Holistic Healthcare Intervention Plan for Anton's Psychosocial Health Case Study

Introduction: Comprehensive Treatment Strategy for Anton's Physical and Mental Health

This case study analysis will focus on narrative analysis of the case scenario of Aaton. This assessment will include the best-fit intervention plan with which the physical health of Anton can be improved along with his lifestyle modification. The case study of Anton represents a complex interplay of biological, sexual, social, and psychological health issues which is stemming from the prior case of substance misuse and the psychotic signs and symptoms. The intervention plan therefore will be designed by focusing on physical heath by adhering the evidence-based practices and it will foster collaborative patient-professional relationships to ensure a comprehensive impact on the overall health and wellbeing of Anton.

Case study: A Holistic Healthcare Intervention Plan for Managing Anton's Psychosocial and Biological Health Issues

According to the case study, Anton started to get addicted to drug abuse at young age, and with time he developed psychotic symptoms like he started to believe that people were watching him and wanted to hurt him. Olanzapine Relprevv 150mg IMI has been prescribed to Anton by his GP along with 100 mg of Quetiapine each night. The key areas of concern for Anton revolve around his mental health, substance abuse, social isolation, and physical well-being. However, he has become reclusive, engaging in excessive online activities which lead him to gain weight and lead an unhealthy lifestyle. His desire for a girlfriend has been hindered by concern about his impotence. On the other hand, Unemployment, and stress have also contributed to the erratic sleep pattern of Anton.

Considering this overall scenario, the Critical Biological Health Issues, that have to be addressed are:

Mental health and physical and psychological health issues

Anton has a psychotic illness or more specifically he is paranoid. He has the intention that someone is following him and trying to hurt him. He is addicted to heavy smoking along with substance misuse (drugs). According to the case scenario, the use of Olanzapine Relprevv and Quetiapine led him to develop reclusive behavior, significant gain of weight, excessive addiction to online gaming, and disruptive sleeping patterns which indicate the metabolic side effects associated with the medication. Additionally, the concern related to impotence suggests the sexual dysfunction of Anton, which can be linked with psychotropic medication as well as physiological issues.

Sexual Health issues of Anton are:

Impotence concern: According to Anton, he was concerned and embarrassed that he was “almost” impotent, which indicates his potential sexual dysfunction. This issue can be related to his biological health condition, side effects of psychotropic medication, and underlying physiological factors that need to be addressed.

2. Lifestyle issue:

Social health issues of Anton can be addressed by focusing on his isolating and reclusive behavioral approach. According to Anton, he has developed a withdrawal behavior from outdoor activities and increased his addiction to online interaction and gaming suggesting his social isolation. Secondly, due to impotence, Anton is unsure about sustaining future relationships which makes him socially isolated. Unemployment is another social issue for Anton which arises due to several factors, including the history of underachievement at school, loss of job due to declining performance, loss of driving license, and reclusiveness and lack of motivation. As per the case scenario, it can be assumed that his worries about his mental health, inconsistent sleep habits, and doubt about his capacity to handle stress make matters worse in case of unemployment issues.

3. Substance Misuse:

The Physical health issues of Anton that need to be addressed are: as per the case scenario, Anton has been consuming nicotine and he is cannabis since the age of 14, which indicates a prolonged case history of substance misuse. Heavy cannabis use coupled with the consumption of party drugs causes respiratory issues, a shortening of breathing, and an increase the cardiovascular risk. Additionally, over the last 12 months, Anton has gained weight by 15 kgs, particularly around the midriff refers to physical health issues. Additionally, excessive addiction to consuming “unhealthy” foods, and an increased rate of appetite have increased the risk of diabetes, obesity, and cardiovascular problems to a considerable extent. On the other hand, daily consumption of 100 mg of Quetiapine every night has caused impaired immune responsiveness, fatigue, increased susceptibility to shortening of breathing, and other health issues.

Plan to holistically resolve the health problems of Anton

Considering the Physical heath issues of Anton, it can be stated that the intervention plan should focus on evidence-based practices and guidelines to ensure that the plan is patient-centric, collaborative, and holistic to ensure the restoration of health and well-being of Anton.

Medication Review and Blood Monitoring:

Impact of Olanzapine Relprevv in Blood

• It is an oral antipsychotic drug used for mania and schizophrenia, and common side effects related to this drug are orthostatic hypotension (sudden lowering of blood pressure, hormonal imbalance), weight gain, and restlessness due to shortening of breathing (Drugs.com 2023).

Impact of Quetiapine in blood

• Quetiapine is another psychotic drug which used to prescribe to treat the depressive behaviour, manic, and psychotic thought (Australian Institute of Health and Welfare 2020). The common imoact of this drug on blood upon administration are: sedation, low blood pressure, weight gain.

Therefore, the intervention plan should include monitoring of blood pressure and blood sugar levels regularly.

During this session, focus will also be given to monitoring the effectiveness and side effects of Olanzapine Relprevv and Quetiapine regularly, which were being prescribed to Anton due to his Paranoid and disruptive sleeping pattern. Based on the reassessment, the dosages should be adjusted as per APA guidelines (NAMI. 2020). Previously, the GP has prescribed 150mg IMI of Olanzapine Relprevv every two weeks, which can cause drowsiness, dizziness, weight gain, interrupted breathing during sleep, and so on. Based on the onset of side effects, the dosage of the medicine should be adjusted as Anton already has gained a significant amount of weight. To manage his blood pressure, Anton should be instructed to adopt regular physical exercise like, running, and swimming, participate in outdoor games along with consumption of balanced diet (Australian Institute of Health and Welfare 2020). Here Anton will be suggested for regular follow-up appointments with the healthcare professionals to evaluate the adverse effect of medication and adjust the treatment plan accordingly. Anton should also be suggested to keep contact with other healthcare providers like dietitians, and psychiatric to ensure holistic care (www.betterhealth.vic.gov.au. 2020). Here, Anton should prescribe for mental health counselling and follow cognitive behavioural therapy to improve his mental health and behavioural approach, the healthcare professionals and nurses who will work in close proximity with Anton should provide him with emotional support, and encourage open communication, along with adherence to medication at regular basis.

• Psychological therapy and Physical Health Assessment: The use of cognitive behavioral therapy or CBT, and the implementation of regular psychotherapy sessions will be set up to check the degree of prevalence of depressive symptoms, social withdrawal tendency, and other psychological illnesses and risks within Anton (Ma et al. 2020). According to the guidelines of the National Health and Medical Research Council or NHMRC, physical health assessment should identify and address emerging health issues related to medication and lifestyle factors (Nhmrc.gov.au. 2018). With Cognitive behavioural therapy, healthcare professionals can improve the lifestyle and physical health of Anton who is struggling with cannabis and tobacco addiction. It helps the professionals to recognise the thought patterns, emotions, and behavioral triggers related to substance use, which can help to design coping strategies. Additionally, this therapeutic intervention will include the “Breaking the Cycle approach which will address the automatic behavior associated with substance use and the therapy will include the coping skill development strategies (Ma et al. 2020). It can help Anton to manage his cravings and urges to use cannabis and tobacco. This intervention plan will also include, exercises like relaxation, deep breathing, and mindfulness which help Anton to reduce stress-related substance use.
• Patient Education and Empowerment: An education program will be implemented to educate and aware Anton of his mental health condition, and the importance of adhering to medication and lifestyle modification. According to the National Health and Medical Research Council or NHMRC and the Australian Government Department of Health, Anton will be empowered and encouraged to adopt self-management strategies and develop coping skills to increase the sense of control over his thought process and mental health (Nhmrc.gov.au. 2018). During this plan, a regular follow-up appointment will be offered to Anton to monitor his progress in various domains. It can help to adjust the treatment and therapeutic assessment processes as per the progress record and feedback of Anton.

Narrative analysis of the scenario

Considering their psychological, biological, sexual, and social issues of Anton, it can be stated that, Anton is going through prolonged mental health problems like auditory hallucinations, and persistent psychotic illness, which aggravated due to his heavy addiction to smoking habit, and heavy consumption of the drug li cannabis with tobacco. In such a scenario, assistance can be gathered from the healthcare professionals associated with Rekindling the Spirit. Rekindling the Spirit is a healthcare organisation in Australia, that ensures the physical as well as mental well-being of the Aboriginals (Admin RTS. 2023). The organisation specifically provides healthcare support to individuals with substance abuse issues, the problem with violent behaviour, and difficulties connecting with society.

Treatment Plan for Anton based on his Physical Health Issues

Considering the case scenario of Anton, the major barriers to providing treatment and psychological support to Anton are the potential resistance and ambivalence behaviour of Anton towards changes. Additionally, the complex mental health status, substance use, and disruptive lifestyle can also be considered as major barriers to making Anton encouraged for familiar with changing behavioural patterns and psychological support (Sinadinovic et al. 2020). Moreover, time can also be considered as another barrier to providing necessary support and services to Anton. Considering the barrier and health issues, the probable resources and support network that can be provided to Anton for regaining a healthy livelihoods are:

1. Psychiatric and psychological support (Psychologist): Continuous psychiatric and psychological counseling and CBT can be recommended to Anton in collaboration with Rekindling the Spirit's psychiatrists, psychologists, and telemedicine service. Regular sessions of counseling will focus on helping Anton to develop coping skills, reshaping his cognitive behavioural approach, and managing the medicinal side effects (www.betterhealth.vic.gov.au. 2020). The goal of this support plan will be to help Anton for gaining mental stability within the next six months with an ongoing assessment and monitoring process.
2. Community Managed Organisation (Rekindling of Spirit): The Community Managed Organisation like Rekindling of the Spirit organisation can provide social, and psychological support to Anton along with lifestyle management support and an intervention plan, with which Anton can maintain a healthy lifestyle as well as strengthen his mental health and well-being to a considerable extent. Here the role of Rekindling of the Spirit will be to prescribe and recommend a balanced nutritional plan, and consumption of balanced meals for Anton.
3. Role of Dietitian: Considering the significant weight gain and unhealthy eating habits, the dietitian will provide a nutritional guide to Anton, which can help him to manage weight and improve overall health. In the treatment plan, the dietitian will recommend a balanced meal plan that can address the increased appetite of Anton and will focus on healthy food choices, which can satisfy the hunger without exacerbating the weight gain.
4. Role of General Physician and Nurse in treatment plan: the general physician and nurses will play an important role by facilitating physical activity as a part of his treatment plan. The GP will assess the physical health of Anton, address the concerns and limitations, and prescribe an appropriate exercise regimen tailored to his health needs and abilities. The nurses will encourage Anton to adapt to regular physical activities and outdoor activities like running, walking, and cycling. Here Anton will be addressed about his significant weight gain and physical health issues, which can lead him to grab healthier eating habits and lifestyle change (Australian Institute of Health and Welfare. 2020). The Nurse and GP will monitor the progress and adjust the plan as per necessary, the nurse will provide support and encouragement, and assist Anton in the implementation of an exercise plan in regular habits and routines. Positive lifestyle changes are anticipated within the next six months with a target of sustainable and healthy habits over the next years.
5. Smoking Cessation and Alcohol Counselling, and Therapist Role in the Treatment Plan for Anton: Rekindling the Spirit has a specific drug and alcohol counseling program that can support Anton in quitting smoking habits, and consumption of nicotine and drugs (Admin RTS. 2023). Regular counseling and mindful exercise at Rekindling the Spirit can help Anton to reduce the consumption of tobacco and the habit of being cannabis. This goal will be achieved within the next two months.
6. Role of Physician in Sexual Health Assessment: Anton will be encouraged to communicate with a specialist at Rekindling the Spirit about his concern related to impotence (Australian Institute of Health and Welfare. 2020). Transparent communication, medication, and healthy lifestyle practices can help Anton improve his sexual well-being in the next six months.

So, the holistic treatment plan for Anton will be:

Considering the entire case scenario of Anton, it can be stated that a holistic healthcare plan and strategies can help Anton to reshape his livelihood in the next 12 months. In collaboration with Rekindling the Spirit, a culturally sensitive, evidence-based, and patient-centric collaborative intervention plan can be designed to ensure the overall health and well-being of Anton. Rekindling the Spirit is used to provide individual counseling and a comprehensive case management plan which can help Anton to address his own issues in communicating with his healthcare professionals from multiple angles. Traumma-informed care can also be provided to Anton, so that he can reduce the consumption of Tobacco, and Cannabis and can develop positive thinking about his livelihood and surroundings. Rekindling the Spirit used to work closely with the GPs, nurses, and alliance healthcare professionals, and through an intervention plan, the healthcare professionals will motivate Anton to communicate with them openly and encourage him to develop self-management skills and resilience. The professionals will also offer regular follow-ups and continuity of care to maintain positive lifestyle changes for Anton.

References

• Admin RTS (2023). Our Vision, Purpose, and Values. [online] Rekindlingthespirit.org.au. Available at: https://rekindlingthespirit.org.au/index.php/about/our-vision-purpose-and-values [Accessed 31 Jan. 2024].
• Australian Institute of Health and Welfare (2020). Access to mental health services. [online] AIHW Indigenous HPF. Available at: https://www.indigenoushpf.gov.au/measures/3-10-access-mental-health-services.
• Clarke, M. (2023). Time to Work Employment Services Guideline - Department of Employment and Workplace Relations, Australian Government. [online] Department of Employment and Workplace Relations. Available at: https://www.dewr.gov.au/time-work-employment-service/resources/time-work-employment-services-guideline [Accessed 31 Jan. 2024].
• Hammarberg, K., Tran, T., Kirkman, M. & Fisher, J., (2020). Sex and age differences in clinically significant symptoms of depression and anxiety among people in Australia in the first month of COVID-19 restrictions: a national survey. BMJ open, 10(11), p.e042696.https://bmjopen.bmj.com/content/10/11/e042696.abstract
• Ma, C. F., Chan, S. K. W., Chien, W. T., Bressington, D., Mui, E. Y. W., Lee, E. H. M., & Chen, E. Y. H. (2020). Cognitive behavioural family intervention for people diagnosed with severe mental illness and their families: A systematic review and meta‐analysis of randomized controlled trials. Journal of Psychiatric and Mental Health Nursing, 27(2), 128-139. https://onlinelibrary.wiley.com/doi/abs/10.1111/jpm.12567
• NAMI (2020). Sleep Disorders | NAMI: National Alliance on Mental Illness. [online] Nami.org. Available at: https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Sleep-Disorders.
• Nhmrc.gov.au. (2018). Breathing easier during sleep: Case study | NHMRC. [online] Available at: https://www.nhmrc.gov.au/about-us/resources/breathing-easier-during-sleep-case-study [Accessed 31 Jan. 2024].
• Sinadinovic, K., Johansson, M., Johansson, A.S., Lundqvist, T., Lindner, P. & Hermansson, U., (2020). Guided web-based treatment program for reducing cannabis use: a randomized controlled trial. Addiction science & clinical practice, 15, pp.1-13.https://link.springer.com/article/10.1186/s13722-020-00185-8
• www.betterhealth.vic.gov.au. (2020). Aboriginal health services - Better Health Channel. [online] Available at: https://www.betterhealth.vic.gov.au/serviceprofiles/aboriginal-health-services.
• www.dss.gov.au. (2022). Disability Employment Services Guidelines | Department of Social Services, Australian Government. [online] Available at: https://www.dss.gov.au/our-responsibilities-disability-and-carers/disability-employment-services-guidelines.
• Olanzapine vs Quetiapine Comparison. (2023). Drugs.com. https://www.drugs.com/compare/olanzapine-vs-quetiapine