Posted: May 25th, 2022

Discussions and Case Studies 5 pages

Preadolescent child by the name of Janis has been diagnosed as potentially suffering from depression. Her grandmother, her caretaker and guardian, is having to deal with unruly behavior from Janis culminating in a death threat. Because Janis has now displayed a violent behavior (making a death threat), the need for evaluation is urgent. Her alleged depression could turn violent.

The case study mentions she hangs out with a ‘rough’ crowd. This crowd could peer pressure her into taking drugs and alcohol. Many children have peer pressure and unstable conditions at home, motivate them to begin engaging in substance abuse. This substance abuse could lead to other mental health problems and so forth. Alcohol abuse has the potential to increase aggressive behavior and may enable development of generalized anxiety disorder. Janis’ behavior has become more aggressive signaling there could be substance abuse already.

The main questions center on who is Janis hanging out with, what kinds of activities does she engage in when she is with her ‘friends’, and how does she feel about not being with her mother and having a strained relationship with her.

4. I would like to run some blood tests to see if any illegal substances are in her system and understand what kind of ‘rough friends’ she hangs out with. I would also like to see some history on the mother to determine if the mother has any mental health issues and if anxiety and depression runs in the family.

5. I would refer Janis to a primary care physician so she may be able to get some blood work done. I would also provide a referral to a therapist so she can discuss any problems she has with her mother and her current situation. The questions I’d like answered for both are: Are there any drugs in her system? What kinds of friends does she hang out with?

Journal 2

1. The National Institute of Mental Health (NIMH) was made by the U.S. Department of Health and Human Services to transform the treatment and understanding of mental health problems via clinical and basic research thus helping pave the way for recovery, cure, and prevention. Through the fostering of innovative thinking, NIMH ensures a full range of new scientific viewpoints are used to further understanding and awareness of the evolving science of human behavior, the human brain, and human experience.

2. NIMH has a division of AIDS and Autism research. They also research whether there is a strong genetic component to mental health problems. The main mental health problems they feature on the homepage is depression, schizophrenia, bipolar disorder, borderline personality disorder, and anxiety disorders.

3. The selected mental illness is depression. Depression is a common and at times serious mood disorder. Depression can affect daily activities and can last for years (persistent depressive disorder). Some signs and symptoms include persistent sadness and anxiety, irritability, feelings of helplessness and worthlessness, fatigue, and difficulty concentrating among other symptoms. Anyone is vulnerable to depression although women who have recently given birth are very susceptible. Recommended treatments are cognitive behavioral therapy and SSRIs to help deal with the potential side effects of depression.

4. The latest article has the title: ‘Revealed: LSD Docked in its Human Brain Target’ and it was written because mental health specialists have found positive use of LSD in patients with mental health problems and want to understand how LSD is able to give such a mind-altering effect in the human brain.

5. NIMH has a section dedicated to AIDS/HIV research and neuroscience/basic behavioral science. These two sections are given research priority because AIDS/HIV is still a problem today that leads to costly treatments and long-term health problems for those infected. Neuroscience helps experts understand what happens in the human brain when a person experience mental health issues and what medications can do to relieve the problem.

Discussion 7

1. Janis Jones’ goal is to get help in terms of identifying more of her situation. Is she involved with drugs? Does her mother and the situation with her mother play in her rebellious behavior? How to do this is through allowing Janis to see the bigger picture and help her understand the benefits of getting help. Sometimes just seeing the possible benefits of doing something can motivate an individual to go along with instructions.

2. I will make the referrals through phone by calling and via fax. I can fax over Janis’ information and possible need for the additional help. Potential barriers could come in the form of payment. Sometimes insurance will not cover certain services. Furthermore, information collected from the other medical providers may not be shared with me due to the patient or the office not allowing me access to it.

3. The first step in monitoring and assessing service provision is to establish ‘critical limits’ so I can measure quality and effectiveness of the services provided to Janis. Then I would establish suitable record-keeping as well as documentation systems. By scheduling regular visits, I can monitor progress and evaluate impact. There must also be corrective actions established should something go wrong.

4. I will set goals that should be met and attempt to collect information of the service providers in order to communicate with them. I will also set up appointments with Janis and her grandmother and see what kind of progress was made.

5. A situation would be if the therapist is not listening or meeting Janis’ needs and she feels she cannot talk to the therapist about her problems. Then I would try to find her a new therapist, a person she feels more compatible with and feels like they would listen.

6. I would not be a mobilizer because this involves more identification of community problems not personal problems. By linking clients to suitable resources and services, this makes more of a broker.

Journal 3

1. Advocacy is one of the most important things because it helps people that may feel helpless or voiceless have a voice and get the help they need. Sometimes people need assistance in identifying what their needs are. That is why advocacy is in place to help promote effective problem-solving.

2. I would feel very comfortable in an advocacy role. This is because I enjoy helping others. I understand the need to speak up and know that people at times need support and help in doing so.

3. I can develop my skills by talking more with people to get an understanding of the kinds of problems they are dealing with and offer my help. Sometimes it is hard to get people to understand there is someone there that will listen. I want to be able to let people see I am there to listen and to help.

Discussion 8

1. Mrs. Martinez wants to survive by any means necessary. She wants everything done possible to ensure she does not die. Her daughter on the other hand, does not want ventilation or resuscitation performed should her mother require it. This goes against Wilma’s wishes to survive.

2. The alternative directions, as stated earlier are essentially to do not resuscitate or perform mechanical ventilation. Perhaps the daughter sees it as a fruitless endeavor due to her mother’s inoperable condition. She sees that her mother is just getting sicker and wants to be spared the pain of prolonged time dealing with this problem.

Wilma was told to designate a healthcare proxy. Proxies can decide for a patient if the patient cannot make the decision for her or himself. Therefore, autonomy and disagreements can cause tension in such a case. If Wilma cannot decide for herself treatment and her daughter wishes against resuscitating her, this may well go against the wishes of Wilma in wanting to live. Because Wilma speaks Spanish and has her daughter interpret, many things can get lost in translation, especially if the daughter does not want to tell medical staff of her mother’s true wishes to survive. When it comes to cultural considerations, people at times can be very family-centered due to culture and may not want anyone to intervene in such affairs.

Journal 4

1. Greg has been receiving cognitive behavioral therapy (CBT) and a prescription of Prozac for the last 5 years. His depression symptoms have improved and he has been lowering his medication doses each month. Progress has been made in terms of developing positive coping mechanisms and respecting personal boundaries, however his parents are unable to afford continued treatment. His grandfather recently passed away and he is stressed from the event as he had a strong connection with his grandfather. His current status seems slightly unstable making his regression seem possible.

2. Greg has not received inpatient care. This is because his depression was not significant enough where he posed a risk to himself or to others. Therefore, he had weekly therapy sessions totaling 50 sessions annually at $3,000. This was well under the annual limit of $25,000. The weekly sessions have continued for five years totaling $15,000 of outpatient sessions or 250 sessions.

4. To whom it may concern:

Greg is at-risk of regressing in relation to his depression. He has made some remarkable progress in the last two years. He has weekly out-patient visits that have enabled him to grow and most importantly, develop positive coping mechanisms to help him deal with life’s hurdles. However, he has been denied coverage and his grandfather’s death may bring back some of the depressive symptoms he endured when he first began treatment. Because he is well under the maximum allotted $75,000, I suggest he continues to receive inpatient therapy. His situation is not as severe and does not require the kind of treatments that can be costly. He has been recently attempting to wean himself off his medication and that needs time to help him avoid uncomfortable withdrawal symptoms. Please help him get the help he needs.

Thank you

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