Child and Youth Mental Health Services Assessment - Medical Science Assignment Help

Assignment Task:

Task:

MENTAL STATE EXAMINATION

General appearance Kate is a 14 year old Caucasian female appearing younger than her stated age. She is wearing a winter tracksuit with an additional coat. Her stature is short and build is extremely thin, with an ovetrall cachexic appearance. Her current weight is 40kg and height at 164cm = BMI of 14.9. Hair is blond, shoulder length lacks luster and thinning. Complexion is pale, skin is dry, with evidence of lanugo.

Behaviour

Kate is not engaging in conversation and rapport if difficult to establish. Minimal eye contact. She is resitive to being assessed as she is declining the need for an admission. She is at times displaying verbal aggression towards the assessor and her parents due to her not wanting to be admitted.

Speech

Her speech was slow, with a soft volume for the majority of the time, however periods of raised volume when distressed about being admitted. She was articulate, but content limited.

Voiced having a low mood for the past few months especially when at home, but can feel happier when at school with her friends. Affect anxious. Mood and affect congruent.

Thought process

No formal thought disorder evident. Logical flow of thought.

Thought

content

Belief that she is overweight with too much fat on her stomach and thighs and has a lower self esteem with her belief that she perceives herself to be fat.

Perceives that by being hospitalised she will not be able to lose more weight to achieve her goal weight of 38kg. Denied any past thoughts of self harm, suicide or homicidal ideation, but indicated that if she was to be forced fed that she would most likely self harm as she does not want to gain weight.

Perception

Disturbed body image Cognition

Orientated to time place and person. Recent and remote memory appears intact. Concentration decline. IQ is average to above average obtaining A grades at school.

Insight

Impaired insight - Kate fails to acknowledge that her current physical condition is life threatening and requires the need for hospitalisation.

Judegement Impaired Judgement - Restricting her oral intake to achieve a weight of 38kg which is impacting her physical and mental state.

SYMPTOM INTERVENTIONS

Impaired nutritional intake A behavioural modification approach in collaboration with Kate to encourage an amount of food to be eaten each day to result in a desired weekly weight gain of 500gms. Positive reinforcement will be set if weight is gained and negative reinforcements if not achieved. (Kieling, Baker-Henenningham,Belfer,Conti,Ertem,Omigbodum,Rhode,Srinath,Ulkuer & Raham,2015, pp1518). Provide supportive meal supervision with constant obsservations , designed to achieve nutritional rehabilitation, normalising eating to ensure a reduction in compensatory behaviours.( Evans, Elder & Nizette, 2015).

Disturbed body image

Kate’s disturbed body image will incorporate the staff to discuss with her aspects of her physical appearance about which she feels positive. This will assist to her separate physical appearance from personal worth. (Townsend & Morgan, 2017, pp. 45) Acknoweledge Kate’s anxiety and fear of weight gain, be non-judgemental and reassure that her fears are expected and not unique (Sadock,Sadock & Ruiz,2015).

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