Case World, Short answer questions Essay Example

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Culturally Safe Practice and Mental Health Assessment: Case World Justin O’ Dowd

  1. Describe how Justin’s well-being might be impacted by his recent life events

. Zisook & Shear, 2009, p. 67)who explain that losing a loved one can trigger depression just like any other traumatic stressful event and this can result to clinical depression. Depression resulting from grief like in the case of Justin can interfere with function and quality of life just in the case of Justin (Zisook & Shear (2009, p. 67) The death of Justin’s uncle is one event that has contributed to Justin’s depression. Justin was very close to his uncle because according to Aboriginal culture the uncle was his father and teacher too. His death seems to have really affected him because he was inconsolable and devastated. Young (2012, p. 180) explains that after death, the bereaved people can experience intense and distressing emotions. This is supported by

. Zisook & Shear, 2009, p. 67)Lack of employment is another aspect that has affected Justin. Justin is no longer working and this is one reason as to why he is feeling hopeless and thus has contributed to his depression. His unemployment status obviously results to financial challenges, which also adds more stress to Justin. Having no source of income can result to an individual feeling loss of control, being anxious and having mental and emotional distress and depression (Choi, 2010, p. 121). Moreover, dropping out of school has also contributed to Justin’s stress because he feels unworthy and hopeless and feels like the future holds nothing for him. Diabetes in his family has also affected Justin. Justin has witnessed his father being extremely sickly because of diabetes and he also fears that he might not be able to manage his diabetes. Fear of ill health and sickness has been linked to stress and depression in some patients (

  1. How might Justin’s cultural interpretation of mental illness be different from your own?

Justin’s interpretation of mental illness may be different from mine because aboriginals perceive mental illness in a traditional perspective. For example, studies show that aboriginals view mental illness as witchcraft or someone paying for past bad deeds. Aboriginals also do not believe that a mental illness can be handled through treatment but belief in spiritual healing, among other traditional treatment practices (Parker, 2010, p. 3). In addition, aboriginals do not perceive mental illness as a clinical condition but an individual characteristic and hence most of them do not seek assistance they need to overcome their illness (Parker, 2010, p. 3). In the same manner, Justin may not interpret his mental illness as a clinical illness.

  1. Identify how your own attitudes and values relating to mental illness may influence communication with Justin

As a nurse, my values and attitudes will influence my communication with Justin. Personally, I am against stigmatization and discrimination of people with mental illness and hence I perceive patients with mental illness just like other patients with different health conditions. According to Reed & Res (2006, p. 249) attitudes and values from nurses towards patients with mental illness are inextricably associated with aspects that influence the ability of nurses to not only communicate but also the ability to provide care. Nurses who have fearful attitude towards people with mental illness are likely to avoid communicating with their patients. In this case, since I do not fear people with mental illness and also I hold no prejudice against them, my communication with Justin will not be affected in any way. Accordingly, I will use my communication skills to ensure that communication between me and Justin is effective by being emphatic, caring and understanding towards Justin.

  1. How can partnerships with Justin and his immediate/or extended family be developed and maintained throughout this journey of care?

Partnerships can be maintained by ensuring that Justin and his family are provided with the required information to ensure that they understand Justin’s depression. In addition, Justin along with the family should be supported to enable them to accept and understand Justin’s mental illness (Australian Commission on Safety and Quality in Health Care, 2011, p. 50). When Justin and his family understand his mental condition, it will be easier to self-manage effectively and make the appropriate health choices throughout Justin’s treatment. Of equal importance is ensuring that both Justin and the family are educated regarding depression so that they have the necessary skills to participate in Justin’s continuing care (Australian Commission on Safety and Quality in Health Care, 2011, p. 59). Therefore, it would be important to provide Justin and his family with continuing care plans and ensure that they are actively involved in preparing these plans.

  1. What are the social and cultural implications for Justin leaving his home and community for assessment and treatment in the city?

Justin might experience various challenges during his interactions with the healthcare professions because of different cultural beliefs. Evidence shows that there are difficulties in interactions between aboriginal patients and healthcare providers in urban areas (Maher, 1999, p. 234). For example, communication problems may arise between Justin and his healthcare team. This is because most aboriginal people do not speak standard Australian English as their first language and when spoken words may differ due to community influences and hence this may pose a communication challenge between Justin and the healthcare team.

In addition, Justin might face different cultural shock during his treatment and assessment in the city. This is because aboriginals have totally different living styles, for instance foods, dressing styles and way of living are totally different in the city when compared to aboriginals. For example, while in the city for treatment, Justin might not be provided with the type of food he is used to. This is the reason hospitals are encouraged to provide culturally sensitive services, including the types of foods provided to different patients.

Socially, Justin might also find himself socialising differently. For example, aboriginals have different gender protocols when compared to people in city settings. Interactions between opposite sex are not common among aboriginals. For example, it might be culturally inappropriate for an aboriginal male patient to be in the same room with a female patient. For all these reasons, it would be necessary to be ensured that Justin is provided with a culturally safe and respectful environment.

  1. What needs to happen to ensure culturally safe care for Justin he is hospitalised?

During Justin’s hospitalization, it should be ensured that he is provided with care that is in line with his beliefs and customs. This will ensure that he receives culturally safe care. For example, it is important to have a liaison officer or an interpreter who can assist Justin during his communications and interactions with the healthcare providers who are not of aboriginal origin (Berg, 2010, p. 136-137). It should also be ensured that the healthcare providers attending Justin clearly under stand aboriginal protocols in order to avoid putting Justin in uneasy situations. Actions that are culturally a taboo in accordance with the aboriginal culture should be avoided whenever Justin is present. Studies show that there are instances where aboriginal patients are discriminated and experience racism from staff and other patients as well (Berg, 2010, p. 136-137). Accordingly, it will be important to ensure that all healthcare providers who provide care to Justin do not show any racism or discriminate Justin. If possible, if the hospital has aboriginal mental health nurses they would be better placed to deliver nursing care to Justin because they understand aboriginal cultural values (Berg, 2010, p. 136-137). Lastly, while in hospital Justin should be provided with foods that fit his aboriginal culture in order to make his stay in hospital more comfortable and homely.

  1. From the information in the Mental Health Assessment and Mental State Examination, what are the identified areas of concern and priorities of care planning for Justin?

Areas of concern include clinical depression which is the first priority. This is typified by symptoms such as lack of motivation, sleep disturbances, fatigue, and hopelessness. Another area of concern in Justin’s bereavement and hence it is necessary to prioritize this area in order to help Justin accept and deal with his uncle’s death. Justin is not eating well and this can lead to health problems because he had diabetes and therefore management of diabetes also needs to be prioritized during his care.

  1. Communication skills/strategies that are allowing healthcare providers to talk with Justin in a culturally safe manner

The healthcare providers are good listeners and this is making Justin feel that he is valued and he is being given a listening ear. They are also asking open-ended questions and this is giving Justin an opportunity to answer questions comprehensively. In addition, they are using non-verbal communication appropriately. Non-verbal communication and body language are vital means of communication for indigenous people who value this mode more than verbal communication (Fjola, 2009, p. 4). In addition, the healthcare providers are not interjecting Justin and this give him space and time to talk his feelings. Communication skills are very important in cultural safety because healthcare providers are able to make correct interpretations and capture an individual’s concerns (Fjola, 2009, p. 6).

  1. Review the discharge plan and 3 month review and consider how Justin can be supported to maintain his well-being when he has returned to his family and community

Justin should attend all his appointments accordingly. Refer Justin to a therapist who can help Justin learn to cope with his thoughts and feelings. In regard to self-care, Justin should be directed on how to take his medications appropriately and to ensure that he gets enough sleep by creating a sleep routine. Desplenter, Gert & Simeons (2011, p. 4). It is also important for Justin to exercise regularly as physical exercise improves symptoms. Justin should also ensure that he takes balanced diet and avoids drinking alcohol. After discharge, psychiatric homecare should frequently visit Justin after maybe 2 weeks and evaluate how he is managing himself and medications (Desplenter, Gert & Simeons, 2011, p. 5). The family should be educated on how to take care of Justin and be informed of the red flags to note in case Justin starts slipping into depression again. Finally, it would be necessary to help Justin as much as possible to get some activity that is likely to engage him and keep himself busy and if possible an activity that he will be able to generate income and hence tackle the issue of unemployment.

  1. After considering the issues for Justin, reflect on your own experiences of relating to people from different cultures. Consider what you have learnt from Justin’s story

My past experiences when relating with people from different cultures have had some challenges. For example, when relating with people whose first language is not English, I find it hard to communicate because sometimes I do not understand some words because of difference in dialects and pronunciation. Additionally, even though I have never been a racist and also I never discriminate people from different cultures, in the past I have not been as friendly to people from different cultures the same way I am friendly to people from my culture.

From the story of Justin, I have learnt to embrace people from all cultural backgrounds. I have learnt a lot about dealing with patients from different cultures, especially aboriginal community. In future, I plan to work towards positive change in culturally safe nursing practice and challenge attitudes of racism and discrimination in individual practice and in all organizations that I will work for. Finally, during my practice, I will always ensure that I deliver culturally sensitive care and respect all culturally diverse backgrounds for both my patients and colleagues as well.


Australian Commission on Safety and Quality in Health Care, 2011, Patient-centred care: Improving quality and safety through partnerships with patients and consumers, Sydney, ACSQHC.

Berg R, 2010, Cultural safety in health for Aboriginal people: will it work in Australia? Med J Aust, vol. 193, no. 3, pp. 136-137.

Choi L, 2010, Financial Stress and Its Physical Effects On Individuals and Communities, san Francisco, Federal Reserve Bank of San Francisco.

Desplenter F, Gert L & Simeons S, 2011, Following up patients with depression after hospital discharge: a mixed methods approach, International Journal of Mental Health Systems, vol. 15, no. 28.

Aboriginal Nurses Association of Canada. H, 2009, Cultural Competence and Cultural Safety in Nursing Education, Ottawa, Fjola

Maher P. (1999). A Review of ‘Traditional’ Aboriginal Health Beliefs. The Australian Journal of Rural Health, vol. 7, no. 4, pp. 229–236.

Parker R, 2010, Australia’s Aboriginal Population and Mental Health, The Journal of Nervous and Mental Disease, vol. 198, no. 1, pp. 3–7.

 · International journal of mental health nursing, vol. 14, no. 4, pp. 249-257 Reed F & Res L, 2006, The mixed attitudes of nurses caring for people with mental illness in a rural general hospital,

Queensland Health, 2014, Queensland Health Aboriginal and Torres Strait Islander: Patient care guideline, Queensland, State of Queensland.

World Psychiatry, vol. 8, no. 2, pp. 67–74. Zisook S & Shear K, 2009, Grief and bereavement: what psychiatrists need to know,