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Case study 1: John
a) Bio psychosocial assessment
John's biopsychological assessment represents a complicated interplay of different factors contributing to his mental health challenges. He and his family used to take alcohol every day which, biologically, indicates a genetic predisposition to substance utilization disorders. Johns's transformation from marijuana to alcohol demonstrates a shifting pattern possibly impacted by personal coping mechanisms and environmental factors.
On the other hand in the psychological aspect, he experiences potential stress due to his job as a telemarketer, contributing to dissatisfaction. He experiences high pressure due to sales practice which likely increases John's stress level. This blended with a suicide attempt history indicated underlying psychological distress and a psychological support requirement.
In a social context, the aspect of familial is essential. Both parents' alcoholic nature develops a thought in John that alcohol use is a normal matter. Developing circumstances in which the use of substances may be perceived as permissible. Along with that the strained connection between Jones and his parents evidenced by his father's objections about his career selection generates another interpersonal stress layer.
This factor integration highlights the significance of the holistic initiative to John's mental health. Biological interventions such as medication and detoxification can be required to identify substance use components (Bogenschutz et al., 2022). On another note, psychological psychotherapy and counseling other helpful interventions that can help to investigate distress root cause. Socially including family members within the therapeutic procedure is crucial to developing a supportive environment for John.
Acknowledging John's multifaceted nature is essential for formulating a significant treatment plan that identifies the symptoms of mental health issues underlying cause.
b) Possible diagnoses according to the DSM-5-TR and ICD-11
Substance use disorder: excessive and regular alcohol consumption (Day and Rudd, 2019)
Depressive disorder: illustrated by activity interest loss social interaction withdrawal and suicidal tendency
Reasoning
John’s depressive symptoms and alcohol use align with measures for Major depressive disorder and substance use disorder in DSM 5 TR (Rice et al. 2023).
c) Predominant risk and protective factors
John experienced significant respect including the alcoholic nature of his family contributing to genetic predisposition. His demarcated job creates another occupational anxiety and stress worsening mental health risk. Previously he also attempted suicide which demonstrates his struggles severity.
Protective factors
Despite the risk, John advantage of his family's support especially illustrated by his older sister's intervention during his suicidal attempt. Addressing the requirement for change offers a potential proactive factor. Understanding the personal support system and familial support system is essential in establishing a significant treatment plan for John. That can help to eliminate all his struggles and provide a healthier life.
d) Possible treatment and support options
In line with state and national mental health policies treatment recommendations for John include the implementation of cognitive behavioural theory to identify both his alcoholic nature and depressive symptoms (Sewart et al., 2019). Along with that family therapy's essential to promote his support system with identifying family dynamics.
Considering the South Australian mental health strategic plan 2017-2020 incorporating this evidence-based approach aligns with the effort on developing mental health outcomes for South Australians. Nutritional counselling is also suggested to identify the potential influence of alcohol nature on John's overall well-being, aligning with improving Physical health priority for people with mental health issues.
Additionally, the national mental health policy guided in the provided aspects is “National Mental Health Policy 2008”. Policies developed by the health department in the year 2019 offers a strategic framework for leading mental health service delivery entry form around Australia for those people who pose mental health issue like John (Sahealth, 2019).
Referral pathways:
Primary Services: counselling and initial assessment through general practitioners
Secondary services: Referrals to substance abuse counsellors and mental health professionals
Tertiary services: Inpatient rehabilitation for extreme case
e) Cultural and population-based considerations
Identifying cultural conditions for John's case study for developing a treatment plant is essential for enhancing its effectiveness. Acknowledging his perception and cultural background helps to include intervention that allowed with his attitude and beliefs toward substance use and mental health challenges (Aguirre Velasco et al., 2020). It is crucial to approach intervention with cultural sensitivity understanding potential preferences and stigmas that are relevant to effective mental healthcare. Incorporation of Jones's family within this therapeutic procedure can also help to increase the support framework drawing on family dynamics and cultural norms that can impact his possibility of recovery (Gaiha et al., 2020). Cultural competent professional collaboration can also be helpful to ensure that interventions are congruent and respectful with his cultural context establishing an additional effective and inclusive treatment experience. The treatment approaches are outlined in both National and local mental health policy. In the state context “South Australian Mental Health Strategic Plan 2017 to 2020” helps to develop a strategic plan with extensive consultation. This plan's aim is to provide community treatment are in treatment for a person like John (Sahealth, 2019).
Case study 2:
a) Bio psychosocial assessment
Isabel’s biopsychological assessment demonstrates interconnected factors that impact her mental health. In a biological context, she shows a potential eating disorder symptom that is illustrated in her intermittent binge eating and meticulous calorie counting episodes. The behaviour indicates a complicated relationship between food and body image.
Psychologically her parent poses social anxiety likes to avoid social situations and faces intensified self-consciousness. The pressure to fit into societal beauty norms evidenced by her passion for a thin body suggests psychological distress. Her perfectionist tendency noticed within her academic pursuits can be another reason for her anxiety.
Socially her distressful relationship with her father occurred from her parents' divorce and his remarriage adding another stress layer. The dynamic of family likely affects her worth perception and self-esteem.
Acknowledging this interconnected aspect is essential for establishing a comprehensive treatment plan for Isabel. Biological intervention such as counselling can be needed to identify possible eating disorders. Psychologically cognitive behaviour theory can be helpful to significantly manage her social anxiety and help to redevelop her distorted body perfection perception. Socially, family therapy can be valuable in identifying family dynamic influence on her mental health. In short Isabel's challenge needs a significant initiative that acknowledges psychological, biological and social elements interplay. This assessment includes the foundation of a personalised treatment initiative designed to identify her unique requirements and overall emotional well-being.
b) Possible diagnoses according to the DSM-5-TR and ICD-11
Diagnosis
Social anxiety disorder: social gathering evidence and interaction anxiety
Body dysmorphic disorder: preoccupation and misshapen body image
Avoidant food intake disorder (ARFID): intermittent binge eating and calorie counting noticed
Reasoning:
Her symptoms align with social anxiety disorder, ARFID and body dysmorphic disorder in DSM 5 TR (Silvers and Erlich, 2023). Distorted body image disorder eating patterns and social anxiety have contributed to these recommended diagnoses.
c) Predominant risk and protective factors
Risk factors
Isabel struggles with multiple risk factors including her family history, her relationship with her father and her parents' separation possibly influencing her self-esteem. Body image concerns amplify her mental health challenges and complications. Additionally, her social anxiety also enhances her vulnerability which hinders her social interaction. The potential eating disorder worsens her situation complications.
Protective factors
Despite her challenges, her academic persistence offers a proactive factor demonstrating determination and resilience. However, she possesses a limited support system with a strained parental relationship. Concentration on increasing proactive factors while identifying multiple risk factors is essential for developing a holistic intervention for Isabel.
d) Possible treatment and support options
Cognitive behavioural theory: this theory is effective in identifying social anxiety and distorted body image perception risk (Swee, Hudson and Heimberg, 2021). This approach concentrates on modifying and addressing negative thought patterns.
Nutritional counseling
Nutritional counselling can help to collaborate with nutritionists which is valuable to balancing healthy eating habits and provide guidance about her concerns related to body image.
The treatment selection aligns with the principle shape in “National mental health policy 2008 and the Fifth National mental health and suicide prevention plan 2017” (Sahealth, 2019). Both the national framework highlights meeting Service delivery and integrated planning and coordinating support and treatment for people with mental illness. This intervention boosts a collaborative person-centred and comprehensive initiative for mental health care representative of National mental health policies' larger goals.
Locally “South Australian Mental Health Strategic Plan (2017-2020)” highlights developing mental health and well-being outcomes of South Australians (Sahealth, 2019). The proposed treatment option aligns with state-level initiatives by identifying people's requirements and improving collaborative initiatives involving families which are valuable for Isabel.
Referral pathways:
Primary Services: initial assessment through general practitioners for Referrals to mental health professionals
Secondary services: Psychiatric consultation
Tertiary services: Inpatient outpatient programs
e) Cultural and population-based considerations
Considering the potential social challenges and age treatment plant or initiative needs to acknowledge peers and age-specified approaches' significance. Adolescence is a crucial stage for mental growth and its appropriate support can increase intervention effectiveness. Along with that acknowledging cultural influence on a person's body image is also essential (Skrastins, 2023). Addressing potential cultural means that have contributed to issues like people's concern maintenance of a culturally sensitive initiative. Including different therapeutic initiatives such as those allowed with her preferences and cultural background are also essential for an effective and comprehensive treatment strategy (Coulston et al., 2023). This approach aligns with the larger goal of establishing cultural competency and inclusivity that is outlined in local and national mental health policies. As national mental health policies aim, vision and fundamental policy action lead to a direction for state, territory and national mental health plans development for people with mental health challenges. South Australian Mental Health Strategic Plan 2017 2020 focuses on improving people's mental health and well-being for South Australians (Sahealth, 2019).
References
Aguirre Velasco, A., Cruz, I.S.S., Billings, J., Jimenez, M. and Rowe, S. (2020). What are the barriers, facilitators and interventions targeting help-seeking behaviours for common mental health problems in adolescents? A systematic review. BMC Psychiatry, [online] 20(1), pp.1–22. doi:https://doi.org/10.1186/s12888-020-02659-0.
Bogenschutz, M.P., Ross, S., Bhatt, S., Baron, T., Forcehimes, A.A., Laska, E., Mennenga, S.E., O’Donnell, K., Owens, L.T., Podrebarac, S., Rotrosen, J., Tonigan, J.S. and Worth, L. (2022). Percentage of heavy drinking days following psilocybin-assisted psychotherapy vs placebo in the treatment of adult patients with alcohol use disorder. JAMA Psychiatry, 79(10). doi:https://doi.org/10.1001/jamapsychiatry.2022.2096.
Coulston, F., Cameron, K.L., Sellick, K., Cavallaro, M., Spittle, A. and Toovey, R. (2023). Circus Activities as a Health Intervention for Children, Youth, and Adolescents: A Scoping Review. Journal of Clinical Medicine, 12(5), p.2046. doi:https://doi.org/10.3390/jcm12052046.
Day, E. and Rudd, J.H.F. (2019). Alcohol use disorders and the heart. Addiction, 114(9), pp.1670–1678. doi:https://doi.org/10.1111/add.14703.
Gaiha, S.M., Taylor Salisbury, T., Koschorke, M., Raman, U. and Petticrew, M. (2020). Stigma associated with mental health problems among young people in India: a systematic review of magnitude, manifestations and recommendations. BMC Psychiatry, 20(1). doi:https://doi.org/10.1186/s12888-020-02937-x.
Rice, S., Seidler, Z., Kealy, D., Ogrodniczuk, J., Zajac, I. and Oliffe, J., 2022. Men’s depression, externalizing, and DSM-5-TR: primary signs and symptoms or co-occurring symptoms?. Harvard Review of Psychiatry, 30(5), pp.317-322.
Sahealth (2019). Mental Health Services Plan 2020-2025. [online] www.sahealth.sa.gov.au. Available at: https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/resources/mental+health+services+plan+2020-2025 [Accessed 6 Dec. 2023].
Sewart, A.R., Niles, A.N., Burklund, L.J., Saxbe, D.E., Lieberman, M.D. and Craske, M.G. (2019). Examining Positive and Negative Affect as Outcomes and Moderators of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy for Social Anxiety Disorder. Behavior Therapy, 50(6). doi:https://doi.org/10.1016/j.beth.2019.07.001.
Silvers, E. and Erlich, K. (2023). Picky eating or something more? Differentiating ARFID from typical childhood development. The Nurse Practitioner, [online] 48(12), p.16. doi:https://doi.org/10.1097/01.NPR.0000000000000119.
Skrastins, E. (2023). Voices from the archive : the emergence of promiscuity as a mental disorder in Tasmania. [online] figshare.utas.edu.au. Available at: https://figshare.utas.edu.au/articles/thesis/Voices_from_the_archive_the_emergence_of_promiscuity_as_a_mental_disorder_in_Tasmania/24165531 [Accessed 6 Dec. 2023].
Swee, M.B., Hudson, C.C. and Heimberg, R.G. (2021). Examining the relationship between shame and social anxiety disorder: A systematic review. Clinical Psychology Review, 90, p.102088. doi:https://doi.org/10.1016/j.cpr.2021.102088.
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