Mental Health Assignment: Risk Assessment & Action Plan for Clinical Case
Question
Task
The Case of Marko
Marko is a 68-year-old male who has presented for treatment. Marko is of Croatian background. He completed high school to year 10 in Croatia, and then began working in his parents’ bakery. A few years later he married and immigrated to Australia with his wife. He has 4 children, all of whom are adults living away from the family home. His wife died 1 year ago, and Marko now lives alone although his children visit regularly to check on him. Marko was diagnosed with prostate cancer 4 months ago with several metastases found in the bones of his pelvis. He has undergone surgical intervention to assist with pain control and joint stability. However, he has postural problems and lives with daily pain and fatigue.
Marko has been encouraged by his medical team to seek treatment for his postural problems and associated pain. However, he is disinterested and agrees to attend one session reluctantly to “keep everyone off his back”. He reports experiencing increased depressed mood, flat affect, and fatigue. He feels tired all the time, and has difficulty falling asleep and staying asleep. His tiredness means he sometimes naps during the day and he has very little energy to engage in simple tasks including personal grooming and maintenance around the home. He has been worried and unenthusiastic since receiving his diagnosis. He had also been increasingly dysphoric and overwhelmed after the death of his wife and finds it difficult to find enjoyment in daily life. He spends most of his days at home by himself. He feels sad and empty for most of the day, almost every day, and has reported being increasingly tearful.
Marko expresses a lack of interest in any form of medical treatment or desire to engage in physical exercise, and states that he would just like to die. He has frequent suicidal thoughts and expresses that he has the means and could “surely create a lethal drug cocktail” with the medications he has been prescribed for his cancer and pain. Despite having access to means, he reports not having devised a specific suicide plan. He reports being hopeful his pain will improve, which displays a sense of future orientation. However, aside from his children whom he loves, he believes that his life is lacking meaning and purpose. He reports feeling ambivalent about his future and indicates that his feelings sway from wanting his pain and health to improve to wanting his life to be over.
Marko says he understands why his health professionals want him to try and be more active to better manage his pain and health conditions. His disinterest and low motivation, his medical conditions and thoughts about dying, and his depressed mood are making it difficult for him to invest in the treatment process.
Consider the above case and prepare a detailed mental health assignment to summarize the case, conduct a suicide risk assessment, justify your identified risk level, and present an action plan detailing how you would manage the client.
Part 1: Summary and description of mental health condition
Summary of case and presenting problem (approximately 200 words)
Your assignment should begin with a brief introductory paragraph that (a) describes the client and (b) their presenting problem. When describing the client, provide a summary of the relevant demographic information of the client (e.g., gender, age, health status). When describing the presenting problem, include:
- A summary of the reasons the client has come for treatment
- An overview of the current key symptoms/issues, history of the problem (i.e., when the symptoms began), and the impact of these symptoms on the client’s functioning or well-being (i.e., impact on relationships/job/quality of life etc).
Part 2: Risk assessment and action plan
Assessment of risk and justification (approximately 250 words)
Based on the case study, assess the client’s suicide risk and (a) provide a risk classification (low, medium, or high) and (b) justify the rationale for your risk assessment rating using information presented in the case study, in class, and in evidence-based sources (e.g., “I have evaluated the client’s suicide risk as low, based on….”). You must clearly explain how you have reached your decision (i.e., what information from the case study and class you considered in your evaluation, and what evidence-based literature supports your position).
Action plan (approximately 550 words)
Following your risk classification and justification, provide a risk management action plan you would use when working with this client. The strategies you recommend must be evidence-based, relevant to the personal details provided in the case study and must be congruent with the suicide risk classification identified. Each strategy and what it involves should be clearly described and a rationale given for how this strategy is relevant to the client.
Answer
Mental Health Assignment Part 1: Summary and Description of mental health condition
Reasons to seek treatment by client
In reference to present case of Marko, the diagnosis of prostate cancer made him primarily seek for medical health treatment. Marko’s demographic identity specifies to be a male patient of the age of 68 years who is lately diagnosed with Prostate Cancer as medical condition for past four months. Due to the excessive pain and joint instability Marko had to seek for clinical examination. As a result of significant findings derived in Marko’s physical condition like metastases in several bones particularly in pelvis region which necessitated him to take professional healthcare assistance. As a result of these symptomatic representations shooting up to crucial levels, Marko needed to take the decision of undergoing surgical treatment (Calati et al. 2019). For the unbearable pain to be curbed down and joint instability to be intervened, the thorough check up and needed care progress was planned.
Marko is subjected to a life where there is no one around him at constant stretch. After his wife’s death, Marko felt completely left alone. As the children were all adult, all four of them stayed away from family house. This necessitated Marko to be monitored by professional health specialists so that he gets checked by external support group. The increasing thoughts of strong suicidal activities are recurrent in Marko. Although his children keep a check with visits to his place, the times he stays alone can be highly vulnerable to commit something unwanted and unfortunate.
Overview of current key symptoms
The significant life event changed the mental state of harmony for Marko. After his wife’s passing, the feeling of loneliness, depression and boredom led him through adverse experiences. Due to poor health condition and uncontrolled continuous pain, the level of fatigue rose. Issue with postures made him reluctant to even seek proper medical care treatment (Calati et al. 2019). The flat affect, state of being unemotional and excessive depressed mood made him succumb to unusual tiredness. The routine of normal life got dismantled with lack of interest in personal hygiene and grooming with strong sense of un-enthusiasm. This resulted in developing dysphoria after being overwhelmed with Marko’s wife passing.
The symptom of prostate cancer gets manifested in a severe manner with critical pain. The joint stability is another requirement which grows as a clinical symptom for Marko. Fatigue is the prime outward response that Marko shows as a symptomatic representation of depression (Park et al. 2020). The strong unwillingness to move and change postures is a major concern which adds to the diagnosis of depressive characteristics. Finding it extremely difficult to fall asleep in time and staying asleep during day time are incoherent activities which are clinically significant symptoms to support the mental condition related findings. Showing strong impulse driven urge to perform suicide with existing prescribed drugs is strong indication of depressive mood. The swinging mental state to want two contradictory actions to control or improve the pain condition and look for suicidal opportunities are indications of instable mood condition. This leads towards low motivation, dying tendencies and difficulty in coping with treatment interests.
Part 2: Risk assessment and action plan
Under the diagnosis of psychological health condition and physical disease, the indication about depression and prostate cancer are respectively determined. The symptomatic representations are identified at distinguished levels for Marko’s health condition to be clinically represented (Gray, Azizoddin & Nersesian, 2020). The difficulty indicated through the risk assessment chart shows how Marko is critically subjected to health proneness and risks. The incapability to lead a normal life shows strong indication about clinical risks in Marko’s health and mental condition. When the sleeplessness becomes a significant mental health determinant, the risk level reaches at high level. This not only gets reflected through Marko’s incapacity to sleep in normal timings but also shows reverse activity of going off to sleep in unusual times like day time. This naturally makes the health risk extent reach high category.
Marko has multiple reasons collectively acting on his mental state to result in depressive mood. The diagnosis of Prostate cancer, pain and metastases located in multiple bones of pelvis make the physical condition subjected to unbearable experiences. The passing of his wife and children staying away from their family house is a significant and strong triggering point to make Marko succumb to depression (Granek et al. 2019). This makes the risk extent reach extremely high level. It is the depressed mood that makes the suicidal thought as a related risk outcome. Although the risk extent is reached at sometimes category, the mental condition is impacted.
The events like wife’s death and health deterioration collectively make Marko succumb to mental state impactful by becoming emotionless. This naturally makes flat affect as a critical risk indicator. However, the severity of fatigue is much higher in risk correlation as posture movement and willingness of Marko is severely affected.
Action plan
Strategies are planned for managing depressive mood symptoms as follows:
Relaxation training:
Helping Marko to cope up with loneliness, fatigue and sleeplessness through mind relaxation is used. Training techniques applied for Marko’s vulnerability to commit suicide. Using online measure can help depressive symptoms to be curbed out. The voluntary online technique is administered to treat people like Marko having sleeplessness, loneliness and depression.
Light Therapy:
With the purpose of bringing hope in the life of Marko, the light therapy is used. As Marko’s depression makes him find to reason or purpose to live, this therapeutic strategy is applied (Conejero et al. 2018). The issues with sleep, mood instability and SAD symptoms are impacted with brain chemical approach.
Making Marko involved in interesting activities and taking him outdoor can help create avenue of enjoyment and positive thinking.
Self-help books on cognitive behavioral therapy CBT)
Marko can be treated about his feelings of suicidal thoughts and sleep deprivation and excessive fatigue to not move or change postures with CBT. This helps controlling the depressive symptoms with the self help books to treat the specific issues of mood switching from contrasting thoughts to curb out the trials of suffering and prolong care service sessions.
References
Calati, R., Ferrari, C., Brittner, M., Oasi, O., Olié, E., Carvalho, A. F., &Courtet, P. (2019). Suicidal thoughts and behaviors and social isolation: A narrative review of the literature. Journal of affective disorders, 245, 653-667. Retrieved from https://www.sciencedirect.com/science/article/pii/S016503271831694X
Conejero, I., Olié, E., Courtet, P., &Calati, R. (2018). Suicide in older adults: current perspectives. Clinical interventions in aging, 13, 691. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5916258/
Granek, L., Nakash, O., Ariad, S., Shapira, S., & Ben?David, M. A. (2019). Oncology health care professionals' perspectives on the causes of mental health distress in cancer patients. Psycho?oncology, 28(8), 1695-1701. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1002/pon.5144
Gray, T. F., Azizoddin, D. R., &Nersesian, P. V. (2020). Loneliness among cancer caregivers: a narrative review. Mental health assignment Palliative & supportive care, 18(3), 359-367. Retrieved from https://www.cambridge.org/core/journals/palliative-and-supportive-care/article/loneliness-among-cancer-caregivers-a-narrative-review/9E43133ECC1364CAFCFCAFE4F29D1842
Park, C., Majeed, A., Gill, H., Tamura, J., Ho, R. C., Mansur, R. B., ...& McIntyre, R. S. (2020). The effect of loneliness on distinct health outcomes: A comprehensive review and meta-analysis. Psychiatry Research, 113514. Retrieved from https://www.sciencedirect.com/science/article/pii/S0165178120331759
