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


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.
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
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




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