[ANSWER]NRS83004 Acute Mental Health Assessment 2 – Risk Assessment in Mental Health: A Critical Review of Risk Assessment Approaches

TASK DESCRIPTION ON Risk Assessment in Mental Health

Assessment overview

Assessment policies and Information

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Assessment 1: Seclusion debate.

Overview

The use of seclusion is essential in the acute mental health setting: Yes or No?

This assessment provides you with the opportunity to explore the arguments for OR against seclusion and to develop, with the use of relevant literature, an argument that supports the stance you have taken – for or against the use of seclusion in the acute mental health setting.

Learning outcomes

This assessment task is aligned to the following learning outcomes:

            Critique the Mental Health Act and the ethics of acute care within the contexts of clinical intervention and consumer experiences of care

Appraise a range of acute care conditions engagement and interventions

Assessment details

Participate in the following discussion board by performing the following steps:

Undertake some research on the use of seclusion in the acute mental health setting. Choose a stance for or against the use of seclusion and justify your choice.

Identify the legal and ethical concerns associated with your stance and discuss how you would address these concerns.

Submission format

Please upload your research and synopsis as a Word document via Turnitin in Blackboard.

After the due date please share on the discussion board in blackboard labelled “Share your position on seclusion”.

Assessment 1 rubric (total marks =

Assessment 2: Critical Review

Overview

Risk assessment in mental health settings is one of the most challenging roles of the mental health professional. This assessment is designed to encourage you to explore the most recent evidence that informs best practice in conducting risk assessments in acute mental health.

Learning outcomes

This assessment task is aligned to the following learning outcomes:

• Appraise a range of acute care conditions engagement and interventions
• Appraise a range of complex acute care conditions engagement and interventions
• Critically reflect on acute mental health risk factors, engagement, observation and interventions

Assessment details

Write an essay that:

• Provides a brief overview of the type of risk assessments that are necessary to consider in acute mental health
• Critiques the effectiveness or accuracy of available risk assessment tools/methods
• Discusses how the risk assessment process could be improved or optimised, ensuring your arguments are evidence based.

Submission format [Risk Assessment in Mental Health]

Please upload your assessment as a Word document via Turnitin in Blackboard

Assessment 2 rubric (total marks = 40)

Assessment 3: Treatment Plan [Risk Assessment in Mental Health]

Overview

Theory is useful as an underpinning to care for consumers, but it’s important to be able to move the theory into action. In the following case study you will have the opportunity to demonstrate that you can take what you have learned and apply it to real-world scenarios.

Learning outcomes [Risk Assessment in Mental Health]

This assessment task is aligned to the following learning outcomes:

1.       Appraise a range of complex acute care conditions engagement and interventions

5.       Design a package of Trauma Informed Care applicable to acute mental health settings.

Assessment details

Review and analyse the following scenario and create a holistic wellbeing assessment and treatment plan for the individual based on the principles of ‘Trauma Informed Care’. The plan you develop must be supported by critiqued evidenced-based research, with links between physical and mental wellbeing created and justified. Implementation processes of the package/plan must also be designed with specific reference to overcoming inhibiting factors in the consumer’s experience.

The Scenario

Shanae is a 22 year old woman who has been brought to the emergency department by the local ambulance service following an intentional overdose of paracetamol and self-inflicted cuts to both wrists in the early hours of the morning. Emergency services were alerted by a former boyfriend of Shanae who had received a series of increasingly frantic text messages saying that she had “had enough”.

He rang her and found her intoxicated and she confessed to “doing a stupid thing”. She was initially cooperative with police but less so with the ambulance who placed her on an Emergency Examination Authority (Queensland). She was quite difficult to manage in the emergency department and on one occasion she pulled out her N-Acetylcysteine (NAC) infusion stating she just wanted to go home and have a smoke. She did however go to sleep after agreeing to take 10 mg of diazepam and 5 mg of olanzapine.

Shanae was assessed by the acute care team nurse whilst still on the NAC infusion and a brief admission at the low dependency psychiatric unit was agreed upon once she was medically cleared from toxicology which occurred later that evening.

Shanae explained that she had been depressed for as long as she could remember. She had taken several overdoes in the past (on one occasion she had been admitted to ICU). She had a history in intentional self-injury from around 12 years of age. She stated that it had been a particularly bad week. She had lost her waitressing job two weeks ago after going on “bender” for five days using (methamphetamine and MDMA) with friends and failing to turn up to work.

She is living in a share house and is behind on her rent (for two weeks). Relationships are “all-right” in the house but Shanae says she doesn’t like living with other people. On the day of the overdose she then attempted to become registered at Centrelink. She said she “really lost it” with the unhelpful staff and she had walked out of Centrelink after “screaming the place down”.

Additionally her boyfriend of several months (whom she texted) said he was moving to another town for work and did not want to pursue a relationship further. She has not been eating very much for several weeks because she says she is not hungry and usually throws up if she tries. She said she was sick of the daily struggle.

Mental State Assessment (On Admission):

Appearance & Behaviour: Shanae is a thin young woman (height 159 cm, 45 kg), pale in complexion, wearing no makeup and dressed in a hospital gown. She has shoulder length unkempt hair and blue eyes. She has a tattoo saying “Jack” on her right forearm. Both wrists are bandaged. She has several 2-3 cm scars on her forearms and some evidence of scaring on her thighs. She made fleeting eye contact and rapport was reasonable.

Speech: Shanae was softly spoken (at times barely audible).

Mood & Affect: Shanae reported that her mood was depressed (2 out of 10). Her affect was predominantly sad but she occasionally smiled spontaneously at other patients. She says that she often thinks about suicide when things are tough. Shanae reported that she really did try and kill

herself and purchased two boxes of Panadol and a bottle of vodka on the way home from Centrelink. She states that she doesn’t care now but might cut herself if she is feeling overwhelmed.

Thoughts / Cognition: States she doesn’t think like other people and often drifts off and can’t recall what she was thinking about. States that she would like to have a baby or an animal to care for.

States that she would like to get a job in childcare or working with animals. Preoccupied with food for the last week which she says is usual after “partying”. States she feels guilty after she has the “munchies” and now throws up.

Perceptions: Perceives herself as fat. States that she occasionally here the voice of an unknown man when it is dark. He whispers to her to “stay very still” and other utterances like that. She generally sleeps with the light on. She reports when really angry she hears the voice of a man called Peter who also berates her. She last heard Peter’s voice when she walked home from Centrelink. At these times she often feels a compulsion to cut herself and states that she can’t promise she won’t cut herself in hospital. [Risk Assessment in Mental Health]

Cognition / Memory: Shanae states that there is a lot she doesn’t want to remember from her childhood. Her short term memory however appears largely unimpaired. She was able to undertake serial 7 backwards from 100 with ease and remembered an 8 number sequence of numbers after 5 minutes. Orientated to time, place and person.

Judgement: States that she is impulsive and will “fly off the handle” several times a day at people. Reports risky drug use although says she’d never use a needle. Also reports occasionally shoplifting or having sex with strangers “just for kicks”. She is unsure how she is going to resolve her current crisis.

Impression:

Self-harm and suicide attempt in the context of a long history of emotion dysregulation and poor distress tolerance, gross intoxication with alcohol, poor social supports, post methamphetamine intoxication dysphoria and recent stressors / losses including employment and an intimate relationship.

A diagnosis of border personality disorder is established, which Shanae says “is probably right”.

Please see the week 4 (Trauma informed care) material for further information about Shanae’s history.

Task

Write a treatment plan for the care of Shanae as an inpatient and outline a course of care and treatment that will assist Shanae in resolving her mental health problems.

Requirements:

1. Outline the critical biological, psychological, and social health issues that need to be addressed in this episode of care. Pay particular attention to past trauma/experiences and how they may have contributed to the consumers’ current presentation.
2. Outline a plan to holistically address/resolve the health problems, providing reference to the latest evidence and authoritative guidelines.
3. Recommend referrals to allied health or other health service providers, if appropriate, and outline (based on research evidence or guidelines) how those professionals might respond.
4. Recommend one or more community resources groups which the person might access to assist them in improving their health

Submission format

Please submit your case studies via Turnitin in Blackboard.

Assessment 3 rubric (Total marks = 50) [Risk Assessment in Mental Health]

[ANSWER PREVIEW]

The current risk assessment environment is dominated by structured professional judgement (SPJ) and actuarial approaches. Unlike in unstructured clinical judgement, risk assessment in SPJ is founded on succinct and evidence-based clinical guidelines and criteria (Van Der Heide et al., 2019). Empirical knowledge is extensively applied in the development of questions and indicators which form the basis of the approach. Sometimes called the qualitative risk assessment approach, SPJ mediates between the rudimentary unstructured clinical judgement and the more modern actuarial risk assessment approach (Singh, 2015). [Risk Assessment in Mental Health]

The main aim of the approach is to prevent the risk of violence and others (Government of Canada Department of Justice, 2017). SPJ provides a six-step roadmap including variables that assessors can use to evaluate the level of risk the patient poses. The first step is to gather relevant information, evaluate availability of risk factors, determine their relevance, brainstorm corresponding protective factors, outline a risk management framework, and conclude the judgement (Whittington et al., 2013). [Risk Assessment in Mental Health]

Apart from following these steps, the mental health expert is free to explore other case-specific factors that may influence the levels of risk in a patient (Whittington et al., 2013). Some examples of SPJ tools include Historical Clinical Risk Management-20 (HCR-20)..[Buy Full Answer for Just USD 9: 2511 WORDS] [Risk Assessment in Mental Health]

[SOLUTION DESCRIPTION]

Type: Essay

Word Count: 2511

Grade/Mark: 89 (Distinction)

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