Critical Analysis of Mental Health Assessment and Treatment in a School Nurse Setting: The Case of Leah MHN302
- Subject Code :
MHN302
- University :
Griffith University Exam Question Bank is not sponsored or endorsed by this college or university.
- Country :
United Kingdom
Case study
The practitioner in this case is a Student School Nurse (SSN) working within a school nursing service.
Leah is a 12-year-old girl who recently transitioned from primary to secondary school. Leah suffers from Generalised Anxiety Disorder (GAD), which has been exacerbated by the recent life changes. She lives with her mother and younger brother following her parents' separation last year. Her father now lives in another city and maintains sporadic contact, which has deeply affected Leah. She had previously been close to her father and is struggling to process the changes in their relationship. Leahs mother reports that Leah has always shown signs of excessive apprehension and overthinking, and over the past year her symptoms have noticeable intensified, particularly following the separation.
Since the separation, Leahs mother has taken on two part-time jobs to manage financially, meaning she is often not home until late in the evening. Leahs mother has a long-standing history of anxiety and depression, which has been exacerbated by the current financial strain and the challenges of parenting alone. Although Leah is caring and responsible towards her younger brother, she has started to feel overwhelmed with the responsibility, particularly alongside the demands of starting at a much larger school.
Leah has become known to the school nursing team after attending the SSNs drop-in clinic multiple times, complaining of persistent nausea, dizziness, and tightness in her chest. During these visits, the SSN noticed that Leah appeared tense, visibly distressed, frequently wringing her hands and displaying shallow breathing.
Teachers have also raised concerns about Leahs recent withdrawal in class. Despite being described as a bright and capable student, her participation has declined, and she often seems preoccupied. Her attendance has dropped slightly, and staff have noticed that when she does attend, she appears fatigued and struggles to focus on tasks.
Following a wellbeing check-in initiated by her tutor, Leahs mother shared that Leah has recently been having difficulty falling asleep, often staying awake into the early hours of the morning. When she does sleep, she frequently wakes from vivid dreams and has begun expressing worries about things going wrong at school or home.
Assignment Brief
Your critique and analysis throughout the paper should be with reference to relevant literature, such as empirical studies and national guidelines. You need to demonstrate critical awareness of theory and research pertaining to the assessment and treatment of child and adolescent mental health, whilst also demonstrating an ability to apply these in practice.
Outline for the essay: 3000 words
(Use the adolescent case study that you have worked with, in which you have been personally involved in a mental health assessment and treatment.
- Introduction to your essay (150 words)
- Summarise a brief background/history of the adolescent (mother/father) and in what context you worked with this person, describe your work area and your role within. Include demographic details, familial, social, mental and medical history, presenting mental health and / physical health problems and any associated risk (you can include some of this information in an appendix to save on word count). It is essential that you address the issue of confidentiality, and that the child and work area cannot be identified from your work (200 words).
- Give a critical account of the engagement and assessment, or how you plan to engage and assess with this young person, including what you consider to be the strengths and limitations of the assessment and engagement strategies that you chose/choose. (700 words).
- Provide a rationale for using a case formulation, choose the formulation type: the 4Ps, Four Ps model which consists of predisposing, precipitating, perpetuating, and protective factors, Biopsychosocial, Cognitive Behavioural Therapy). Demonstrate your understanding of the chosen formulation type by relating it to your case study. You may want to provide a table or diagram which outlines your formulation of the case. When discussing any factors (e.g. risk, protective, etc) in your formulation dont forget to substantiate your discussion with literature (700 words).
- Critically discuss the treatment plan for the young person, making links between this plan, your assessment and the case formulation. Your choice of interventions needs to be evidence-based and substantiated with literature. (CAMHS referral was made for a recommended treatment plan of Cognitive Behavioural Therapy (CBT) for GAD for Leah, CBT becomes second line treatment for GAD if education and active monitoring in primary care setting does not improve) (600 words).
- Provide a reflection on the process as a practitioner using Gibbs (1988) reflection model, considering what you learned and what you might do differently in the future and why. If you are using one of the vignettes you can reflect on your role in promoting emotional wellbeing in children and adolescent (500 words).
- Conclusion to your essay: 150 (words).
- Make sure to attach an appendix for the Completed RCADs below for Leah and appendix for Completed Four Ps for Leah
APPENDIX 2: Completed Four Ps for Leah (Find Reference)
Predisposing |
Precipitating |
Perpetuating |
Protective |
|
Bio |
Maternal history of anxiety and depression |
Leah has sleep difficulties and often wakes from vivid dreams |
Financial stress due to single-parent household |
Leah is accesses drop-in services when feeling unwell |
Psycho |
Leah experiences persistent fatigue, dizziness, and difficulty concentrating in class |
Feeling overwhelmed by family responsibilities and the transition to a new school |
Ongoing emotional distress linked to her parents' separation and minimal contact with her father, to whom she was previously close |
Leah is able to articulate her feelings during one-on-one conversations with supportive professionals |
Social |
Parental separation and loss of daily contact with father |
Change in school environment; loss of familiar friendships and routine |
Difficulty forming new friendships and limited opportunities for peer connection |
Leah is known to the school nursing team and receives ongoing support from her tutor |
MARKING CRITERIA
|
Distinction ? 70 |
Merit 60-69 |
Pass 50 - 59 |
Fail 40 49 |
Fail 0-39 |
Understanding |
Able to demonstrate an advanced, in-depth, authoritative, full understanding of key issues relating to the subject/intervention/patient case. There is evidence of originality |
Able to demonstrate an in-depth understanding of key issues relating to the subject/intervention/patient case. There is with evidence of some originality |
Able to demonstrate understanding of some key issues relating to the subject/intervention/patient case with evidence of the ability to reflect critically |
There is a superficial understanding of some key issues relating to the subject/intervention/patient case but there is a lack of focus |
There is a lack of understanding of/ or focus on key issues relating to the subject/intervention/patient case. |
Depth of knowledge |
This is complex work with the key issues analysed. A wide range of sources are used selectively to support the argument/discussion. There is strong evidence of a critical approach to key issues and the ability to evaluate arguments |
The key issues are analysed, and relevant sources used effectively to support argument/discussion. There is clear evidence of a critical approach to key issues and some ability to evaluate arguments |
Some key issues are addressed. Relevant sources are used to support argument/discussion. There is some evidence of a critical approach to key issues and the ability to evaluate arguments |
The key issues are not always understood or addressed. There are gaps in the use of relevant sources used to support work. There is limited evidence of a critical approach to key issues and ability to evaluate arguments |
Key issues are misunderstood or not addressed. There is limited or no use of relevant sources to support work. There is no evidence of a critical approach to key issues or ability to evaluate arguments |
Structure |
The work is coherent and compelling with a logical presentation. There is excellent integration of theory and clinical issues within a clear overall structure |
This is coherent work which is logically presented. There is full integration of theory and clinical issues within a clear overall structure. |
Competent work in places but lacks fluency/coherence. There is evidence of appropriate integration of theory and clinical issues within a clear overall structure. |
There are weaknesses in structure, fluency and/or coherence. There is little evidence of appropriate integration of theory and clinical issues within a clear overall structure. |
The work is confused and incoherent. There is a poor structure depicting confused practice |
Assignment/Faculty specific |
Advanced, analytical understanding of links between theory and practice and the impact of these on clinical care is demonstrated. There is excellent application of in-depth knowledge within the clinical environment and in relation to clinical decisions. |
There is advanced, analytical understanding of links between theory and practice and the impact of these on clinical care. Thorough application of in-depth knowledge within the clinical environment and in relation to clinical decisions is demonstrated. |
There is adequate analysis of links between theory and practice and the impact of these on clinical care. There is adequate application of in-depth knowledge within the clinical environment and in relation to clinical decisions |
There are superficial and descriptive links drawn between theory and practice and a limited description of the impact of these on clinical care. There is limited application of knowledge, some of which is superficial, within the clinical environment. There are few links drawn between knowledge and clinical decision making |
There is poor understanding of the relevant issues and their application to practice. There is limited and poor application of knowledge, some of which is superficial, within the clinical environment. Few links are drawn between knowledge and clinical decision making. |
Presentation and style |
This is insightful work displaying in-depth knowledge. Highest standards of presentation. Illustrates excellence in integrating theory and practice. Faculty referencing system used appropriately. |
This is thoughtful work displaying good knowledge and accuracy. Illustrates good analytical integration of theoretical knowledge and practice. Faculty referencing system used with minimal errors. |
The work displays knowledge and understanding in some areas, but some key issues are not addressed. Satisfactory standard of presentation. Faculty referencing system mainly used appropriately throughout. |
The work displays patchy knowledge and understanding, and some key issues are not addressed. Presentational weaknesses. The knowledge is weak or limited; there is limited analysis or application to practice. Faculty referencing system is presented with some errors. |
There is some attempt to write something relevant but with many flaws. There are indications of poor or unsafe practice. Faculty referencing system is not used or presented with major errors. |
