Case Study on Mental Health 1
Case Study, Mohr
CHAPTER 1, Introduction to Psychiatric–Mental Health Nursing In completing the case study,
students will be addressing the following learning objectives: Explain elements that contribute
to mental health.
Review trends, problems, and goals related to the delivery of mental health care and treatment
of mental illness.
1. Karen is a 25-year-old white woman who lives alone in an apartment with her dog. Karen has
been divorced for 2 years and is taking Prozac prescribed by her psychiatrist for depression.
Karen and her boyfriend had been discussing marriage until he told her that he wanted to end
their relationship. Karen became even more depressed and could not work for a week. Karen
returned to work, refusing to discuss her issues with family, friends, or coworkers. She did,
however, make an appointment to see a psychiatric nurse practitioner. Karen told the nurse
that she was making some changes in her life. Karen said that she and a girlfriend were joining
a gym program for workouts and a social group for young men and women. Karen stated that
she realizes that her former boyfriend had not been committed to her, and she anticipates
meeting and dating other young men from the adult social group. Karen also said that she
thinks that the gym exercise will be beneficial to her mentally and physically.
Learning Objectives: 1, 4)
a. How will the psychiatric nurse assess if Karen has made progress toward self-
realization? Ans: Karen had suffered from depression which is a form of mental
disorder as a result of divorce and a broken relationship with her boyfriend. This
situation according to Hypocriticus in 15th century BC, upholds the brain as the organ
of consciousness; this occurs when both normal and abnormal behavior arise from the
brain. The psychiatric nurse can assess if Karen has made progress towards self-
realisation by committing to diagnosing and treating her responses to the problems
that caused her psychiatric disorder. In-addition, the nurse can make assessment
based on Karen’s psychoanalytical disposition such as:
trasferrence,defense mechanism,countertransference,acting out, denial of the reality
befallen her and projection.
b. Identify strengths that Karen has for progress in personal growth.
The strengths Karen has for progress in personal growth include the followings:
• Ability to make use of social support, that is, she visited a psychiatric nurse, social
group and registered in a gym.
• She was realistic about her situation, therefore made herself ready to face the reality
before her.
• Karen sought immediate medical attention where she was administeredwith Prozac to
help mitigate her depression state.
,Case Study on Mental Health 1
• Her cognitive behavioural responses showed optimism towards a better life as well as
fighting against her depressed state. Hence, her willingness to date younger men.
c. Karen has been seeking treatment for her depression. Analyze the factors that might
contribute to Karen’s reluctance to discuss her depression with others.
Karen’s reluctance to discuss her depression with others hinges on the fact that her
depression was a kind called social depression. Social depression is a psychological disorder
caused by several factors such as: interpersonal relationship which involves the relationship
between a person and the interactions of emotions of each individual expressed directly and
discreetly to each other. Another is a Common interpersonal relationship, this includes :
Family, social environment (work place), and interaction among age groups and genders.
Because Karen had divorce and broken relationship, she didn’t feel safe in herself discussing
her depression with family and friends but to seek a professional whose job is to attend to
her depressed case. Hence, her neuroticism was calm and strong willed.
Case Study, Mohr: CHAPTER 2, Neuroscience: Biology and Behavior
In completing the case study, students will be addressing the following learning objectives:
Discuss neuroplasticity and how this concept relates to mental health and mental illness.
Briefly explain the importance of interaction between genes and environment, the role of
endophenotypes, and the stress-diathesis model of psychiatric illness.
1. Michael is a 22-year-old college senior whose GPA has declined with this semester’s grades.
Michael plans to apply to medical school and thinks that the lower GPA may prevent his
acceptance to medical school. For the last 2 weeks, Michael has skipped most classes because
he has insomnia and fatigue. Michael is now very depressed and has been thinking of suicide.
He took a loaded gun from his father’s gun cabinet and then wrote a suicide note to his family.
At the last moment, he telephoned 911 and told them of his suicide plan. The police came, took
the gun away, and then took Michael to the city hospital to be admitted for psychiatric
treatment. In the admission interview with the psychiatric nurse, Michael said that his pastor
thought that only weak-willed people experienced depression and that it was a punishment for
personal sins and the sins of one’s ancestors. Michael told the nurse that he must be weak-
willed and will never be able to accomplish anything. The psychiatric nurse explained that
multiple factors are the cause of depression. The nurse told Michael that one theory holds that
an imbalance of neurotransmitters, or chemical messengers of the brain, occurs in depression.
Neurotransmitters influence the individual’s emotions, thoughts, and subsequent behavior.
Recent research implies that neurobiology, heredity, as well as Psychological and
environmental factors may be involved in the development and progression of depression.
(Learning Objectives: 5, 6)
, Case Study on Mental Health 1
a. Will Michael think that the psychiatric nurse’s explanation for the cause of depression is
more correct than that of his pastor?
b. Michael asks the nurse why he has to have psychotherapy. He states that he only needs to
take a couple of pills to get better. How should the nurse respond to Michael’s question and
comment?
c. Develop an assessment question for each of the following possible causes of Michael’s
development of depression:
Genetic, Environment and Stress.
Case Study, Mohr
CHAPTER 3, Conceptual Frameworks and Theories:
In completing the case study, students will be addressing the following learning
objective: Give examples of behavioral and cognitive-behavioral interventions.
The student nurse has been assigned a 37-year-old woman admitted to the psychiatric hospital
with an anxiety disorder. This morning, the student notices that the client has a tense facial
expression and is walking constantly around the group room. The student walked over to the
client and used reflective communication by stating, “I see that you have a tense expression
and are walking around almost all of the time. Is there something that we could discuss?” The
client replied that she has talked on the telephone to her mother who was keeping her children
while she was in the hospital. The client said that her mother had told her that she was not a
good mother, and then said, “I guess I am a bad mother, but I could never measure up to my
mother’s expectations.” The student has learned that negative self-talk can greatly aggravate
anxiety and lead to depression. The student decided to use a behavioral intervention with the
client and asked the client who is a good artist and why the client liked the artist’s works. The
student and the client then made a list of activities that the client liked. The student taught the
client to engage in one of these activities when an unpleasant experience evoked negative
thoughts. The following day, the student decided that the client needed some cognitive
restructuring for her relationship with her mother. The student taught the client that during
discussions with her mother, feelings of incompetence might be experienced when the mother
made negative comments. The client was instructed that if her mother made negative
comments about parenting, she was to immediately tell her mother that she was a good parent
to her children and terminate the conversation at the first opportunity.
Case Study, Mohr
CHAPTER 1, Introduction to Psychiatric–Mental Health Nursing In completing the case study,
students will be addressing the following learning objectives: Explain elements that contribute
to mental health.
Review trends, problems, and goals related to the delivery of mental health care and treatment
of mental illness.
1. Karen is a 25-year-old white woman who lives alone in an apartment with her dog. Karen has
been divorced for 2 years and is taking Prozac prescribed by her psychiatrist for depression.
Karen and her boyfriend had been discussing marriage until he told her that he wanted to end
their relationship. Karen became even more depressed and could not work for a week. Karen
returned to work, refusing to discuss her issues with family, friends, or coworkers. She did,
however, make an appointment to see a psychiatric nurse practitioner. Karen told the nurse
that she was making some changes in her life. Karen said that she and a girlfriend were joining
a gym program for workouts and a social group for young men and women. Karen stated that
she realizes that her former boyfriend had not been committed to her, and she anticipates
meeting and dating other young men from the adult social group. Karen also said that she
thinks that the gym exercise will be beneficial to her mentally and physically.
Learning Objectives: 1, 4)
a. How will the psychiatric nurse assess if Karen has made progress toward self-
realization? Ans: Karen had suffered from depression which is a form of mental
disorder as a result of divorce and a broken relationship with her boyfriend. This
situation according to Hypocriticus in 15th century BC, upholds the brain as the organ
of consciousness; this occurs when both normal and abnormal behavior arise from the
brain. The psychiatric nurse can assess if Karen has made progress towards self-
realisation by committing to diagnosing and treating her responses to the problems
that caused her psychiatric disorder. In-addition, the nurse can make assessment
based on Karen’s psychoanalytical disposition such as:
trasferrence,defense mechanism,countertransference,acting out, denial of the reality
befallen her and projection.
b. Identify strengths that Karen has for progress in personal growth.
The strengths Karen has for progress in personal growth include the followings:
• Ability to make use of social support, that is, she visited a psychiatric nurse, social
group and registered in a gym.
• She was realistic about her situation, therefore made herself ready to face the reality
before her.
• Karen sought immediate medical attention where she was administeredwith Prozac to
help mitigate her depression state.
,Case Study on Mental Health 1
• Her cognitive behavioural responses showed optimism towards a better life as well as
fighting against her depressed state. Hence, her willingness to date younger men.
c. Karen has been seeking treatment for her depression. Analyze the factors that might
contribute to Karen’s reluctance to discuss her depression with others.
Karen’s reluctance to discuss her depression with others hinges on the fact that her
depression was a kind called social depression. Social depression is a psychological disorder
caused by several factors such as: interpersonal relationship which involves the relationship
between a person and the interactions of emotions of each individual expressed directly and
discreetly to each other. Another is a Common interpersonal relationship, this includes :
Family, social environment (work place), and interaction among age groups and genders.
Because Karen had divorce and broken relationship, she didn’t feel safe in herself discussing
her depression with family and friends but to seek a professional whose job is to attend to
her depressed case. Hence, her neuroticism was calm and strong willed.
Case Study, Mohr: CHAPTER 2, Neuroscience: Biology and Behavior
In completing the case study, students will be addressing the following learning objectives:
Discuss neuroplasticity and how this concept relates to mental health and mental illness.
Briefly explain the importance of interaction between genes and environment, the role of
endophenotypes, and the stress-diathesis model of psychiatric illness.
1. Michael is a 22-year-old college senior whose GPA has declined with this semester’s grades.
Michael plans to apply to medical school and thinks that the lower GPA may prevent his
acceptance to medical school. For the last 2 weeks, Michael has skipped most classes because
he has insomnia and fatigue. Michael is now very depressed and has been thinking of suicide.
He took a loaded gun from his father’s gun cabinet and then wrote a suicide note to his family.
At the last moment, he telephoned 911 and told them of his suicide plan. The police came, took
the gun away, and then took Michael to the city hospital to be admitted for psychiatric
treatment. In the admission interview with the psychiatric nurse, Michael said that his pastor
thought that only weak-willed people experienced depression and that it was a punishment for
personal sins and the sins of one’s ancestors. Michael told the nurse that he must be weak-
willed and will never be able to accomplish anything. The psychiatric nurse explained that
multiple factors are the cause of depression. The nurse told Michael that one theory holds that
an imbalance of neurotransmitters, or chemical messengers of the brain, occurs in depression.
Neurotransmitters influence the individual’s emotions, thoughts, and subsequent behavior.
Recent research implies that neurobiology, heredity, as well as Psychological and
environmental factors may be involved in the development and progression of depression.
(Learning Objectives: 5, 6)
, Case Study on Mental Health 1
a. Will Michael think that the psychiatric nurse’s explanation for the cause of depression is
more correct than that of his pastor?
b. Michael asks the nurse why he has to have psychotherapy. He states that he only needs to
take a couple of pills to get better. How should the nurse respond to Michael’s question and
comment?
c. Develop an assessment question for each of the following possible causes of Michael’s
development of depression:
Genetic, Environment and Stress.
Case Study, Mohr
CHAPTER 3, Conceptual Frameworks and Theories:
In completing the case study, students will be addressing the following learning
objective: Give examples of behavioral and cognitive-behavioral interventions.
The student nurse has been assigned a 37-year-old woman admitted to the psychiatric hospital
with an anxiety disorder. This morning, the student notices that the client has a tense facial
expression and is walking constantly around the group room. The student walked over to the
client and used reflective communication by stating, “I see that you have a tense expression
and are walking around almost all of the time. Is there something that we could discuss?” The
client replied that she has talked on the telephone to her mother who was keeping her children
while she was in the hospital. The client said that her mother had told her that she was not a
good mother, and then said, “I guess I am a bad mother, but I could never measure up to my
mother’s expectations.” The student has learned that negative self-talk can greatly aggravate
anxiety and lead to depression. The student decided to use a behavioral intervention with the
client and asked the client who is a good artist and why the client liked the artist’s works. The
student and the client then made a list of activities that the client liked. The student taught the
client to engage in one of these activities when an unpleasant experience evoked negative
thoughts. The following day, the student decided that the client needed some cognitive
restructuring for her relationship with her mother. The student taught the client that during
discussions with her mother, feelings of incompetence might be experienced when the mother
made negative comments. The client was instructed that if her mother made negative
comments about parenting, she was to immediately tell her mother that she was a good parent
to her children and terminate the conversation at the first opportunity.
