SBI313 : Case Study Emergency Mental Health Assessment Task 1

Case

You are called to a 15-year-old female who is struggling with bathing does, chest pain and Pre-lifting. The patient is in the school, where school find and welfare on set.

She has been distressed since morning break; she is with one of her friends and reported that she takes the inhaler for a condition. You arrive at the school, which you have not seen before. It is a large boarding school with impressive grounds.

You are directed by the staff to one of the female boarding houses, where you are met by four other students, who point to the window to tell you that the parents arrived during her morning, which has caused her to be upset.

You are informed that the patient has a history of this in a bad way and can barely cope. When you are at the patient’s side, one of the staff mentions that she is having an attack. The patient has tears pouring down her face, a pile of notes on her lap, and a picture of a teenage boy open on her smartphone.

Other than the testy nerves, you notice that the patient is red-eyed, her appearance looks well, her clothes are clean, and she is generally well. The points very drying and challenge to the assessment.

Work of breathing:
We came and hear that she is breathing very fast and moving a large amount of air with each breath, despite using her inhaler. She does not need supplemental oxygen.

Systematic Approach

• Airway: Clear and patent, seen through bathing and speaking in best efforts.

• Breathing: High rate; escalation noted; some breath sounds set of test will not posted.

• The patient looks well-pleased with observed signs. Capillary refill is around normal, hands cold to touch. Pulse consistent, fit to securing.

Case Progression:
It is apparent from your systematic assessment that there is no evidence of asthma, owing to the large volume of air being moved and absence of adventitious breath sounds. You talk to the patient and notice that her respiratory rate is decreasing while you are talking with her.

She tells you that:

• Her life is over because her boyfriend has dumped her.

• She is worried that she will never find anyone to love her again.

• She is concerned this will adversely affect her GCSE exam results next month.

Mental Health Assessment

You are coaching the patient to manage her breathing to a normal rate and find that the best way to achieve this is to talk with her.

She tells you that:

• She has been worried a lot recently and not sleeping properly

• She has separated from her boyfriend

• She is very concerned about body image and schoolwork—it is final exams year

• She does not want to let her family down

• She worries about school fees paid by her parents and thinks she is a failure compared with her siblings

• She keeps feeling dizzy and worrying about everything, lacking energy, and cannot stop thinking

• She has not been eating properly and her hands are trembling all the time

• The only time she feels better is at drama class, when she is acting in the school play

Brief Summary of Assessment Requirements

The assessment requires students to:

1. Identify and describe the presenting problem using a clear case summary

2. Perform a systematic assessment including airway, breathing, circulation, and mental health

3. Evaluate symptoms and vital signs in the context of potential causes

4. Document patient-reported concerns related to anxiety and emotional stress

5. Interpret findings to differentiate between physiological and psychological causes

Key pointers to be covered:

• Patient history and context

• Observational findings

• Systematic approach to physical and mental assessment

• Identification of stressors and coping mechanisms

• Appropriate intervention strategies

Approach by Academic Mentor

The Academic Mentor guided the student through the assessment process as follows:

1. Step 1 Case Familiarization:

   • Read the case thoroughly

   • Highlight key symptoms and patient concerns

2. Step 2 Systematic Assessment:

   • Apply ABCDE (Airway, Breathing, Circulation, Disability, Exposure) framework

   • Record vital signs, airway status, and observable behaviors

3. Step 3 Mental Health Evaluation:

   • Engage patient in conversation to assess anxiety triggers

   • Identify psychosocial stressors including family, school, and relationships

4. Step 4 Interpretation of Findings:

   • Analyze breathing patterns to rule out asthma

   • Correlate emotional distress with physical symptoms

5. Step 5 Documentation and Reflection:

   • Compile observations into a structured report

   • Reflect on patient interaction and intervention strategies

Final Outcome and Learning Objectives

Outcome Achieved:

• Comprehensive understanding of patient presentation and anxiety symptoms

• Correct application of systematic assessment framework

• Clear distinction between physiological and psychological causes of distress

• Effective documentation and reflection on case findings

Learning Objectives Covered:

1. Develop critical assessment skills for adolescent mental health emergencies

2. Apply ABCDE and systematic assessment frameworks in practice

3. Identify and evaluate psychosocial and emotional stressors

4. Enhance communication skills to support and reassure patients

5. Gain experience in documentation, analysis, and reporting for case studies

This structure provides:

• A clear summary of assessment requirements

• Step-by-step guidance followed by the Academic Mentor

• Outcomes achieved and key learning objectives

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