Assignment 2: Research Proposal
International Relations
28th May 2025
3
Integrating Evidence-Based Approaches in Acute Mental Health Services
Problems Formulation
Sarah has significant depressive symptoms such as chronic unhappiness, anhedonia, poor appetite, interrupted sleep, and suicidal thoughts. She also has symptoms of generalized anxiety disorder, including excessive worry and restlessness. Sarah considers her current circumstances as overwhelming and hopeless, affected by past trauma, recent relationship collapse, and social isolation. She feels caught in a cycle of despair and seeks release from her emotional anguish.
Introduction
A significant number of patients with mental health disorders have concurrent medical conditions or may exhibit substance dependence (Abernathy et al., 2016). The typical duration from the onset of symptoms of depressive disorders to receiving therapy is over a decade,(Tran et al., 2020) and the majority of patients with depression do not get sufficient care .Depression, anxiety, and schizophrenia are the primary contributors to impairment and financial strain in several nations (Ee et al., 2020). This leads to intricate therapeutic constraints that may not be sufficiently resolved by a caring approach exclusively provided by a single physician utilizing a single technique. Therefore, creating a comprehensive care model that incorporates evidence-based, individualized step-by-step approaches is crucial. This approach should include conventional drug therapies and innovative supplementary treatments implemented through a collaborative care strategy. This essay explores the development and critical evaluation of a collaborative care plan for Sarah, presenting with significant depressive and anxiety symptoms within an acute mental health service setting.
Collaborative Care Plan
Integrating physical and mental healthcare professionals in a joint model may enhance the treatment standards and meet the consumer's physiological and psychiatric health requirements (Camacho et al., 2018). Evidence from findings and studies indicate that collaborative care designs are outstanding compared to traditional care designs in treating depressive conduct, anxiety-related illnesses, bipolar instability, and schizophrenia (Camacho et al., 2018; Salisbury et al., 2019), along with patients with associated physical ailments (Reilly et al., 2013). Collaborative care strategies can mitigate healthcare inequalities among patients of diverse socioeconomic and racial origins, enhancing their exposure to treatment (Dham et al., 2022).
Patient Setting
Sarah is utilizing an acute mental health service that offers intense assistance and intervention for those facing acute mental health issues (Johnson et al., 2022). Acute care employs an integrated approach, including psychiatrists, psychologists, social workers, and nurses (Maconick et al., 2023), to effectively meet the varied needs of patients such as Sarah. The collaborative atmosphere of this environment enables comprehensive evaluation, formulation of treatment strategies, and continuous assistance customized to Sarah's requirements and desires. Pattanshetty (2016) describes acute mental illness as a critical condition or a sudden period associated with a single or variety of psychiatric conditions in which an individual exhibits several specific mental health symptoms of such intensity that hinders their ability to operate effectively in a social environment. Likewise, it is characterized by notable and concerning signs that need prompt medical intervention.
Consumer's Goals
An essential aspect of the collaborative care plan is the determination of Sarah's goals, acting as guiding principles in her recovery journey. Goal planning is crucial to mental recovery as it promotes behavioural change (Epton et al., 2017). Similarly, research suggests goal setting improves inspiration, commitment, self-worth, and health-related wellness service users (Stewart et al.,2022). Goal approaches help consumers determine their desired results, identify particular behaviours to be changed, and devise strategies for implementing changes (Bailey, 2017). The goal planning theory posits that consciously and specifically setting sufficiently challenging objectives conveys enhanced results. These goals may be impacted by characteristics involving personal drive and confidence.
Sarah's objective is to achieve emotional stability by specifically targeting her chronic sadness, anhedonia, interrupted sleep, and self-harm ideas that are linked to her depression and anxiety symptoms. Attaining mood stabilization is essential for Sarah to restore her mental balance and enhance her overall standard of life. Ensuring safety is a top priority, including addressing the immediate dangers related to Sarah's suicidal thoughts and potential for self-inflicted damage. To ensure Sarah's well-being throughout treatment, it is crucial to implement safety precautions, such as creating a plan of action and maintaining constant monitoring (Epton et al., 2017).
Moreover, Sarah aspires to initiate a recovery journey distinguished by development, resilience, and self-empowerment. This objective entails tackling the root causes contributing to her psychological issues, such as previous traumatic experiences and current deterioration in her relationships, using evidence-based treatments and therapy assistance. Moreover, Sarah's objective is to establish effective coping mechanisms, increase her self-awareness, and cultivate psychological resilience as she strives to regain control over her life and progress towards a more satisfactory lifestyle.
Lastly, Sarah recognizes the significance of social support in her healing process. She tries to reestablish connections with her social support system, including her family and friends. Developing solid connections and fostering a supportive atmosphere are crucial for Sarah's healing, personal development, and recuperation (Ong et al., 2021).
Role of Significant Others
Appreciating the significance of social support in Sarah's recovery, including family and friends, plays a crucial part in her acute care. Family and friends often spot the first symptoms of a client's mental health issue and possess beneficial information about the client that may assist in their recovery journey (Moore et al., 2018). The significant others' participation in helping their beloved one may bring about several benefits, such as reduced stress and caregiving responsibilities, enhanced well-being, and a better comprehension of the treatment process (Migliorini et al., 2022; Rickwood et al., 2015). Therefore, collaborating with Sarah's significant others contributes to treatment planning, provides emotional support, and assists in implementing strategies to promote her well-being. Their participation cultivates a nurturing atmosphere favourable to Sarah's restoration and amplifies the efficacy of treatment options.
Furthermore, the involvement of significant others in the care of Sarah has the potential to result in favourable patient results, including a decrease in relapses, a reduction in hospital admissions, reduced periods of hospitalization, and enhanced adherence to medication and treatment regimens (Ong et al., 2021). According to Griffiths et al. (2019), intervening early and engaging the family when signs of distress first appear may be beneficial in lessening the intensity of the attacks.
Biopsychosocial Interventions
Pharmacotherapy
Sarah's therapeutic regimen involves psychopharmacological interventions overseen by a psychiatrist. Antidepressants and anxiolytics are administered to treat her depression and anxiety symptoms, taking into account individual considerations like symptom intensity, drug acceptability, and possible adverse effects. Certain antidepressants, particularly SSRIs and mirtazapine, are valuable in minimising anxiety symptoms and are recommended as first-line treatment for sustained use (Strawn et al., 2018). However, regular monitoring is crucial to evaluate drug effectiveness, adjust doses as required, and minimize adverse reactions, ensuring Sarah receives optimum pharmacological assistance in managing her mental health.
Psychotherapy
Trauma-Focused Cognitive-Behavioural Therapy (TF-CBT) is a crucial psychotherapeutic approach for Sarah's acute care and is rated among the most effective trauma therapies (Bennett et al., 2021). CBT seeks to uncover and address dysfunctional thinking patterns linked with depression and anxiety (Ledley et al., 2018), providing Sarah with cognitive restructuring methods and behavioural tactics to help her develop adaptive coping skills and problem-solving abilities. Furthermore, trauma-focused therapy offers a specialized method to deal with Sarah's past traumatic experiences, allowing her to process and integrate trauma memories, emotions, and beliefs in a safe and supportive therapeutic setting (Kaminer et al., 2023).
Additionally, Cognitive-Behavioural Group Therapy (CBGT) is an increasingly affordable therapy option for depressed individuals than independent CBT. As a result, Sarah can better communicate her thoughts and emotions in the group setting and engage in interpersonal discussions, collaboration, and involvement, which increases her sense of belonging (Moloud et al., 2022). However, research by Jannati et al. (2017) challenges the effectiveness of CBGT, indicating that CBGT has no impact on optimism in individuals with bipolar I ailments,
Physical Health Promotion
Recognizing the interconnectedness of physical and mental health, Sarah's care plan emphasizes the importance of physical health promotion. Consistent physical activity constitutes among the most effective and accessible strategies for preserving outstanding health and improving general well-being. Periodic physical exercise, appropriate sleep patterns, and a nutritious diet are essential to Sarah's overall well-being. Physical exercise improves mood and lowers sadness and anxiety symptoms while promoting general physical health and vitality. Schuch et al. (2017) found that those who have poor to moderate aerobic fitness are more likely to experience depression. As a result, by emphasizing physical health promotion, Sarah obtains more control over her well-being. Sarah gains greater control over her well-being, leading to improved mental health outcomes and a greater sense of empowerment in her recovery journey.
Nursing Considerations
Nurses play a vital role in providing care, establishing therapeutic relationships, ensuring safety and collaboration, providing psychoeducation, and implementing crisis intervention strategies (Elin et al., 2022). By fostering trust, promoting safety, enhancing knowledge, and responding effectively to crises, nurses contribute to the holistic care of Sarah within the acute mental health service setting.
When creating Sarah's collaborative care plan, several critical components were taken into account to satisfy her intricate mental health requirements in acute care. Evidence-based approaches, including pharmacotherapy, psychotherapy, physical health promotion, and the inclusion of significant others, demonstrate a thorough and interdisciplinary approach to her treatment (Ee et al., 2020). By addressing Sarah's significant depressive and anxiety symptoms, as well as considering her contextual factors, such as past trauma and social isolation, the care plan demonstrates a commitment to comprehensive and person-centred care (Dham et al., 2022). Nevertheless, a thorough analysis of my experience and the client's viewpoint, Sarah, reveals some aspects that require further evaluation and improvement.
As a healthcare practitioner, I consider the collaborative care plan well-planned and based on evidence, using modern literature to guide decision-making. The focus on cooperation among various healthcare professionals, including family and friends (Griffiths et al., 2019), aligns with the most effective methods in mental healthcare (Camacho et al., 2018). However, a possible drawback is the absence of defined tactics for managing cultural elements and promoting diversity in care provision. Cultural competence is crucial in delivering efficient treatment, especially when addressing Sarah's social isolation and any cultural factors that may impact her mental health issues. Stubbe (2020) asserts that incorporating cultural sensitivity and awareness into the care plan can improve its efficacy and alignment with Sarah's specific requirements.
As the client, the collaborative care plan presents opportunities and challenges from Sarah's standpoint. A potential upside for Sarah is that she might appreciate the comprehensive approach that takes into account her objectives, including her crucial connections, and offers a range of evidence-based interventions to address her mental health concerns. Nevertheless, Sarah's perception of care may also be impacted by variables such as effective communication, empowerment, and the consistency of care. Essential components of client-centred care include ensuring clear communication on the treatment plan, involving the consumer in decision-making processes, and offering ongoing assistance throughout their recovery journey (Bauer et al., 2019). In addition, establishing a therapeutic connection founded on trust, empathy, and mutual respect can enhance Sarah's involvement in therapy and facilitate favourable results.
When evaluating the outcomes of the collaborative care plan, it is crucial to examine both immediate and long-lasting measures of success. Immediate results may include enhancements in Sarah's emotional state, alleviation of symptoms related to anxiety and depression (Johnson et al, 2016), and heightened involvement with therapy. Long-term effects include lasting enhancements in Sarah's mental well-being, improved adaptive strategies, and reinforced social support systems initiatives (Coventry et al., 2014). To measure these results, it is necessary to continuously evaluate, collaborate with healthcare specialists, and actively embrace Sarah and her significant others in the treatment process.
Nevertheless, there are prospects for improvement. By improving cultural sensitivity, emphasising consumer-centred care, and stressing communication and empowerment, we may enhance the effectiveness and comprehensiveness of care delivery (Panagioti et al, 2016). Through a thorough analysis of my experience and Sarah's viewpoint on care, we can pinpoint areas that need improvement and work towards maximizing results in mental health treatment within acute care environments.
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