CNA742 Foundations Of Mental Health Nursing Practice


This paper is emphasizing more on the discharge planning report to the community mental health team who will be responsible in ensuring that patient is taken care of. Report will be about forensic mental health patient who will be released from the custody to community. The patients’ name is Mr. X who has been in a custody for a while but later on the forensic mental health experts in Prime spurs mental hospital have discovered that Mr. X unsuitable to stand trial for a crime and ordered to be imprisoned in a correctional institution, mental health facility, or other facility for the duration of the trial. Not only have the experts from mental hospital who have confirmed the case but also teamed of judges from the district court of the area. Such team of judges from the district court are also responsible in ensuring that the patient was treated fairly by the health mental experts as well as the community mental health team will also treat patient fair. Thus this report will have four parts where part one will guide community health experts how to treat patient legaly, biologicaly, psychologicaly, environmentaly, and social-occupational techniques. The second part will be on problems that may arise with the patient and how they can be managed by the community. Third part is evaluation of the protective factors that patient might have as well as how to mitigate them in future. Finally it will be a management plan for the patient to help in managing risks posed to him as a result of mental disorder.

Part 1
Legal Treatment

Mr. X is a forensic patient who is under the supervision of a court-appointed guardian. He will be referred to the community mental health team, which will then notify the appropriate authorities of his diagnosis, evaluation, and treatment plan. Forensic patients with term orders in custody should be transferred to Limited Community Treatment if they do not comply with treatment and care plans, based on his prior history of non-adherence and non-compliance (Völlm, et al., 2018). The following organization has been authorized to take legal action against a detained client who does not comply with the treatment terms and other legal restrictions that apply to him after he is released to the community. It will be necessary to submit Mr. X to a Limited Community Treatment organization in case he does not cooperate with the treatment plan.

Biological Treatment

This kind of therapy will be fairly simple since it just entails following the doctor’s recommendations. Mr. X would get biological therapy, which would entail the administration of medications that he had previously been given. Mr. X is now being treated with clopixol depot 400mgs monthly and olanzapine 20mgs nocte, both of which are prescription medications (Aitchison et al., 1999). Following an examination and review of the side effects of the medications that have been supplied to him, it is possible to continue taking these medications.

Psychological Treatment

It is possible that Mr. X will benefit from a multi-component intervention based on motivational interviewing ideas as a part of his psychological treatment. Developing a trustworthy and culturally acceptable therapeutic relationship with him might be the emphasis of the psychological therapy that is given to him. Aspects of the program that will be used include psychoeducation, anger management, and social skill training, contingency management, and cognitive-behavioral therapy (Carroll, & Kiluk, 2021).

Environmental Treatment

Mr. X may benefit from environmental support by creating an environment that is tailored to his specific needs and provides him with total help (Brennan, et al., 2022). A pill container containing all of Mr. X’s medications, as well as signs on the boxes with the names of the medications and their dosages, may be created by his family members so that Mr. X can ingest the medications on his own. Remembering his medications, medical visit schedules, psychiatric sessions, case hearing follow-up schedules, lunch routines, and other important events may be accomplished by either marking on calendars or utilizing an iPad to remind him of these events. In addition, the caregiver may aid him in maintaining his personal cleanliness, which will benefit him in the long run. Because he suffers from paranoid schizophrenia, the caretakers must first establish a trusting connection with him before giving him with environmental support services.

Social-Occupational Treatment

He will be involved in productive but leisure activities of his choosing, such as gardening or sports, as part of his occupational therapy. He may be encouraged to participate in community activities such as social activities, which he can do in partnership with other members of the community (Lopes, 2020).  It is possible to encourage his daily self-care efforts via instruction, the use of reminders, and the use of trackers.

Part 2

Individuals who have a history of incarceration are often exposed to a range of social problems, including stigma, discrimination, abuse, exploitation, homelessness, and labeling, all of which raise their chance of acquiring mental disorders in the long run. It is normal for members of the general population to have negative stereotypes and preconceptions about persons who have had the unfortunate experience of being jailed in some capacity. Such a negative attitude toward former convicts may enhance the risk that they would face challenges in the future, such as social isolation, social distance, insult, and bullying, as a result of their previous imprisonment (Quinn, et al., 2019). In the case of Mr. X, who is already suffering from serious mental problems, the severity and recurrence of symptoms may be aggravated by stigma, social marginalization, and discrimination in the job, among other factors. Numerous studies have shown that the Australian population has a high degree of social distance and awareness of complicated mental illnesses such as schizophrenia, personality disorders such as antisocial personality disorder, and other mental health difficulties, among other things. Persons suffering from mental disorders such as antisocial personality disorder and schizophrenia are often seen by indigenous aboriginal people as unpredictable, aggressive, and dangerous individuals who suffer from some form of deficiency or handicap. Providing Mr. X with a mental health awareness program that is carried out in conjunction with mental health experts in the community and in a culturally sensitive and appropriate way will make his reintegration into mainstream society safe and dignified. This will help to ensure that people of the community are aware of the emotional and social care that Mr. X will need in order to fully recover. In order to effectively connect with members of the community, the interventional approach for social skill training will comprise teaching him social, communicational, and interpersonal skills, as well as other life skills (Lawrence, & Falaye, 2020).

Having a case manager, who will also be a part of the community mental health team, will allow him or her to coordinate with the community social worker and make arrangements for him or her to reside in subsidized housing. To guarantee that the roommates understand that he is safe and that he need empathy and understanding in order to stay in the house on a long-term basis, the social worker may submit a letter of competence to the owner of the rental property.

Part 3

Affording Mr. X protection is the presence of social and mental health assistance offered by the community mental health care team, which is supplied by the mental health care team. Social workers, a case manager, a community mental health leader (CMHL), psychologists, and psychiatrists, as well as pharmacists and a primary care physician, are among the professionals involved (PCP).

Mr. X’s mental health intervention is a protective factor in this situation. Do a risk assessment to find out how likely it is that Mr. X will become aggressive, violent, and a danger to the community in the future. The chance of someone committing violence towards another person may be determined by using the one way to gauge a person’s propensity for violence towards the people around him or she is to conduct a structured risk assessment (Clemmow, et al., 2020). The case manager and the psychologist will conduct a risk assessment of Mr. X’s current mental state and determine whether or not he poses a threat to others. A final assessment of the risk of self-harm or suicide attempts will be included in the report as a whole. Anxiety and worry may lead to self-injury in people with paranoid schizophrenia; thus, it’s important to be aware of Mr. X’s mental health. The following characteristics will be assessed: tendency for antisocial behavior, probability of domestic violence and abuse, possibility of murder, strengths and weaknesses of the personality, and so forth.

The degree of risk will be determined by taking into account a variety of factors, such as the environment’s precipitating and protective aspects, as well as recent and past violent instances. Follow-up activities for the risk assessment report should be carried out on a regular basis and modified as appropriate. For the whole community, including the local government, a risk management plan should be developed based on the risk assessment report. Monitoring the family environment and teaching pupils social and anger-control skills are part of a risk management plan (Sagar, et al., 2019).The case manager must ensure that Mr. X’s dignity, independence, and respect are safeguarded when risk management measures are being used. In order for him to feel at ease in the home and in the neighborhood, you must build a relationship of trust with him. But it should be emphasized that the risk assessment reports are not deterministic but rather provide a probabilistic analysis of the scenario.

Part 4

Because of Mr. X’s history of mental illness, it is necessary for the community health care team to provide Mr. X with therapy and to screen for the presence of different mental health problems before implementing the management plan. Providers of community health services must examine the patient’s medical history for indicators of paranoid schizophrenia, antisocial personality disorder, and a substance misuse issue, among other things (Feldman & Gitu, 2021).

As part of the management plan, the community health care team must develop a strategy for patient risk assessment and carry out the risk assessment on a weekly or monthly basis as part of the process. When the community health care team evaluates Mr. X’s risk of harm, they must consider both his personal safety and the safety of others in the community. Putting methods and support systems in place that are founded on mutually agreed-upon values and principles is the ultimate objective of clinical risk management. These technologies may be able to adapt the requirements, weaknesses, and changing behavior of a service user.

With regard to Mr. X’s mental condition, it is critical that he be informed about the need of taking his medication on a regular basis. Clopixol and Olanzapine are prescribed to the patient, both of which must be taken on a daily basis in order to keep the patient’s symptoms under control. When doing a risk assessment, the community health care team must keep track of the patient’s medication adherence by monitoring the patient’s medication adherence throughout the course of the evaluation. Whenever Mr. X’s medication is administered, his community care team should be aware that dosage is a vital component of medication management and is required in order to avoid adverse effects from developing.

Following that, the patient may be included in psycho-educational and psychiatric therapy provided by community health care. Cognitive behavioral therapy (CBT) is a common psychological treatment that has been shown to be effective in treating a variety of mental disorders, including schizophrenia and bipolar disorder (Ceci, et al., 2022). CBT must be offered to the patient by the community health care team in order for the treatment to be effective for the patient. Cognitive behavioral therapy (CBT) is required since it is a goal-oriented, problem-specific approach. CBT is a problem-solving strategy that is only effective if the client participates actively in the process of healing. The purpose of this activity is to get them to concentrate on their current difficulties, thoughts, and actions. CBT is a problem-solving strategy that places a strong focus on the present moment. This therapy differs from others in that it is concerned with and addresses present issues and barriers. The emphasis of this method is not on what caused the patient’s discomfort or symptoms in the past, but rather on how to improve the patient’s present mental state.

Community health care professionals may encourage Mr. X’s family to participate in treatment and educate them about their loved one’s disease in order for Mr. X’s mental health to improve. People who are suffering from mental illness may find that their families may play an important role in the treatment, rehabilitation, and recovery of those who are close to them. In order to keep their loved ones’ attention and ensure that they grasp what they’re saying, families of persons suffering from mental illness, for example, must practice effective communication with them. According to Zhang (2016), family psychoeducation may be beneficial in helping patients and their families reclaim their sense of self-worth while also coping with the illness they are experiencing. Generally speaking, family members are the primary caretakers for their ailing loved ones, providing both physical and emotional support to the patient. Growing body of literature supports the benefits of include family members in the treatment of mental illness, and research on the importance of family members in the management of schizophrenia is now underway.

Community health caregivers must apply this final management plan in order to keep the patient from ingesting illicit substances and from engaging in substance abuse behavior (Watts, et al., 2020). Cognitive behavioral therapy (CBT), which is associated with the community health care team, is one of the most effective non-pharmacological treatments for reducing the frequency of illicit drug use. During the course of executing this strategy, it is also feasible for the team to broaden community collaboration in order to better equip the community to deliver preventive and treatment services for alcohol and tobacco use disorders. Improved service delivery may be achieved by inter-agency collaboration, coalition building, and networking, all of which are examples of measures that can be taken. For Mr. X to see significant improvement in his condition, he must be encouraged to live a healthy lifestyle as well.


Völlm, B. A., Clarke, M., Herrando, V. T., Seppänen, A. O., Gosek, P., Heitzman, J., & Bulten, E. (2018). European Psychiatric Association (EPA) guidance on forensic psychiatry: Evidence based assessment and treatment of mentally disordered offenders. European Psychiatry, 51, 58-73.

Aitchison, K. J., Murray, R. M., Power, P. J., & Tsapakis, E. M. (Eds.). (1999). First episode psychosis. CRC Press.,+both+of+which+are+prescription+medications&ots=fTdgXB9RgC&sig=9pvyQYPbG6ktEmsSA7UlS8K_awQ&redir_esc=y#v=onepage&q&f=false

Brennan, C., Adams, K., Saikaly, R., Lichtenstein, S., Spavor, J., Penney, S., … & Kidd, S. A. (2022). Cognitive adaptation training for forensic psychiatry inpatients with schizophrenia spectrum diagnoses. The Journal of Forensic Psychiatry & Psychology, 1-15.

Carroll, K. M., & Kiluk, B. D. (2021). Cognitive-behavioral therapy. The American Psychiatric Association Publishing Textbook of Substance Use Disorder Treatment, 345.,+anger+management,+and+social+skill+training,+contingency+management,+and+cognitive-behavioral+therapy&ots=g3dYlFZ6Si&sig=AlJ12c_5z0ipqWEsNLJxQ3MKpck&redir_esc=y#v=onepage&q&f=false

Lopes, R. E. (2020). Citizenship, rights, and social occupational therapy. Social occupational therapy: Theoretical and practical designs, 1-10.

Lawrence, K. C., & Falaye, A. O. (2020). Trauma?focused counselling and social effectiveness skills training interventions on impaired psychological functioning of internally displaced adolescents in Nigeria. Journal of Community & Applied Social Psychology, 30(6), 616-627.

Quinn, S., Doyle, S., & Emerson, C. (2019). Female prisoners’ problems living in an Irish prison: An exploratory study. Occupational Therapy in Mental Health, 35(3), 219-237.

Clemmow, C., Bouhana, N., & Gill, P. (2020). Analyzing person?exposure patterns in lone?actor terrorism: implications for threat assessment and intelligence gathering. Criminology & Public Policy, 19(2), 451-482.

Sagar, R., Patra, B. N., & Patil, V. (2019). Clinical practice guidelines for the management of conduct disorder. Indian journal of psychiatry, 61(Suppl 2), 270.

Zhang, C. (2016). The involvement of family members in the treatment of patients with schizophrenia. Current Treatment Options in Psychiatry, 3(2), 111-118.

Watts, J. R., McDaniels, B., Rivera-Torres, S., Resiak, D., Mpofu, E., & Redwine, S. (2020). Community Substance Use Safety. In Sustainable Community Health (pp. 201-237). Palgrave Macmillan, Cham.

Ceci, F. M., Francati, S., Ferraguti, G., Coriale, G., Ciccarelli, R., Minni, A., … & Fiore, M. (2022). Behavioral dysregulations by chronic alcohol abuse. Motivational enhancement therapy and cognitive behavioral therapy outcomes. Rivista di Psichiatria, 57(1), 1-9.

Feldman, E., & Gitu, A. C. (2021). Recognizing Personality Disorders in Patients Presenting to the Primary Care Provider. Primary Care Reports, 27(9).