Individual Written Case Study on Mental Health Recovery

Introduction: Mental Health Recovery Planning After Inpatient Discharge

This report aims to develop a recovery plan for Ben, who is a 34-year-old individual and was discharged from an inpatient unit to a community setting after facing aggressive and psychotic episodes. In this report, the primary focus will be given on his mental health status and history of Ben, information about the substance use tendency and critical analysis of the case scenario of Ben to develop a patient-centric, integrated, and informed recovery plan for the patient. another purpose of this recovery plan will be to focus on Ben’s transition from inpatient care to the community setting, addressing his psychological symptoms, medication management, and social support system to highlight the importance of a collaborative care approach in a healthcare setting.

Considering the case scenario of Ben, it was seen that he has a prior history of depression and borderline personality disorder with suicidal tendencies. Additionally, he has a history of consuming drugs (alcohol, cannabis, and methamphetamine) at the age of 14. These episodes of behavioural approaches indicate a persistent mental health crisis for Ben, which is important to address on an early basis to ensure his overall health and return to the community settings of rural Victoria Australia. As per the case scenario, it is also seen that due to his aggressive and psychotic behaviour, Ben was admitted to the Emergency Department by his girlfriend and through police intervention. This crisis as a whole highlights the urgent need for stabilizing Ben’s mental health condition and ongoing support for preventing the further relapse of mental health crisis by focusing on both the severity of mental health issues and the immediate risks posed to himself and others. Here comes the important purpose of developing a patient-centric recovery plan for Ben.

Recovery Goals

According to the case study, Ben was diagnosed with drug-induced psychosis, along with borderline personality disorder. On discharge from the hospital, the medication that was being prescribed to Ben included Diazepam 5 mg TDS to help Ben develop withdrawal habits from methamphetamine and cannabis. Ben has also started Escitalopram 10 mg. Upon communication with Ben, it was understood that Ben currently is worried as he might get back to the substance misusing habit and relapse of his aggressive behavioural approach. As a care worker, it is important to develop a SMART goal of recovery plan for Ben, which will include the following:

Monitoring Progress And Early Warning Signs

According to the Mental Health Act 2009, the Mental Health and Wellbeing Act 2022, and the Mental Health Act 2016 of Australia, it becomes the foremost responsibility of any care worker to provide necessary treatment to people with mental illness, specifically those who are at risk (Maylea, 2022). Based on these healthcare acts, the strategies that have to be adopted by care workers to ensure recovery of Ben are as follows:

1. To ensure medication adherence and its effectiveness on the overall health and well-being of Ben, regular psychiatric appointment and supervision has to be followed. Blood tests, symptom checklists, collecting feedback regarding the side effects of medicines will be used as sources of data for evaluating the effectiveness of the prescribed medication on overall mental health status, and substance misuse habits of Ben, which in turn can provide scope for adjusting the dosage of the medicines as per requirements (O’Donovan et al., 2019). A diary for medicines intake, dosage, and time can also be used as a tool to track daily adherence and overall progress.
2. Reducing substance use: Weekly drug screening tests, attendance and evaluation of records for substance use, and weekly commencement of support group discussion and counselling are the best-fit approaches for Ben to encourage him to avoid the consumption of ice, alcohol and cannabis. Regular self-assessment reports and feedback assessments from Ben and the support group can also be advocated to ensure the early and long-term reduction of substance use habits for the patient (O’Donovan et al., 2019).
3. Increasing emotional well-being and developing coping strategies: weekly cognitive behavioural therapy sessions can be used as an approach to monitor the overall progress of Ben towards healthy livelihoods. Mood assessment and behavioural observation during therapy can provide deep insight into the current emotional status of Ben, which in turn can help care workers to make necessary adjustments in medication and therapy sessions (Schuman-Olivier et al., 2020).
4. Workplace integration: Ben’s gradual return to the community settings, and his workplace can be monitored by regular check-ins with his employers, feedback from the local communities about his participation in local gatherings, and feedback from employees about Ben’s ability to manage his work responsibilities and communicative ability.

As a whole, monitoring the progress of Ben towards his recovery goal should include regular follow-up processes and appointments to the Community Mental Health service. Standardised assessment tools like the Beck Depression Inventory and the Alcohol Use Disorder Identification Test or AUDIT can also be used as essential tools for measuring his change of moods and substance use patterns. The Beck Depression Inventory is a 21-item self-report questionnaire which is used to measure the signs and symptoms of depression and clinicians often use this tool to determine the appropriate level of treatment for depression (American Psychological Association, 2024). On the other hand, the alcohol use disorder identification test or AUDIT-C has been used for helping patients like Ben who are hazardous drinkers or have active alcohol use disorder.

It is a 10-item screening tool developed by the World Health Organization to assess the pattern of alcohol and substance consumption, and alcohol-related problems, and identify the best-fit clinical intervention for the healthcare workers (Saunders, 2019). These two tools can be used for monitoring the early warning signs that indicate the potential relapse of the disorder. For example, an increased rate of irritability or sudden change of mood, sudden withdrawal from social interaction and support system, sudden increase of craving for the substances along with a change in cognitive behaviour, and adherence to prescribed medication can be considered as the early sign of relapse of substance-based mental disorder and other mental illness for Ben.

According to many researchers Sánchez-Guarnido et al. (2021), lack of early recognition of mental disorders in people can lead to further relapse of the condition. Therefore the purpose of risk assessment and evaluation is to make decisions based on the outcome of the risk analysis. This can provide insight to the care workers about what risks need early treatment and address and priority of that treatment.

According to, regular risk assessments including mental health status evaluation and self-report questionnaires are considered to be important for detecting the early signs of relapse as these tools provide an objective measure of the current health condition of the patient (Samartzis & Talias, 2020). Therefore, in the case of Ben, using these tools can allow care workers to timely intervene so that the risk of severe episodes of psychotic behaviour of the patient can be controlled at an early stage by ensuring his overall health outcomes.

Intervention And Relapse Prevention Strategies

To support Ben’s recovery and prevent the scope of sudden relapse of the mental illness and aggressive episodes and psychotic behaviour, a comprehensive intervention and relapse prevention strategies are essential to developing, based on their complex mental illness and substance misuse tendency of Ben. The following evidence-based intervention plan and prevention strategies can be recommended.

1. Medication management: continuous monitoring of the degree of adherence to the prescribed medication like Olanzapine (10 mg) and Diazepam (5 mg TDS) will be carried out along with the development and intervention of a tapering plan by the psychiatrist. Regular updates of the plan and review can also be scheduled to evaluate the progress of Ben and make necessary adjustments in the ongoing medication plan and dosage rate to manage the withdrawal symptoms and other psychotic illnesses of the patient (Ayre et al., 2023).
2. Psychosocial support: cognitive behavioural therapy and regular therapy sessions can be carried out or intervene in the recovery plan of Ben to address Ben’s low mood, persistent psychotic behaviour, anxiety about relapse and other concerns related to employment. With cognitive behavioural therapy, the healthcare worker can provide support to Ben in terms of managing his negative thought processes and patterns and adapting coping skills to increase social integration and networking (Nakao et al., 2021). In this process, the professional should also encourage the family's involvement in the treatment plan. Education and training can be provided to Ben’s girlfriend regarding his condition and recovery strategies.

On the other hand, the relapse prevention strategies will include:

• Development of a crisis intervention plan which includes the steps that Ben must follow if he experiences worsening symptoms or feels the urge to use substances. This plan should include the contact information of his psychiatrists, therapist, support groups, and family members (Varghese et al., 2020).
• Support groups: Ben can also be encouraged to take part in support groups where he can communicate with people who have similar substance misuse tendencies and prior experiences regarding how to deal with psychotic distress and behavioural approaches. This can help him in developing a sense of community, and a sense of belonging, which in turn can trigger the reduction of the feeling of self-isolation, and suicidal tendencies and promote accountability (Maylea, 2022).
• Mindfulness and stress reduction: these practices and techniques can also be used to prevent the scope of relapse of psychotic behaviour or the tendency of substance misuse. Meditation, yoga, proper exercises, and counselling sessions can help Ben manage his anxiety and promote the development of coping strategies and skills for emotional regulation.

Collaborative Approach

The collaborative recovery model or CRM is a conceptual framework to enhance mental health services and organisational development. The purpose of the collaborative recovery model is to shift mental health care from symptom management to recovery-oriented practices by emphasizing on individualized recovery processes (Henderson et al., 2019). The main principles of CRM are to nurture hope and support the autonomy and subjective goa ownership of the patient. By taking this model into consideration, it can be stated that the recovery plan of Ben should include the active participation of healthcare professionals, a multidisciplinary team, and his family members.

More specifically the responsibility of mental healthcare professionals in Ben’s recovery plan would be to provide necessary psychosocial support through regular therapeutic sessions, respectful communication, and prescribing proper medication and other therapeutic interventions by addressing the mental health condition and needs of Ben (Hungerford, 2014). On the other hand, the role of the psychiatrist in Ben’s recovery plan will include the review and adjustment of medications like Olanzapine for psychotic symptoms, Diazepam for developing withdrawal habits against substances, and Escitalopram for reducing depression. In this care plan, Ben’s girlfriend will be encouraged to take an active part in Ben’s recovery plan. Essential training, education and support will be provided to her about Ben’s current condition and possible strategy for recovery. Her involvement can offer mental strength and necessary support to Ben for getting back to normal livelihood and he can reduce the sense of isolation and suicidal tendencies.

Conclusion

To conclude this assessment, it can be stated that based on the case summary, Ben has an immediate need for an informed, personalised, and collaborative recovery plan, in this assessment a SMART goal has been set up for the recovery plan and process for Ben, where the stress has been given on evidence-based intervention for stabilizing the current health condition of Ben and ensure his recovery and return to a community setting from psychotic behavioural episodes.

To develop the recovery plan, the probable challenges that may arise are managing medication side effects, ensuring substance abstinence and encouraging Ben to continuously engage in therapeutic sessions. However, overcoming these hurdles needs ongoing collaboration between healthcare providers, care workers, Ben, and his girlfriend which can promote adaptability and accountability to Ben’s evolving needs.

References

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