, cultural background and the affordability of the available services were considered during the assessment so that the interventions can be culturally sensitive (Yilmaz et al. 2017) and does not challenge her belief system.

The clinical decision-making model enables the mental healthcare practitioners to judicially incorporate the elicited information from the consumer in the choice of the evidence based best practice in dealing with the present challenges (Wallström and Ekman 2018). Based on the information gathered from the assessment, the author planned to focus on prioritizing the intervention of Gary’s self-harming behvaiour, as there is a potentially high risk of infecting himself through the cuts and might lead to other adverse consequences. To deal with the self-harming behvaiour, the author chose to provide Cognitive Behavioural Therapy (CBT) to recognize and modulate the automatic negative thoughts that might trigger his self-harming behaviour (Ghorbani et al. 2020). Additionally, teaching emotion regulation skills and stress coping skills (Cancio et al. 2018) have also been considered for Gary (Townsend & Morgan 2017). The author had appropriately considered Gary’s holistic needs to refer him to a drug detox service in the community to reduce his drug use (Wallström and Ekman 2018). The author also considered mutually collaborating with the youth worker to provide him with a job. The author referred him to alternative accommodation to provide him with a safe and secure living condition and an occupational therapist so that help him attend his court cases and cater to Gary’s social and emotional needs (Massie 2019).

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It is essential to understand the underlying factors contributing to the self-cutting behvaiour in Gary. Self-harming behaviour can be associated with a number of underlying issues like that of depression (Yates et al. 2017), emotional dysregulation (Dadomo et al. 2018), stressors, distress, substance abuse or psychosis (Pelizza et al. 2019). Therefore, in the context of providing Gary with a holistic care and recovery support, it is equally essential to understand the underlying causes of the self-harming behvaiour unique to the case of Gary. It is additionally a requirement to assess the risk associated with self-harming behvaiour. In this regard, the author was able to implement the biopsychosocial model to determine the social, biological and psychological factors that might have contributed to her self-harming behaviour. It is not easy to determine the possibility of a person to engage in suicidal attempts or detect suicidal ideation from self-harming behvaiours (O’Conno et al. 2018), as self-harming behaviours are unpredictable and erratic in nature (Olfson et al. 2018). Therefore, the author had not relied solely upon the risk assessment results as the reports of risk assessment in self-harming behaviour is merely predictive in nature not deterministic. In this context, the author involved Tor, the friend who had been the only support for him and Gary’s Nan. In developing the interventions for dealing with self-harming behaviour, it is essential to involve the family members in the support system (Mastrocola and Flynn 2017) to ensure that Gary is receiving adequate social and emotional support that can help him relieve his stress (Krysinska et al. 2020).

Person-Centered Approach In Mental Health Assessment

Through this reflective activity, the author has been able to understand strengths and weakness in one’s clinical practice (Choperena et al. 2018). As a mental health nurse, the author believes that it is essential to upgrade one’s assessment skills and develop one’s skills in applying person-centered care and assessment techniques into one’s practice. This reflective process has consolidated the author’s self-confidence and clinical knowledge in assessment and person-centered intervention plan (Howatson-Jones 2016). The author recognized that the areas of strengths are the ability to empathize and prioritize the needs of the consumer in supporting and assisting a consumer on the way to recovery journey. Through the reflective process, the author also understood the impact of a person centered approach (Wallström and Ekman 2018). However, the author intends to improve the skills of interviewing and the risk assessment so that in future practice, the consumers do not have to face any adverse consequences. The author plans to improve her assessment skills by learning more about the components of Neuman’s assessment model and watching videos of experts exemplifying the skills of interviewing and assessment.

Through the assessment and planning interventions, the author has been able to learn about the implications of the person-centered approach in understanding and planning for a person who has self-harming behaviour. Furthermore, the author learned about self-harm and integrative intervention plan (risk management plan) through the reflective process. The author also learned ways to tackle issues by weighing the risk and benefits of involving a particular support person in the interventional plan (Steele et al. 2018). For instance, the author learned the counter-productivity of introducing Tor as an emotional support for Gary as it would only strengthen the self-harming behaviour due to peer influence (Lamblin et al. 2017). Therefore, the support of Tor was not considered in the interventional plan.

References

Aggarwal, S. and Patton, G., 2018. Engaging families in the management of adolescent self-harm. Evidence-based mental health, 21(1), pp.16-22.

Ashoorian, D.M. and Davidson, R.M., 2021. Shared decision making for psychiatric medication management: a summary of its uptake, barriers and facilitators. International Journal of Clinical Pharmacy, pp.1-5.

Cancio, E.J., Larsen, R., Mathur, S.R., Estes, M.B., Johns, B. and Chang, M., 2018. Special education teacher stress: Coping strategies. Education and Treatment of Children, 41(4), pp.457-481.

Choperena, A., Oroviogoicoechea, C., Zaragoza Salcedo, A., Olza Moreno, I. and Jones, D., 2019. Nursing narratives and reflective practice: a theoretical review. Journal of advanced nursing, 75(8), pp.1637-1647.

Citrome, L., McEvoy, J.P., Todtenkopf, M.S., McDonnell, D. and Weiden, P.J., 2019. A commentary on the efficacy of olanzapine for the treatment of schizophrenia: the past, present, and future. Neuropsychiatric disease and treatment, 15, p.2559.

Dadomo, H., Panzeri, M., Caponcello, D., Carmelita, A. and Grecucci, A., 2018. Schema therapy for emotional dysregulation in personality disorders: a review. Current opinion in psychiatry, 31(1), pp.43-49.

Esterhuizen, P., 2019. Reflective practice in nursing. Learning Matters.

Gerace, A., 2020. Roses by other names? Empathy, sympathy, and compassion in mental health nursing. International journal of mental health nursing, 29(4), pp.736-744.

Ghorbani, S., Kameneh, A.S., Motahedy, A. and Alipour, Z., 2020. Comparative effectiveness of cognitive-behavioral therapy and dialectical behavior therapy on emotion regulation, positive and negative affection, aggressive and self-harm behaviors of 13-16-year-old female students. International Journal of Multicultural and Multireligious Understanding, 7(9), pp.20-32.

Krysinska, K., Curtis, S., Lamblin, M., Stefanac, N., Gibson, K., Byrne, S., Thorn, P., Rice, S.M., McRoberts, A., Ferrey, A. and Perry, Y., 2020. Parents’ experience and psychoeducation needs when supporting a young person who self-harms. International journal of environmental research and public health, 17(10), p.3662.

Lamblin, M., Murawski, C., Whittle, S. and Fornito, A., 2017. Social connectedness, mental health and the adolescent brain. Neuroscience . Reflective Analysis Of Person-Centered Mental Health Assessment Paper