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Mental health does not simply mean the lack of mental sickness but rather means a state of social and emotional wellbeing, where people are able to cope with the normal stress of their lives, achieving their maximum potential (MentalHealth.gov, 2020). Disturbed mental health can be associated with a variety of mental illnesses such as anxiety and depression, and disorders such as adjustment disorder. Adjustment disorder refers to the occurrence of symptoms including stress, sadness, and hopelessness following stressful events or sexuality conflicts (Medline Plus, 2020). This study focuses on a case study focusing on the mental state of Sanjeev, a 32-year old man who is suffering from a combination of anxiety and depression along with adjustment disorder. Furthermore, the treatment plan for Sanjeev including the importance of focussed psychological strategies will also be discussed.
Before the commencement of any medical treatment for a patient, the analysis of the patient’s actual state of mind has to be carried out by his mental social worker. From Sanjeev’s case study, he can be concluded to be anxious and depressed following the denial by the Immigration department and he is extremely worried that he will have to go back to India. He does not want to go back to India, to hiding his sexuality from his family and relatives and living his life as somebody else. As a consequence of this anxiety and depression, Sanjeev has started to become very teary and sad all the time, having the thoughts of harming himself rather than going back to his country. Based on the symptoms of gloominess Sanjeev is encountering, he is diagnosed with adjustment disorder. Adjustment syndrome is a mental disorder in which stress greater than what is normally expected is experienced in response to stressful conditions such as conflicts in relationships or issues associated with sexuality, which are also experienced by Sanjeev.
Adjustment syndrome is characterised by the symptoms such as frequent and excessive crying, worrying, all the time, lost appetite, and can lead to the outburst of other symptoms such as depressed and anxious behaviour, accompanied by suicidal thoughts (Mayo Clinic, 2017). Since all these symptoms are visible in Sanjeev, his treatment has to take place according to adjustment syndrome, concurrently taking care of the risk factors associated with the same. The risk factors associated with the syndrome include certain stressful situations and life-experiences of a person. Sanjeev has to be taught healthy and effective skills required in coping with the current situation in order to protect him from hurting himself (Mayo Clinic, 2017). He has to be reminded that this situation is time-restricted and he will eventually get through it.
In order to provide proper and effective treatment to Sanjeev, his needs have to be determined along with the establishment of the treatment goals and a link between the factors influencing his mental condition to mitigate the potential risk factors that can aggravate Sanjeev’s mental condition. An accredited mental health social worker can determine Sanjeev’s needs by having effective communication with him. Effective communication aims to understand the intentional and sentimental basis of the information that is verbally given by the patient to his counsellor or therapist and is an important aspect of a patient-therapist interaction (Robinson, Segal and Smith, 2019). The evidences from the case study suggest that Sanjeev is worried that if he will have to go back to India, people there will not accept him as who he is rendering him think that it will be a better option to kill himself rather than face the criticism. Therefore, one of Sanjeev’s needs is that he requires guidance to deal with his thoughts of self-harming behaviour. Furthermore, Sanjeev needs positivity to deal with the denial from the Immigration department of Australia as Sanjeev’s migration lawyer reported that the entire process may take several more months.
All the treatment plans related to the patients’ mental care must have treatment goals because a goal is the building block of every treatment plan. Moreover, these goals should focus on the patient's needs and must be specific and realistic (Good Therapy, 2019). The goal of Sanjeev’s treatment is to provide him a positive insight into his life and make him realize that he should be optimistic about the final decision about his stay in Australia from the tribunal. The factors associated with Sanjeev’s mental status are his fear of returning to India, where he will have to either tell everybody the truth about his sexuality or fake his real identity. The mental healthcare social worker will have to make him understand the worth of his life and that even if he will have to go back to India; the value of his life is more than anything else. In addition to this, Sanjeev thinks that the events of harassment and prosecution against him are inevitable and that he will not be able to do anything else but to fake his sexuality in front of everybody by marrying a girl, which is not completely true. The mental healthcare social worker will have to make him discern the importance of fighting for ourselves. He can be told about the fact that things are difficult in the beginning but change eventually happens and therefore, he can try to tell his parents the truth about his sexuality and that he is gay, rather than sacrificing his own life, thinking about something that might not even have happened.
Focussed psychological approaches/strategies (FPS) are the evidence-based approaches used by mental health workers including social workers (The Department of Health, 2016). These strategies that can be followed by mental healthcare professionals include psycho-educating/motivational interviewing, skills training, cognitive-behavioural therapies, relaxation strategies, and interpersonal therapies. Interpersonal therapies are specifically used for patients suffering from depression (The Department of Health, 2016). The focussed psychological strategies can help significantly improve Sanjeev’s state of mind also and since Sanjeev needs to be taught the skills to cope with his current stressful situation, the mental healthcare worker can use the strategies such as cognitive behavioural therapies, relaxation therapies, skills training, and psycho-educating with Sanjeev. Psychoeducation refers to educating the patient about the mental conditions he is diagnosed with (Good Therapy, 2017). This therapy is based on the principle that a person can better face the challenges if he is better acquainted with the type of challenges he will be encountering, focussing on his own strengths and weaknesses.
Additionally, the mental health worker can also make use of cognitive behavioural therapies (CBT) to help Sanjeev. CBT refers to the wide range of psychotherapies aimed at addressing the emotions, behaviour, and thoughts of a patient and changing the negative thoughts contributing and worsening emotional complications, anxious and depressed behaviours. By the means of CBT, these thoughts can be recognised, challenged and exchanged with positive, realistic and objective thoughts. The use of CBT can impart benefits in managing the mental illness symptoms and their recurrence, learning the techniques required for coping from distressing situations, grief and loss, overcoming emotional trauma and learning better way of communication (Mayo Clinic, 2019). CBT includes the use of techniques such as behavioural modifications or interventions, and cognitive therapies, all aimed at improving the patient’s way of thinking. Furthermore, the mental health worker can teach Sanjeev the strategies that can help him relax such as mindful meditation techniques or controlled breathing techniques. Sanjeev’s skills training will also help him in overcoming his anxiety. The skills’ training involves teaching him skills for managing his anger and stress and training required for problem solving (The Department of Health, 2016).
The mental health worker can implement these strategies only if Sanjeev will trust him enough to learn from him and believe him that learning these strategies can actually help him cope with the stress he is currently having. This can be done by making the use of effective therapeutic communication with Sanjeev. Therapeutic communication refers to the client-centered in-person process of interaction between a healthcare professional and his patient, focused on the advancement of both the emotional and physical health of the patient (Martin & Chanda, 2016). Therapeutic communication is wellbeing centered and stress-alleviating shared interaction between the medical attendant and the patient, having the essential purpose of setting up the trust required to make a significant trade between the doctor and his patient (Martin & Chanda, 2016). Since Sanjeev has visited the therapist with an expectation of getting help from him, once the development of the required level of trust and rapport will happen, the likelihood of Sanjeev agreeing and adapting to the strategies taught by the mental health worker will also increase.
This study is based on the provided case study related to the mental condition of a 32-year old man suffering from adjustment disorder and having a hard time coping with the denial from the Immigration office of Australia. He thinks that he cannot afford to return to India as he will have to change himself based on his family’s desires, which makes him extremely sad and wanting to kill himself. His mental condition can be improved by following a proper treatment plan based on his needs and considering the factors related to his depleted mental state. The mental health social worker will have to make effective communication with Sanjeev in order to implement focussed psychological strategies aimed at alleviating his symptoms.
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