Testing for mental health is an essential component of medical practice especially with the present quality of life that exposes patients to multiple factors like stress and anxiety that makes them susceptible to one type of mental illness or another. The following is a report following an interview with Ms. Jones, who comes to the clinic with complications of sleep and exhaustion that have lasted about three and a half weeks. She says she has been feeling exhausted lately and has been having issues, especially just before going to bed. I Interviewed Ms. Jones and discovered many things about her and also about her condition and recommended seeing a therapist who can assist her in dealing with her condition.
During the interview, I found Ms. Jones to be alert, coherent, and oriented, and this makes the assessment easier because she answered all the questions appropriately. Therefore I collected all the data I needed to make the assessment. According to Katz and Korslund, (2019), the assessment of patient demeanor during the actual assessment period offers essential information about the condition of the patient and further enhances the assessment by offering information that may not be obvious and that the patient may not volunteer.
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Although the assessment went relatively well, I encountered a number of challenges, and this included failure to ask her about suicidal thoughts. I asked her whether she thought of harming other people. However, I failed to ask her whether she was harboring any suicidal thoughts within her. She said she has problems sleeping and only gets to sleep up to four hours, and such a combination of symptoms may lead patients towards the direction of suicide. According to Dunster-Page et al., (2017), behaviors of self-harming have the most robust association with the patient-rated alliance. Therefore, patients must be checked for tendencies of self-harming to ensure correct diagnosis of the medical issue.
Based on the assessment, I found that Ms. Jones worries a lot and takes so much on her plate, which in turn is giving her insomnia and feeling tired and irritable whenever she is awake. I believe she needs to learn relaxation techniques and meditation exercises and utilize time management. Besides my assessment of her, I feel the need to work more on my critical thinking skills. Hezel et al. (2019) posit that anxiety disorders generally affect the quality of life by lowering intimacy towards personal gratification, appreciation, and acknowledgment of limitations. Therefore, patients must be bold enough to seek help whenever they feel the need.
I believe that questions that spoke to her lack of sufficient sleep and her affinity to worrying about everything with her future yielded the best outcomes. These questions helped her to open up about her tendency to become irritable because of her lack of sleep, and this is a vital sign to look out for when assessing for mental health conditions. Based on my assessment of her symptoms, I would recommend seeing a therapist and not any diagnostic tests. Bickley, (2013) posits that it is significant that clinicians learn the collective characteristics of psychological sickness because the disorders are currently frequent at the wake of the shortage of psychiatrists, and it is likely that the primary care physician will be the first person in the line of care to encounter the patient’s distress.
I am currently considering sleep disturbance and anxiety differential diagnoses. Sleep disturbance is a broad scope of diseases that generally encompass the issues of initiating as well as maintaining sleep, for instance, insomnia. Moreover, it entails disorders of excessive drowsiness as well as those of sleep and wake schedules. Furthermore, it involves types of dysfunctions associated with sleep, the different stages of sleep, and partial arousal.
I worked with Ms. Jones in various perspectives encouraging her to monitor as well as log her episodes of anxiety and insomnia. I asked her to do this with the concerned factors and return the log in the next visit. I urged her to decrease the use of caffeine and instead increase water intake and other light fluids. I recommended to her strategies for reduction of anxiety, and this included relaxation, deep breathing as well as meditation. I asked her to continue monitoring and exploring the need for possible referral to psychiatric or pharmacological intervention.
I would not explore the recommendation of any forms of medication at this juncture and instead recommend seeing a social worker or a psychiatrist. This is because patients of mental health must first exhaust other non-medicinal means of treatment before considering medicinal solutions. I believe my assessment enhanced my affinity towards critical thinking because the situation placed me on a pedestal in which I had to think outside standard conventions and come up with a favorable solution that would work for the specific client.
Overall, mental health is a prevalent issue in the present quality of life due to various factors, and both the patient and the physician must collaborate with accurate diagnosis and examination of the problem to ensure the right approach to solving the issue before it escalates to other complex solutions. This assessment allowed me to test my skills and abilities in the area of medical examination.
References
Bickley, L. (2013). Bate’s guide to physical examination and history taking (11th). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.
Dunster-Page, C., Haddock, G., Wainwright, L., & Berry, K. (2017). The relationship between therapeutic alliance and patient's suicidal thoughts, self-harming behaviors, and suicide attempts: A systematic review. Journal of Affective Disorders, 223 (1), 165-174.
Hezel, D., Stewart, E., Riemannd, B., & McNallya, R. (2019). Standard of proof and intolerance of uncertainty in obsessive-compulsive disorder and social anxiety disorder. Journal of Behavior Therapy and Experimental Psychiatry, 64 (1), 36-44.
Katz, L., & Korslund, K. (2019). Principles of Behavioral Assessment and Management of “Life-Threatening Behavior” in Dialectical Behavior Therapy. Cognitive and Behavioral Practice, 1 (1), 121-132.
