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MENTAL HEALTH DIAGNOSIS AND ASSESSMENT

Mental Health Diagnosis and Assessment Paper Assignment Instructions

Overview

You will write a research-based paper of at least 5 pages (not counting the title and reference pages) in current APA format that focuses on mental health assessment and a mental health diagnosis of your choice. The paper must include at least 3 scholarly references in addition to the course textbooks and the Bible. The paper will focus on 1 mental health disorder, and you will describe the symptoms that would be present for a client that could come to see you as a social worker.

Instructions

Create a scenario where a client would present the mental health symptoms of a mental health diagnosis that you choose to research. Describe the client’s presenting symptoms and how you have used the appropriate assessment tools, such as the mental status examination, cultural views, family history, any substance abuse history, and any physical health problems, to make the correct diagnosis (as discussed in the textbooks). Then, discuss the appropriate interventions for that specific diagnosis with research information about what has been effective for the chosen mental health diagnosis. The paper must include a description of the client’s strengths and the utilization of the biblical views for making both the assessment and treatment interventions. Incorporate at least 1 relevant Bible verse.

 

Write your paper in current APA format. The paper must include:

1. Title page

2. Describe the use of the different assessment tools, such as the mental health status examination and the other important areas of focus with a client, for making the appropriate mental health diagnosis with the fictional client who would come in for services from you as the social worker.

3. Describe the symptoms that meet the criteria for the chosen mental health diagnosis with the fictional client who would come in for services from you as the social worker.

4. From what you have learned, prepare at least 2 suggestions for treatment interventions (specific type of evidence-based therapy that has helped with the chosen diagnosis, common types of medications prescribed, etc.) for the chosen diagnosis.

5. Description of the client’s strengths and how the social worker uses the biblical viewpoints to assess and treat the client.

6. Reference page for resources, including both textbooks, the Bible, and at least 3 scholarly references published within the past 5 years. LU’s library includes many resources to meet your needs. Newspaper articles and blogs do not qualify as professional resources.

 

 

Note: Your assignment will be checked for originality via the SafeAssign plagiarism tool.

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 MENTAL HEALTH DIAGNOSIS AND ASSESSMENT 

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Case scenario

H.I is a 23-year-old female who was brought to the emergency department by the police and her best friend for persistently calling the police emergency 911 number each time alleging that people were spying on her. She had called the police seven times accusing passers-by of spying on her prompting the police to arrest her. According to her, the passers-by were out to hurt her boyfriend, and spying on her was a scheme to know his whereabouts. Moreover, H.I claims to have a stomach ache, and she attributes it to a snake inside her stomach. She wants the snake removed because she has not eaten for days. At the emergency department, she is very uncooperative and does not answer any questions posed to her. She claims now where is safe and accuses the interviewing health practitioner of being an accomplice to the spies. She seems paranoid, edgy, and anxious. On further inquiry, she reports to sleep only 2 hours a night and would remain awake throughout the night. She is not suicidal or homicidal.

Past psychiatric history

H.I has never been on treatment for any disorder nor has she been diagnosed with any psychiatric disorder. She has never been hospitalized and hence has no caregivers. She has never been on any medications. She has been verbally and physically aggressive before and has not had any suicidal ideations either.

Substance use and history

H.I occasionally takes alcohol but does not reveal the quantity. She reports that she drinks about once every month and does not take any other substances of abuse. She has never had any complications from her drinking habit.

Family Psychiatric/Substance Use History:

H.I’s mother died two years ago. Her mother was on treatment for depression. On the other hand, her late father was admitted twice due to horrible drug-related experiences for about 8 days following each incidence. Her paternal grandparents were admitted for several years to a state hospital. H.I has no children at the moment.

Psychosocial History:

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Psychosocial History:

H.I lives in Fairfax, Virginia. She has a sister who is a decade older than her. H.I lives with her boyfriend who works as a truck driver, as a result, is frequently out of town on duty. H.I has a high school diploma. She has no history of military services or any pending legal issues. Her best friend, D.W, recounts that the death of H.I’s mother affected her, imposing an emotional burden on her. She however denies any childhood traumatic event. Her concerns during the interview were regarding her safety; as she feels people are spying on her.

Medical History:

H.I has a non-remarkable medical history; she denies any history of surgeries or head injuries.

Current Medication:

She is currently not on any medications.

Allergies:

She has no known food or drug allergies

ROS:

• GENERAL:  H.I is a young lady in a fair general condition with no fever, fatigue. Chills or weakness.

• HEENT: Eyes: she has no blurry vision, visual loss, no yellow sclerae or no double vision,

Ears, Nose, Throat: she does not have a sore throat, no hearing loss, running nose, no congestion, no nasal, or sneezing.

• SKIN: she has no rashes or itchiness.

• CARDIOVASCULAR: she has no chest pain, no chest discomfort, no pressure in the chest, no edema, or no palpitations,

• RESPIRATORY: she has no shortness of breath or cough.

• GASTROINTESTINAL: H.I has no diarrhea, no vomiting, no nausea, or anorexia, She however claims to have a stomach ache allegedly because of a snake in her stomach.

• GENITOURINARY: she has no hesitancy, no frequency, or urgency when urinating. Her urine has no odd color or bad odor.

• NEUROLOGICAL:  H.I has no dizziness, no headache, no paralysis, no syncope, no numbness, or tingling sensation. She neither has changes in bowel or bladder control.

• MUSCULOSKELETAL: She reports no pain in his back, joints, or muscles neither does he have stiffness in her joints.

• HEMATOLOGIC: she has no bruising, no bleeding tendencies, or anemia. 

• LYMPHATICS: She does not have a history of enlarged lymph nodes or splenectomy.

• ENDOCRINOLOGIC: Currently she does not have heat or cold intolerances with no polydipsia, polyuria, or sweating.

Objective:

Physical exam:

H.I declined to have a physical examination performed on her.

Diagnostic results:

She also refused to have samples taken for laboratory assessment as well as her vital taken.  

Mental State Examination Assessment:

H.I is a 23-year old neatly kempt young lady, who is groomed and dressed appropriately. She is paranoid and anxious; while her uncooperative nature makes it difficult to establish rapport with. Her tone and volume of speech are adequately normal, and her speech is also coherent. She has no psychomotor abnormality; no mannerisms or stereotypes. She does not have suicidal ideations nor is she homicidal. She has an irritable mood, with a mood-congruent affect. Her thought process is goal-oriented and linear. She has impaired thought content with somatic delusions. She does not however have flight of ideas or looseness of associations. She does not have a disturbance of perceptions; no illusions or tactile, visual, auditory hallucinations. She is alert and well oriented in time place and person. Her insight is poor at level one because she completely denies being sick. She refuses to respond to questions about her memory and other personal questions. It is hence difficult to assess her attention, memory, and concentration.

Delusional disorder

H.I presents with delusional disorder. In DSM-5, the disorder is hall-marked by well-systematized delusion while the patient’s personality is well preserved. The delusions in this disorder present for a month (APA, 2013). For delusional disorders, patients have an almost normal behavior save for the ramifications of the delusions they have. In the scenario, H.I displays somatic and paranoid delusions. She is paranoid that passers-by are spying on her in an attempt to kill her boyfriend. Her somatic delusion, on the other hand, is displayed as she claims that a snake is lodged in her stomach. The diagnostic criteria for diagnosis of the disorder require five criteria met (APA, 2013). Criteria A requires a patient to have one or more delusions lasting a month or longer. In criteria B, a patient should not meet the criteria for schizophrenia in their lifetime. H.I has never been diagnosed with any mental illness and she meets this criterion. Criteria C requires a patient to have a generally preserved behavior with little impact on the person’s behavior. Criteria D requires none or brief major depressive or manic episodes to have occurred and the last criteria is that the presentation of the patient should not be attributed to the physiological effects of any substance. In 2nd Thessalonians 2:11, And for this cause, God shall send them strong delusion, that they should believe a lie. This is in the context of preparation for the coming of Jesus while addressing the Thessalonians in the church (Thessalonians 2:11, ESV).

The main differential diagnoses involve distinguishing the disorder from schizophrenia, mood disorder, and paranoid personality disorder. The main difference with mood disorders is the absence of depressive or manic episodes, which if present develop after the psychosis or occurs briefly compared to the symptoms. Hallucinations are rarely present in delusional disorders, and when they occur they are related to the delusions. People with paranoid personality disorder are usually hypervigilant and suspicious but do not have delusions (Wehder, 2020). There are different types of delusions that patients can present with other than the ones in this case scenario. Patients can have erotomaniac, persecutory, jealous, or grandiose delusional disorders. Monohypochondriachal paranoia is used to describe the delusional disorder depicted in the case scenario. It comprises somatic subtype delusional disorder. The persecutory type of delusional disorder is the most common type of this rare disorder occurring in middle to late adult life.

The disorder has a prevalence of less than 0.5% of the general population and its rarity has brought treatment recommendations based on clinical observation rather than research. There is a poor response to antipsychotics as evidenced by clinical experience; they are however good for relieving anxiety and agitation. The first-generation antipsychotics haloperidol 5-10 mg/day or second-generation antipsychotic risperidone 2-6 mg/day can be used in treatment. Monohypochondriachal paranoia responds well to pimozide 4-8 mg/day (Joseph, 2019).

Psychotherapy is important in helping patients to seize control of their symptoms, develop plans for preventing relapses, and identify early warning signs of relapses. The use of cognitive-behavioral therapy has been advocated for in treating psychotic and delusional disorders (Shahid, 2019). It helps the patient to learn how to change and recognize behaviors and thought patterns that lead to maladaptive behaviors. Individual therapy on the other hand can help a patient to correct distorted thought processes due to delusions.

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