Introduction
This study is a case analysis of a mental patient who goes by a fictitious name, Sandy. The patient has a history of mental disorders and therefore has undergone several psychosocial, social, and biological interventions to treat his condition. According to the patient’s mental history, he has previously been engaged in alcohol abuse, ecstasy use, and cannabis addiction. He has also had a history of schizophrenia and paranoia, with instances of hallucination. Specifically, he underwent periods where he heard voices speaking to him, telling him he should kill some people, but sometimes, there were voices that told him to kill himself. These are just a few of the symptoms of Sandy’s mental condition but the rest will be further discussed in subsequent paragraphs of this study.
Nonetheless, this study seeks to develop an understanding of the stress vulnerability model. Sandy has been chosen for this analysis because he demonstrates all the possible symptoms of a mental patient with a long history of poor mental health. Moreover, the patient exhibits all the classical symptoms of a recurring mental condition and different modes of treatment have been used on him as well. The patient, therefore, represents a person who has undergone a comprehensive mental health diagnosis with experience in a variety of mental medications.
However, about Sandy’s mental condition, and in the context of developing a deeper understanding of his psychosocial interventions, this study upholds patient confidentiality first by using a fictitious name (as observed above) and by following the guidelines of the nursing and midwifery Council. The nursing and midwifery council is the legal body mandated by the United Kingdom (UK) government to regulate all nursing and midwifery professions by safeguarding the interests of the public when health practitioners are going about their nursing or midwifery duties (Fraser, 2009, p. 86).
An Understanding of the Situation with the Stress Vulnerability Model
According to the stress vulnerability model, it is noted that patients have unique biological, psychosocial, and social elements that ultimately affect the way they deal with stress (Hearing Voices 2011, p. 2). When analyzing Sandy’s situation, we note these three elements. The psychosocial element of his mental condition can be observed from his restraint on killing himself because of his Christian belief. His fear for germs, as is manifested from his refusal to eat when someone coughs or his hoarding of urine is also a manifestation of his psychosocial nature that manifests as part of his vulnerability to withstand stress. The same element can be observed when he is afraid to sleep because he thinks there are people after him and more especially, his life. This is especially manifested in his paranoia. The social element can be seen from his increased paranoia when his mother leaves for London to arrange a funeral because he expresses fear in eating, washing clothes, and carrying out other basic duties, normal people in his position would. Lastly, the biological element of his vulnerability to stress and mental condition is manifested from his increased vulnerability to schizophrenia because it was noted in his uncle before.
Sandy’s vulnerability to stress factors can however be traced back to his teen years when he was engaged in a lot of fights which subsequently led him to be expelled severally from a number of schools. When he was 9 years old, Sandy left school and started indulging in alcohol at the age of 14. He had also been diagnosed with ADHD that affected his behavioral and learning capabilities at a young age. This ultimately led many experts to diagnose him like reading. All these variables when analyzed collectively increased his vulnerability to stress and ultimately, acute mental conditions like schizophrenia (Noll 2007, p. 19). Furthermore, his vulnerability to stress and mental health condition may also have been further aggravated by the fact that he had engaged in the abuse of cannabis and his use of ecstasy and speed at a given time during his developmental stages (Abadinsky, 2008, p. 94). These factors have been noted to affect an individual’s susceptibility to stress factors, as can be noted by research studies done by Zubin (1977) who came up with the Stress vulnerability model. According to the researcher, people with a low vulnerability to stress can withstand high levels of stress but those under social exclusion may easily experience psychotic symptoms (Zubin, 1977). The same sentiments are also resonated by Cryan (2010) who notes that people with a genetic predisposition to mental conditions are also bound to suffer the same fate in the same way people predisposed to certain social adversities like the death of a parent are.
The rationale for Possible Psychosocial Interventions
Sandy has been identified in this case study as a unique mental patient who has undergone a number of psychological, sociological, and physiological interventions. These interventions can be analyzed complimentarily with the stress vulnerability model. For instance, the patient was analyzed upon the mum’s intervention in November 2005 because he refused to go to the hospital or take up available medication as a matter of urgency. This is practical sense is a form of sociological intervention and when analyzed according to the stress vulnerability model, it seeks to enforce the social element of human stress factors (Rubin, 2010, p. 56). In March 2006, Sandy was also allocated a care coordinator as another form of sociological intervention (Clarke, 2009). This intervention served the same purpose as the intervention the mother had on Sandy’s treatment in the above analysis. In addition, In March 2007, it was recommended that Sandy attend a resource center to help him have better mental health. This was a psychosocial intervention in his course of treatment. This effort is also in line with treating the psychosocial element noted in the stress vulnerability model that seeks to increase his resistance to stress factors (Fink, 2009, p. 200).
In the resource center, Sandy would have been able to get better in a convenient surroundings meant to facilitate his healing process. This environment would be surrounded by experts who would in turn facilitate his healing process adequately (Callaghan, 2009). This was also another psychosocial intervention. In August 2007, Sandy was also visited at home by a social worker as a form of psychosocial intervention. The same was also undertaken in November 2007. According to the stress vulnerability model, it can be observed that biological interventions were necessary to improve the reduction of stress factors in general (Cohen, 2008). Because of this reason, Sandy was subjected to physiological interventions where he had to go with a social worker on shopping trips to exercise his physical self. He was also given support to attend the walk and talk group as a method of physiological intervention in October 2009. A little earlier on (in January 2008), he was also advised to start exercise activities alongside setting small achievable tasks that he could accomplish. This line of treatment was in accordance with the biological empowerment of the stress vulnerability model (Grant, 2004).
Even though the stress vulnerability model acts as a blueprint to the treatment of mental health conditions, an inherent risk underlies its application. Specifically, it is important to note that the stress vulnerability model does not provide a framework through which the various modes of treatment can be integrated (Harrison, 2004). In addition, it is important to note that just like other drug regimens; the stress vulnerability model can have long-term disadvantages even though it has many short-term benefits (Norman, 2009). Falloon (2005, p. 36) notes that this problem is especially severe for people suffering from schizophrenic episodes and those who have been confined in their homes as an institutional intervention.
In as much as the stress vulnerability model has its own disadvantages, it informs us of some alternative interventions which can be used to treat mental patients. One alternative method that can be used is a community-centered initiative where the general community takes part in helping the mental patient get better faster (Priest, 2004). This should not however be perceived in the literal sense, but rather conventionally, because it means that the community should be sensitized on the appropriate practices they can uphold when interacting with mental patients so that they can help them get better too (Reid, 2004). In a more general perspective, the stress vulnerability model can be used to the benefit of mental patients like Sandy, in the sense that, healthcare will be improved on the basis that there will be an increased awareness of stress sensors and therefore healthcare professionals will be more informed of what strategies to develop to improve the patient recovery process (Repper, 2003). This is the major advantage the stress vulnerability model offers mental health patients.
One of the major limitations to the stress vulnerability model is the fact that some factors underpinning stress vulnerability cannot be quantified under the three categories of biological, psychosocial, and social factors identified in the stress vulnerability model (Rogers, 2005). These factors have been necessitated by modern life pressures that have emerged as new factors to stress vulnerability. The scope of the stress vulnerability model is therefore limited in a sense, and therefore, many factors that contribute to stress vulnerability today are excluded from the model (Ryan, 2004).
After this analysis of the stress vulnerability model, healthcare professionals and more so, nurses who are in contact with mental patients should change the way they treat mental health patients as part of their person-centered care. Specifically, they should acknowledge the importance of tackling stress management in a multifaceted manner. This means that they should try to include aspects of social and psychosocial interventions in person-centered care and also appreciate and make the patients aware of the biological influence on their vulnerability to stress. This should be the major area of change for person-centered care.
Conclusion
In this study, the stress vulnerability model is identified as the blueprint for the treatment and care of mental health patients. More so, the model is relied on, to understand the dynamism of Sandy as a unique mental patient for this analysis. The various interventions identified in his historical treatment chart can be comprehended from the stress vulnerability model, according to its three major categories (biological, psychosocial, and social). From this understanding, we can deduce the fact that to a large extent, Sandy’s treatment was comprehensive and in line with the stress vulnerability model. This acts as the basic criteria for this analysis.
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