Scenario B – Tracey is a 35 year old woman who presents for assessment to the Emergency Mental Health Community Team. She is six months pregnant with her third child. Her other children, to her ex-partner, are aged three and five. Tracey is in a heterosexual relationship with her partner of one year, Peter. Peter moved in to live with Tracey and her children eight months ago. The children’s father is distressed about Peter moving in to live with his children. There is verbal hostility between Tracey and her ex- partner each time he visits to collect the children for a weekend visit. Her expartner frequently states he is making arrangements for court to have full time care of the children. Tracey and her current partner, Peter, are in $35,000 uncontrolled debt after a recent new joint business venture failed. A finance company calls weekly requesting payment. Tracey and her partner stopped making the mortgage repayments three months ago, with the belief that dealing with the uncontrolled debt would be a better option. Her parents are supportive but live in Queensland. Tracey is able to have face to face contact with them once a year. She does chat with her parents over telephone every week if possible. Tracey states she is worried about how she will cope with her two children and new baby. She reports low mood, weekly panic attacks and fleeting thoughts of suicide. During your meeting with Tracey, you note she is fidgety and restless, breathing rapidly, shaking slightly, sweating and tearful. She is not wishing to actively engage with the mental health services, for fear it will impact on her having care of her children, stating she will visit her General Practitioner (GP).

1) Investigate and outline the prevalence/incidence of anxiety (depending on the scenario you have chosen) in Australia – Your answer needs to cover: gender, age groups, specific risk groups, hospitalisations. 225 words

? Please refer to ABS Australia 2007. ( Only Australia statistics)

2) Using current literature discuss TWO (2) factors that may have contributed to the development of the client’s presentation and mental health concerns. 225 words

? Contributed factors: Child custody issues, financial stress, Verbal hostility with ex husband
3) Using current literature discuss TWO (2) ethico-legal issues related to your scenario.225 words
The Mental Health Act (2007) is the legal construct used predominately for clinical care in the mental health services. Please ensure if you are using the Mental Health Act, you refer to the latest NSW version. However you may also wish to consider legal frameworks around access to health records, storage of health records or privacy. Professional nursing standards or ethics literature may also help guide your thinking.

For example you may wish to consider:

• the professional boundaries around confidentiality
• the use of the mental health act for when safety concerns are noted
• a nurse’s role in assessment and engagement with a client knowing that they may have to activate resources to possibly schedule a person and detain them ( ie remove their freedom) due to concerns about their safety
• You may also consider a person’s right to engage with mental health services when there are actual risks or potential risks to their safety or the safety of others
• The ethics of a nurse taking no action if risks to self are identified or potential risks are noted
• a person’s autonomy and right to choose
• a nurse’s discussion with other health professionals ie. GP
• a nurse’s involvement with family members when risks are noted versus a person’s right to choose no family involvement
• a nurse’s professional and ethical role in child protection matters for risks or potential risks
• non-maleficence; a principle to avoid harm. However assessment and interventions may cause distress to the person and their family
4) Identify TWO (2) nursing/midwifery concerns / problems with evidence from your chosen scenario- Your risk identification should be focused on the next 1-5 days of nursing/midwifery care for your client.100-150 words(USE TABLE)
? Symptoms of anxiety
? Inability to cope
? Fleeting thoughts to suicide
? Reducing engagement in services
? For each nursing / midwifery concern / problem you have identified in Question 4, outline and describe TWO (2) evidence based nursing / midwifery interventions (ie; what you would actually do as a nurse / midwife to support the person and how you would do it). Your interventions should be focused on nursing / midwifery care for your client over the next 1-5 days. They must be interventions which you would actually undertake directly with your client within your role as a nurse. You are also required to provide a clear rationale for each nursing intervention (ie. Why have you chosen the particular nursing interventions? How will the interventions support the person or contribute positively to their current presentation or concern?) Each intervention and rationale must be supported by current literature. 225 words (USE TABLE)

Positive nurse- client relationship with recovery based communication
? Safety planning
? Psycho-education to build hope and reduce stress
? Sleep hygiene
? Relaxation techniques
? Behavioural scheduling and goal setting
? Medications for anxiety

1) Use a table to present your answers for questions 4 and 5.
2) Ensure that your answers incorporate literature
3) The total word count for assessment one is 1000 words. As a guide:
225 words for question 1, 2, 3 and 5. 100 – 150 for question 4.
4) No introduction or conclusion to your work is needed.

5) Consider referring to the Australian Bureau of Statistics, Department of Health, Mental Health Commission websites for up to date information. You may also wish to refer to the DSM V.
6) It may be helpful to consider the information you have about the Stress Vulnerability Model. This may assist you to think about vulnerabilities a person may have to developing mental health concerns.

7) Question 3 refers to ethical or / and legal issues.
The Mental Health Act (2007) is the legal construct used predominately for clinical care in the mental health services. Please ensure if you are using the Mental Health Act, you refer to the latest NSW version. However you may also wish to consider legal frameworks around access to health records, storage of health records or privacy. Professional nursing standards or ethics literature may also help guide your thinking.

For example you may wish to consider:

• the professional boundaries around confidentiality
• the use of the mental health act for when safety concerns are noted
• a nurse’s role in assessment and engagement with a client knowing that they may have to activate resources to possibly schedule a person and detain them ( ie remove their freedom) due to concerns about their safety
• You may also consider a person’s right to engage with mental health services when there are actual risks or potential risks to their safety or the safety of others
• The ethics of a nurse taking no action if risks to self are identified or potential risks are noted
• a person’s autonomy and right to choose
• a nurse’s discussion with other health professionals ie. GP
• a nurse’s involvement with family members when risks are noted versus a person’s right to choose no family involvement
• a nurse’s professional and ethical role in child protection matters for risks or potential risks
• non-maleficence; a principle to avoid harm. However assessment and interventions may cause distress to the person and their family
8) The nursing concerns should focus on mental health, associated risks, relationships, engagement with services, coping strategies, for example. Actual or potential risks within 1 – 5 days of your meeting with the person should be considered. Make sure they are risks which are identified or indicated within the case study so relate it back to your client.
9) Ensure your interventions are suitable for the problem or nursing concerns you have noted. Be specific with the actual interventions you would offer. ie. describe how you will actually undertake the interventions, including times frames. The interventions are activities which you, as a nurse, would undertake directly with your client.
10) (A note of caution: making a referral to another service or discussing with family members are consultation and not classified as nursing interventions for your assessment. )

Marking criteria

1 – Investigate and outline the prevalence/incidence of anxiety (depending on the scenario you have chosen) in Australia using current literature 10 marks The details related to the prevalence/incidence of depression or anxiety are exceptional and of the highest quality. The answer is well supported by relevant literature
2 – Discuss using current literature TWO (2) factors that may have contributed to the development of Tracey’s presentation and mental health concerns. Discussion consistently conveys evidence of analysis and synthesis showing exceptional understanding of the factors that may have contributed to the client’s presentation and mental health concerns. Sources used are exceptional to support work. Exceptional critical discussion noted
3 – Discuss using current literature TWO (2) ethicolegal issues related to your chosen scenario Exceptional discussion related to the ethico-legal issues related to the scenario. Sources used are exceptional to support work. Exceptional critical discussion
4 – Identify TWO (2) nursing problems/risks with evidence from your chosen scenario
Exceptional identification of TWO (2) nursing/midwifery problems/risks with clear evidence and relevance to the case study chosen
5 – For each nursing/midwifery problem/risk you have identified in Question 4, Outline and describe TWO (2) evidenced based nursing/midwifery interventions and rationales for each Exceptional; clear concisely written relevant nursing/midwifery interventions. Sources used are exceptional to support work. Exceptional critical descriptions noted.
6 – Academic writing & referencing skills Exceptional referencing: both in text and final reference list according to APA style. Extensive, relevant current academic reference list effectively utilised. Publishable writing style and use of language

Please note: References should Not later than 5 years except ABS document which is 2007
Try to search references from Australia
For q1: Only Australia statistics.
APA style

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Promoting mental health and wellbeing

Essay – Promoting mental health and wellbeing (1000 words)

Aim of assessment
The purpose of this guided essay is to enable students to consolidate nursing/midwifery issues covered in class materials and to determine students’ understanding of the topics and applications, in preparation for transition into the professional nursing and midwifery workforce. This is a guided essay based on a case study where the students respond by answering a series of questions.

Details
Using EITHER Scenario A or Scenario B- please answer the following questions:

1. Investigate and outline the prevalence/incidence of depression / anxiety (depending on the scenario you have chosen) in Australia – Your answer needs to cover: gender, age groups, specific risk groups, hospitalisations.
2. Using current literature discuss TWO (2) factors that may have contributed to the development of the client’s presentation and mental health concerns.
3. Using current literature discuss TWO (2) ethico-legal issues related to your scenario.
4. Identify TWO (2) nursing/midwifery concerns / problems with evidence from your chosen scenario- Your risk identification should be focused on the next 1-5 days of nursing/midwifery care for your client.
5. For each nursing / midwifery concern / problem you have identified in Question 4, outline and describe TWO (2) evidence based nursing / midwifery interventions (ie; what you would actually do as a nurse / midwife to support the person and how you would do it). Your interventions should be focused on nursing / midwifery care for your client over the next 1-5 days. They must be interventions which you would actually undertake directly with your client within your role as a nurse or midwife. You are also required to provide a clear rationale for each nursing / midwifery intervention (ie. why have you chosen the particular nursing interventions? How will the interventions support the person or contribute positively to their current presentation or concern?) Each intervention and rationale must be supported by current literature.

Scenario A
David has been referred to you in the Emergency Mental Health Community Team by his GP. His GP is concerned about David’s mental health state and risks to self. David is a 23 year old man, currently living with his mother. Both David and his brother, Peter, have a positive relationship with their mum. David’s mother and father divorced when he was 15 years old. Before his parent’s divorce, David had a positive relationship with his dad. However at the time of his parent’s divorce David became very angry towards his dad. David also directed his anger towards his friends at the time and he quickly became isolated from his peers, ultimately leaving school at 15 years old, at the end of year 9. David and his older brother, Peter, aged 25, had shared interests of bike riding and computers during their teenager years. During your meeting with David, he stated that he did feel that he and his brother had a close relationship and friendship. However, he acknowledged that they had become more distance in recent years. David has had three past heterosexual relationships lasting several months. His last relationship finished two months ago. His most recent girlfriend has disclosed she is three months pregnant and does not wish for David to be involved in the care of the baby.
After leaving school, David had a number of part time labourer jobs. Each job lasted for two to three months. His most recent employment, over a year ago, was terminated by the employer as a result of conflict with his colleagues. David had left three of his previous jobs on his own accord as he felt “he just didn’t fit in”. He recalled a constant feeling of agitation and sadness at the time. During your contact with David, he has not worked for at least a year. He has contact with his father and brother every month or so. Many of the contacts with his father and brother end in verbal hostility. During the assessment with David, you notice he becomes distressed and tearful on your questioning. He reports recent weight loss. He discloses he has been having difficulties sleeping, feeling exhausted and increasingly depressed. You make further attempts to find out what has been happening for David and to engage with him. He asks you to stop questioning as he is ashamed of how he is currently feeling. He is worried about letting his mum down as they have always had a positive relationship. He declines to look at you while you ask him about thoughts of suicide. He does not wish for you to have any discussions with his family.

Scenario B
Tracey is a 35 year old woman who presents for assessment to the Emergency Mental Health Community Team. She is six months pregnant with her third child. Her other children, to her ex-partner, are aged three and five. Tracey is in a heterosexual relationship with her partner of one year, Peter. Peter moved in to live with Tracey and her children eight months ago. The children’s father is distressed about Peter moving in to live with his children. There is verbal hostility between Tracey and her ex- partner each time he visits to collect the children for a weekend visit. Her ex- partner frequently states he is making arrangements for court to have full time care of the children. Tracey and her current partner, Peter, are in $35,000 uncontrolled debt after a recent new joint business venture failed. A finance company calls weekly requesting payment. Tracey and her partner stopped making the mortgage repayments three months ago, with the belief that dealing with the uncontrolled debt would be a better option. Her parents are supportive but live in Queensland. Tracey is able to have face to face contact with them once a year. She does chat with her parents over telephone every week if possible. Tracey states she is worried about how she will cope with her two children and new baby. She reports low mood, weekly panic attacks and fleeting thoughts of suicide. During your meeting with Tracey, you note she is fidgety and restless, breathing rapidly, shaking slightly, sweating and tearful. She is not wishing to actively engage with the mental health services, for fear it will impact on her having care of her children, stating she will visit her General Practitioner (GP).

Important details about your assessment
? Refer to marking criteria and standards for mark allocation for each question.
? This guided essay does not require a standard essay introduction or conclusion.
? The use of tables or column layouts to answer questions 4 and 5, is encouraged.
? There is a word limit of 1000 words.
? You are required to organise your answers in order of questions; by referring to the question
number in your answer.
? Marks will be allocated for academic writing and referencing.

Marking criteria and standards:
Assessment 1 – Guided Essay – Promoting Mental Health and Wellbeing

Investigate and outline the prevalence/incidence of depression / anxiety (depending on the scenario you have chosen) in Australia using current literature. (10 marks). The details related to the prevalence/incidence of depression or anxiety are exceptional and of the highest quality. The answer is well supported by relevant literature. The details related to the prevalence/incidence of depression or anxiety are accurate and of superior quality. The answer is supported by relevant literature.

Discuss using current literature TWO (2) factors that may have contributed to the development of either David’s or Tracey’s presentation and mental health concerns. (10 marks). Discussion consistently conveys evidence of analysis and synthesis showing exceptional understanding of the factors that may have contributed to the client’s presentation and mental health concerns. Sources used are exceptional to support work. Exceptional critical discussion noted. Discussion consistently conveys evidence of critical analysis and shows superior understanding of the factors that may have contributed to the client’s presentation and mental health concerns. Sources used are accurate and superior to support work. Superior critical discussion noted.

Discuss using current literature TWO (2) ethico- legal issues related to your chosen scenario (10 marks). Exceptional discussion related to the ethico-legal issues related to the scenario. Sources used are exceptional to support work. Exceptional critical discussion noted. Superior discussion of the ethico-legal issues related to the scenario. Superior critical analysis and discussion noted. Sources used are of high standard.

Identify TWO (2) nursing/midwifery problems/risks with evidence from your chosen scenario. (5 marks). Exceptional identification of TWO (2) nursing/midwifery problems/risks with clear evidence and relevance to the case study chosen. Superior identification of TWO (2) nursing/midwifery problems/risks with clear evidence and relevance to the case study chosen.

For each nursing/midwifery problem/risk you have identified in Question 4, Outline and describe TWO (2) evidenced based nursing/midwifery interventions and rationales for each. (10 marks). Exceptional; clear concisely written relevant nursing/midwifery interventions. Sources used are exceptional to support work. Exceptional critical descriptions noted. Superior; well written relevant nursing/midwifery interventions. Superior descriptions noted. Sources used are of high standard.

Academic writing & referencing skills (5 marks). Exceptional referencing: both in text and final reference list according to APA style. Extensive, relevant current academic reference list effectively utilised. Publishable writing style and use of language. Superior referencing, with adequate and correct in text and final reference list according to APA style. Comprehensive, relevant, list of current academic references used. Superior writing style and use of language; no errors in spelling, grammar, or punctuation.

Promoting mental health and wellbeing

Essay – Promoting mental health and wellbeing (1000 words)

Aim of assessment
The purpose of this guided essay is to enable students to consolidate nursing/midwifery issues covered in class materials and to determine students’ understanding of the topics and applications, in preparation for transition into the professional nursing and midwifery workforce. This is a guided essay based on a case study where the students respond by answering a series of questions.

Details
Using EITHER Scenario A or Scenario B- please answer the following questions:

1. Investigate and outline the prevalence/incidence of depression / anxiety (depending on the scenario you have chosen) in Australia – Your answer needs to cover: gender, age groups, specific risk groups, hospitalisations.
2. Using current literature discuss TWO (2) factors that may have contributed to the development of the client’s presentation and mental health concerns.
3. Using current literature discuss TWO (2) ethico-legal issues related to your scenario.
4. Identify TWO (2) nursing/midwifery concerns / problems with evidence from your chosen scenario- Your risk identification should be focused on the next 1-5 days of nursing/midwifery care for your client.
5. For each nursing / midwifery concern / problem you have identified in Question 4, outline and describe TWO (2) evidence based nursing / midwifery interventions (ie; what you would actually do as a nurse / midwife to support the person and how you would do it). Your interventions should be focused on nursing / midwifery care for your client over the next 1-5 days. They must be interventions which you would actually undertake directly with your client within your role as a nurse or midwife. You are also required to provide a clear rationale for each nursing / midwifery intervention (ie. why have you chosen the particular nursing interventions? How will the interventions support the person or contribute positively to their current presentation or concern?) Each intervention and rationale must be supported by current literature.

Scenario A
David has been referred to you in the Emergency Mental Health Community Team by his GP. His GP is concerned about David’s mental health state and risks to self. David is a 23 year old man, currently living with his mother. Both David and his brother, Peter, have a positive relationship with their mum. David’s mother and father divorced when he was 15 years old. Before his parent’s divorce, David had a positive relationship with his dad. However at the time of his parent’s divorce David became very angry towards his dad. David also directed his anger towards his friends at the time and he quickly became isolated from his peers, ultimately leaving school at 15 years old, at the end of year 9. David and his older brother, Peter, aged 25, had shared interests of bike riding and computers during their teenager years. During your meeting with David, he stated that he did feel that he and his brother had a close relationship and friendship. However, he acknowledged that they had become more distance in recent years. David has had three past heterosexual relationships lasting several months. His last relationship finished two months ago. His most recent girlfriend has disclosed she is three months pregnant and does not wish for David to be involved in the care of the baby.
After leaving school, David had a number of part time labourer jobs. Each job lasted for two to three months. His most recent employment, over a year ago, was terminated by the employer as a result of conflict with his colleagues. David had left three of his previous jobs on his own accord as he felt “he just didn’t fit in”. He recalled a constant feeling of agitation and sadness at the time. During your contact with David, he has not worked for at least a year. He has contact with his father and brother every month or so. Many of the contacts with his father and brother end in verbal hostility. During the assessment with David, you notice he becomes distressed and tearful on your questioning. He reports recent weight loss. He discloses he has been having difficulties sleeping, feeling exhausted and increasingly depressed. You make further attempts to find out what has been happening for David and to engage with him. He asks you to stop questioning as he is ashamed of how he is currently feeling. He is worried about letting his mum down as they have always had a positive relationship. He declines to look at you while you ask him about thoughts of suicide. He does not wish for you to have any discussions with his family.

Scenario B
Tracey is a 35 year old woman who presents for assessment to the Emergency Mental Health Community Team. She is six months pregnant with her third child. Her other children, to her ex-partner, are aged three and five. Tracey is in a heterosexual relationship with her partner of one year, Peter. Peter moved in to live with Tracey and her children eight months ago. The children’s father is distressed about Peter moving in to live with his children. There is verbal hostility between Tracey and her ex- partner each time he visits to collect the children for a weekend visit. Her ex- partner frequently states he is making arrangements for court to have full time care of the children. Tracey and her current partner, Peter, are in $35,000 uncontrolled debt after a recent new joint business venture failed. A finance company calls weekly requesting payment. Tracey and her partner stopped making the mortgage repayments three months ago, with the belief that dealing with the uncontrolled debt would be a better option. Her parents are supportive but live in Queensland. Tracey is able to have face to face contact with them once a year. She does chat with her parents over telephone every week if possible. Tracey states she is worried about how she will cope with her two children and new baby. She reports low mood, weekly panic attacks and fleeting thoughts of suicide. During your meeting with Tracey, you note she is fidgety and restless, breathing rapidly, shaking slightly, sweating and tearful. She is not wishing to actively engage with the mental health services, for fear it will impact on her having care of her children, stating she will visit her General Practitioner (GP).

Important details about your assessment
? Refer to marking criteria and standards for mark allocation for each question.
? This guided essay does not require a standard essay introduction or conclusion.
? The use of tables or column layouts to answer questions 4 and 5, is encouraged.
? There is a word limit of 1000 words.
? You are required to organise your answers in order of questions; by referring to the question
number in your answer.
? Marks will be allocated for academic writing and referencing.

Marking criteria and standards:
Assessment 1 – Guided Essay – Promoting Mental Health and Wellbeing

Investigate and outline the prevalence/incidence of depression / anxiety (depending on the scenario you have chosen) in Australia using current literature. (10 marks). The details related to the prevalence/incidence of depression or anxiety are exceptional and of the highest quality. The answer is well supported by relevant literature. The details related to the prevalence/incidence of depression or anxiety are accurate and of superior quality. The answer is supported by relevant literature.

Discuss using current literature TWO (2) factors that may have contributed to the development of either David’s or Tracey’s presentation and mental health concerns. (10 marks). Discussion consistently conveys evidence of analysis and synthesis showing exceptional understanding of the factors that may have contributed to the client’s presentation and mental health concerns. Sources used are exceptional to support work. Exceptional critical discussion noted. Discussion consistently conveys evidence of critical analysis and shows superior understanding of the factors that may have contributed to the client’s presentation and mental health concerns. Sources used are accurate and superior to support work. Superior critical discussion noted.

Discuss using current literature TWO (2) ethico- legal issues related to your chosen scenario (10 marks). Exceptional discussion related to the ethico-legal issues related to the scenario. Sources used are exceptional to support work. Exceptional critical discussion noted. Superior discussion of the ethico-legal issues related to the scenario. Superior critical analysis and discussion noted. Sources used are of high standard.

Identify TWO (2) nursing/midwifery problems/risks with evidence from your chosen scenario. (5 marks). Exceptional identification of TWO (2) nursing/midwifery problems/risks with clear evidence and relevance to the case study chosen. Superior identification of TWO (2) nursing/midwifery problems/risks with clear evidence and relevance to the case study chosen.

For each nursing/midwifery problem/risk you have identified in Question 4, Outline and describe TWO (2) evidenced based nursing/midwifery interventions and rationales for each. (10 marks). Exceptional; clear concisely written relevant nursing/midwifery interventions. Sources used are exceptional to support work. Exceptional critical descriptions noted. Superior; well written relevant nursing/midwifery interventions. Superior descriptions noted. Sources used are of high standard.

Academic writing & referencing skills (5 marks). Exceptional referencing: both in text and final reference list according to APA style. Extensive, relevant current academic reference list effectively utilised. Publishable writing style and use of language. Superior referencing, with adequate and correct in text and final reference list according to APA style. Comprehensive, relevant, list of current academic references used. Superior writing style and use of language; no errors in spelling, grammar, or punctuation.