Mental care interventions
The biopsychosocial is the interdisciplinary factor that comprises interconnected parameters of biology, psychology, and social environments. These interdisciplinary factors contribute to the health of the individual, person, society, and community. Tripathi, et al, (2019) opined that the biopsychosocial model help in addressing the psychiatric disorder of the person. Through the model, one can systematically explain the interplay of three factors on the development of a psychiatric disorder. The biopsychosocial perspectives are useful in determining the mental health state of the individual and how the mental state is affected by biology and psyche. Although, the biological influence of a person on mental health and mental illness greatly varies with respect to genetic, trauma, nutrition, toxins, hormone, and infection (Babalola et al., 2017).The model describes the health, illness, and overall activity of the individual as the product of lifestyle, stress, health beliefs, social conditions, family relationships, and social support. The health psychologist states that while dealing with the patient they usually consider the psychological and emotional illness of health. Mental health assessment usually connected with the development of self-esteem, resilience, positive effect, socialization, and consistent health (Young et al., 2017). The systematic consideration of psychological and social factors requires the proper application of natural science. The combination of natural and social science help the medical practitioner to work and adopt the best clinical practices. While considering the biopsychosocial model, the humanistic qualities were evaluated through the application of scientific method with reference to the biological, psychological, and social phenomenon (Kleijnen, 2015).
In the medical treatment or any clinical practices, the biopsychosocial model is considered as one of the best tools in identifying mental illness in patients. The model determines the chronic illness and functional disorder is present in the patient. However, sometimes the patient's experiences and unique biopsychosocial realities is a difficult and formidable task.
Rachel is suffering from depression and due to which she has developed psychosocial differences from family, friends, and society. The depression feeling of Rachel can be attributed because of the nature of not expressing her feelings when her mother died. Her mother died due to manic depression and suspect of suicide was recommended. Social isolation and loneliness are the contributing factors for depression (Khan, 2017). After her mother died, Rachel found difficult to live a life and has developed the feeling of isolation from family. Temirgazina (2013) state that sorrow and grief are the associated factor which results in trouble, loss, and development of unambiguous behavior. Through her nature and her regular bad habits, it can be stated that she is suffering from deep sorrow and does not want to disclose it with anyone. The second reason for depression is that her boyfriend has left her after a long-term relationship. She has broken from inner and does not want to discuss her personal thoughts with anyone. This can also be witnessed by the fact that Rachael usually found teary during the hospital.
The second problem with Rachel is a lesser social interaction. She never talks or discusses with her sister, family or any other society member. Social disconnectedness and isolation contribute to the anxiety and depression symptom severity (Ivan et al., 2020). The paper opined that patients suffering from social distraction characteristics usually develop the characteristics of loneliness, self-care, and irritating characteristics. Moreover, the social connectedness is deeply associated with ingrained human characteristics, genetic mechanisms, companionship, bonding, and her behavior (Ivan, 2020). This shows that Rachel has started developing introvert nature, reducing communication, and started keeping social distance, lesser interaction, and lesser social beliefs. These characters tic were addressed because of Rachel’s social determinant behavior with people surrounding her, family, and friends.
Thirdly, Rachel shows rapid mood swings in her personality and develops an interest in non-living things. In the hospital, Rachel makes herself busy and happy in changing clothes, putting makeup, and flirting with men. This can be evaluated from the paper written by Khan, (2019), he states that living arrangement, false relationships, social isolation have the predominant role in the development of depressive symptoms. This proves that Rachel has developed distinct mental characteristics of mood swings, fashion interest, eating habits, teary times, and many others.
As the registered nurse, the main objective is to examine the interconnectedness between the Rachel social, psychological, behavioral, and immune systems. This examination helps in exploring and determining the contributory factor for illness. The core elements that can be used for the treatment of the patient includes proper management of medicine, symptoms reduction, relapses, collaborative and managerial assessment, cognitive behavioral therapy, and develop structured family environment or surrounding. Rachel is suffering from severe depressive disorder and requires effective treatment. Rachel is a grown adult with severe depression symptoms, whose care, wellness, and health need to be properly maintained otherwise she can develop some giant health issues.
Depression tool needs to be addressed and used to determine the main reason for which Rachel is suffering. Depression tools help to provide accurate and robust diagnoses of depression (Zhang, et al, 2019). Psychotherapy shows the contributory beneficial effect on the patient suffering from depression (Nieuwsma, 2012). Psychotherapy provides a beneficial improvement in patient health as mood, cognition, physical activities, and cognitive behavior. Psychotherapy can be initiated on the regular period to interact with the patient more times. The procedure helps the patient to be relaxed, comfortable, and feel in a controlled manner. The registered nurses main motive for commencing psychotherapy is to track and assess the mood, thinking, and nature of the person. The registered nurse must follow the psychotherapy in four different steps. In the initial few days, individual therapy needs to be accompanied which comprise of discussion between the patient and medical practitioner. This step ensures the nurse knows more about the patient and guides them with respect to her medical condition. The next step is a group discussion, this will help Rachel to discuss or communicate in good behavior in the presence of many people. Thirdly is the family therapy, in this therapy type, Rachael must be made comfortable with the family, friends, and colleagues. The last step helps Rachel to behave properly with the family or friends and Rachael could learn about how to deal socially.
Rachael also developed mood swings and psychopathological conditions. These conditions could be prevalent for the development of suicidal thoughts and behavior (Zhang et al., 2020).Thus a cognitive behavioral therapy would be a promising approach for the betterment of Rachel's health. Cognitive behavior therapy helps in clearing the issues on thoughts, perceptions, feeling, physical sensations, and performed actions (Teater, 2013). Rachael could properly overwhelm with the problems in a positive and mannered way with the utilization of cognitive behavior therapy. The session or the training adopted last for thirty to sixty minutes and during the session, the therapist or the registered nurse would be able to sort the problem and divide the problem into small segments. These segments can be separately discussed with the patient. While discussing, the issues can be resolved and made Rachael be in a good position to face the new challenges of life. Cognitive behavior therapy help in identifying the negative thought of patient, help Rachael to become aware of her negative thinking, and learning new behaviors, new thoughts and putting them in real life. This therapy is one of the powerful approaches that would help Rachael to solve her problem.
Psycho education is an effective adjunctive tool that helps in developing the immense potentialities inpatient (Srivastav&Pandey, 2017). The psycho education also reduces the relapse rate of mental health or mental disturbance. Rachael is suffering from various mood swings and social disturbance, due to which she has developed mental illness, thus psycho education help her to stable her mood swings and other behavioral problems.
Ethical and legal implications
Rachael is suffering from severe depression with the thought of loneliness, selflessness, social distraction, social determinant, and random mood swing. Many factors need to be considered that have a direct, indirect impact on the health of Rachel. The factors include political, social, legal, and ethical. While considering the health of the person, some of the factors that come in reality include justice, beneficence, non-malfeasance, confidentiality, autonomy, and informed consent (Bipeta, 2019). Rachel is not following any social rules of the nation as she is regularly disturbing her neighbors and friends. This may cause negative influence on her personality and if her behavior is not managed, then her neighbors may take legal action against her. Ethically she should not engage herself with the men taff and patient in the hospital as this may against the policy of hospital Moreover, this behavior is legally and ethically correct and can cause serious issues in the coming time. Rachel must be aware of her ethical and legal boundaries and must follow them in a proper framework. She also follows the guidelines that are provided by the caregiver, or medical practitioner. The ethical and legal implications also contribute to the living standard of Rachael and may affect her health, economic status, social, professional, and supportive factors.
Babalola, E., Noei, P., & White, R. (2017). The biopsychosocial approach and global mental health: Synergies and opportunities. Indian Journal of Social Psychiatry, 33, 291-296
Bipeta, R (2019). Legal and ethical aspects of mental health. Indian Journal of Psychological Medicine, 41, 108-112. doi: 10.4103/IJPSYM.IJPSYM_59_19
Ivan, Z., Jose, P., Cornwell, E., Koyanagi, ., Nielsen, L., &Hinrichsen, . (2020). The Lancet, 5, 62-70 DOI:https://doi.org/10.1016/S2468-2667(19)30230-0
Khan, H. (2017). Social isolation, lonlines and their relationships with depressive symptoms: A population based study. PloSONE, 12, 1-21. doi: 10.1371/journal.pone.0182145
Kleijnen, J. (2015). Biopsychosocial medicine: An integrated approach to understand illness. Oxford University, 4, 1-20.Doi: 10.1093/med:psych/9780198530343.003.0008
Kusnanto, H., Agustian, D., &Hilmanto, D.(2018). Biopsychosocial model of illness in primary care: A hermeneutic literature review. Journal of Family Medicine and Primary Care, 7, 497-500. doi: 10.4103/jfmpc.jfmpc_145_17
Nieuwsma, J., Trivedi, R., Mcduffie, J., Kronish, I., Benjamin, D., & Williams, J. (2012). Brief psychotherapy for depression: A systematic review and meta-analysis. The International Journal of Psychiatric Medicine, 43, 129-15 doi:: 10.2190/PM.43.2.c · 1
Srivastav, P. &Pandey, R. (2017). Psycho education an effective tool as treatment modality in mental health. The international Journal of Indian Psychology, 4, 1-10.
Tripathi, A., Das, A., &Kar, S. (2019). Biopsychosocial model in contemporary psychiatry: Current validity and future prospects. Indian Journal of Psychological Medicine, 41, 582-585
Tamirgazina, Z. (2013). Cultural scenarios of emotions of sadness, sorrow, and grief. Pavlodar State Pedagogical Institute, 1, 1-15. doi: 10.5829/idosi.mejsr.2013.13.sesh.1440
Teter, B. (2013). Cognitive behavioural therapy, Journal of Research, 12, 1-7
Young, C., Hanson, C., Craig, J., Clapham, K., &Wiliamson, A. (2017). Psychosocial factors associated with the mental health of indigenous children living in high income countries: A systematic review. International Journal for Equity in Health, 16, 1-17. Doi: 10.1186/s12939-017-0652-5
Zhang, J., Huen, J., Lew, B., Chistopolskaya, K., Talib, M., Sin, C., Leung, N. (2020). Depression, anxiety, and stress s a function of psychological strains: Towards an etiological theory of mood disorders and psychopathologies. Journal of Affective Disorder, 271, 279-285 doi: https://doi.org/10.1016/j.jad.2020.03.076
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