Long Term Conditions

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Long Term Conditions

Michaels Journey

Word Count: 2195

Submission Date: 15th November 2010

Michael is a 45 year old man with a diagnosis of schizophrenia. This is a chronic psychiatric disorder related to loss of contact with reality. Symptoms can include hallucinations, delusions, changed feelings and behaviours, several of which must be recurring for one month (World Health Organisation or WHO, 2007), (Appendix 1). At the age of 4 whilst living in Senegal Michael had an acute febrile episode leading to a diagnosis of cerebral malaria, later appearing to recover well. At the age of 5 Michael was found to have mild learning difficulties.

This assignment shall critically explore the recovery journey of Michael from his long term mental health condition through examining the role of the nurse and philosophy utilised. The process will encompass local and national policy and its’ resulting impact incorporating nursing theory and level of relevance which determines safe practice. The use of the first person will be used on occasion, as Perry (1997) advocates the student writing in the first person perspective enabling theory to be relayed to practice benefitting professional development. For the purpose of this assignment, the patient will be known as Michael (pseudonym), protecting anonymity. The same will apply to other individuals and places involved in accordance with the Nursing and Midwifery Council’s (NMC) code of professional conduct (2008). This states that nurses must respect patient confidentiality as well as the Data Protection Act (Office of Public Sector Information or OPSI, 1998).

There are 15.4 million individuals suffering from a long term health condition in England. A long term condition is defined as difficult to cure but can be managed with various treatments. Serious mental illnesses account for 380,000 of these individuals. Serious mental illnesses in these statistics are defined as schizophrenia, bipolar effective disorder and other psychoses (Department of Health [DH] 2008a).

Michael was born in Senegal in the 1960’s. His mother Peaches split up from her first husband, and moved to England where she managed to gain asylum and moved to an apartment in Harlow, Essex. Peaches found work and met a new partner named Stephen, later marrying and having two sons with him. Michael’s relationship with his stepfather was unstable, increasingly aggressive and ultimately led to his arrest for physical violence when he was 25.

It was found that Michael had suffered a psychotic episode following assessment within the local Psychiatric unit. Michael was detained under section 2, (Mental Health Act [MHA] 1983) for a 28 day assessment period (OPSI, 1998). Psychosis is an acute psychiatric condition which can lead to chronic disorders such as schizophrenia (NHS Choices, 2008). At the end of this period Michael was found to be exhibiting symptoms and behaviour ranging from delusional thoughts, hallucinations and self-injury to attempted suicide and verbal/physical aggression. Michael was diagnosed with paranoid schizophrenia and subsequently placed on section 3, (Barry, 1998) (Appendix 2). This culminated in Michael being there for several years being treated without consent on an intensive care ward under section 58 of the MHA 1983 (Appendix 3). Michael eventually reached a point where he had stabilised enough to be discharged.

The discharge led to Michael taking up a tenancy within a supported living unit that provided a service for people with long term enduring mental health issues and with the option to use section 117 aftercare available through the MHA 1983. Michael also came under the umbrella of the Commission for Social Care Inspection (CSCI) now replaced by the Care Quality Commission (CQC) (Appendix 4) and the strategy Valuing People (Department of Health, 2001a), now replaced by Valuing People Now (DH, 2009a). This legislation created the approach...
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