Comprehensive Integrated Psychiatric Assessment

Comprehensive Integrated Psychiatric Assessment

Child and adolescent depression is becoming a major issue of public health concern. A study conducted in the United States utilizing data collected between 2011 and 2016 showed a rise in depression cases among adolescents from 8.3% to 12.9% (Lu, 2019). The World Health Organization (2021) links adolescent depression to growth and development issues, behavioral and emotional issues, and suicidal and self-harm behaviors. This paper reviews and critiques the techniques and methods of a mental health professional applied in the YMH Boston Vignette 5 case.

What Did The Practitioner Do Well? In What Areas Can The Practitioner Improve?

The practitioner handling Vignette case 5 did well based on how she approached the case. She first asked questions that focused on Tony’s feelings and moods. Moods and feelings have been validated as essential measures of adolescent depression and finding young adults’ mental well-being(Thabrew et al., 2018). She also focused her questions on Tony’s school performance and his interests. She also sought to understand how Tony felt about relationships, school work such as homework, and engaging in co-curricular activities, including games such as basketball. However, she failed to establish a trusting practitioner-patient relationship by introducing herself and orienting Tony to the assessment session. Are you interested in an unpublished edition of the assignment ? Get in touch with us. Our team of experts is ready to help.

Compelling Concerns in the Clinical Interview

Three of the most compelling concerns in the Vignette 5 clinical interview are the declining school performance, disinterest and low energy in things he likes, such as playing basketball, and his feelings of not wanting to live anymore. Disinterest in sports and activities once enjoyed and poor performance has been identified as some of the depressive symptoms in adolescents (Finan et al., 2018). The greatest concern today over adolescent depression is the tendency to self-harm and have suicidal thoughts (Mars et al., 2019). Tony’s confession of feeling not wanting to be alive anymore is a compelling concern that the practitioner should look deeper into understanding underlying factors and the extent of the suicidal thoughts so far.

The Next Question and Reasons for the Question

The next question to pose to Tony after establishing suicidal concerns would be, “Have you decided how, when, or who would take your life?” This question is important as it will help establish whether Tony has already made up his mind to commit suicide. It will help identify how he plans to do it and when he plans to. Subsequently, it will be easier to develop a plan to manage his situation and help him from committing suicide.

Importance of Thorough Child/Adolescent Psychiatric Assessment

The psychiatric assessment focuses on identifying the relationship between the child’s mental health and their overall well-being. Psychiatric assessments help establish the behavioral and development risks of the child or adolescent. They can help identify developmental, mental, and behavioral disorders and related risks. The psychiatric assessments also help identify the associated factors that lead to the development of mental and behavioral issues (Wartberg et al., 2018). The assessments also assist in developing treatment plans for the child/adolescent.

Symptom Rating Scales Appropriate to Use During Child/Adolescent Psychiatric Assessment

The Hamilton Depression Rating Scale (HAM-D or HDRS): Is used to assess depression and design a treatment plan. It usually accompanies an unstructured interview with a patient.

Patient Health Questionnaire (PHQ-9), modified for adolescents: The PHQ-9 for adolescents has validated psychometric measures that assess the severity of depressive symptoms in adolescents (Nandakumar et al., 2019).

Psychiatric Treatment Options for Children and Adolescents that May not be Used When Treating Adults

Play Therapy is a psychiatric therapy that utilizes toys and games to assist children in understanding, verbalizing, and identifying feelings, moods, and emotions. Practitioners observe the child’s interactions with the games and toys to understand their mental state and help them deal with observed negative behaviors or traumatic experiences (Goodyear-Brown, 2019).

Mentalization-based therapy (MBT) helps children and teenagers better understand themselves and develop an identity of themselves. MBT supports teenagers throughout their development to become mentally healthy young adults.

Role Parents/Guardians in Assessment

Guardians and parents are primary caregivers. They largely influence the development of the child. They play an important role in influencing the child’s behavior and assist in developing the child’s self-recognition and acceptance. They can help practitioners identify the different factors that influence the child’s mental health. In addition, parents or guardians can also help the child grow their self-esteem and be open during an assessment.

References

Finan, L. J., Ohannessian, C. M. C., & Gordon, M. S. (2018). Trajectories of depressive symptoms from adolescence to emerging adulthood: The influence of parents, peers, and siblings. Developmental Psychology, 54(8), 1555–1567. https://doi.org/10.1037/DEV0000543

Goodyear-Brown, P. (2019). Trauma and Play Therapy. Trauma and Play Therapy. https://doi.org/10.4324/9781351216869/TRAUMA-PLAY-THERAPY-PARIS-GOODYEAR-BROWN

Lu, W. (2019). Adolescent Depression: National Trends, Risk Factors, and Healthcare Disparities. American Journal of Health Behavior, 43(1), 181–194. https://doi.org/10.5993/AJHB.43.1.15

Mars, B., Heron, J., Klonsky, E., … P. M.-T. L., & 2019, undefined. (n.d.). Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm: a population-based birth cohort study. Elsevier. Retrieved June 1, 2022, from https://www.sciencedirect.com/science/article/pii/S2215036619300306

Nandakumar, A. L., Vande Voort, J. L., Nakonezny, P. A., Orth, S. S., Romanowicz, M., Sonmez, A. I., Ward, J. A., Rackley, S. J., Huxsahl, J. E., & Croarkin, P. E. (2019). Psychometric Properties of the Patient Health Questionnaire-9 Modified for Major Depressive Disorder in Adolescents. Journal of Child and Adolescent Psychopharmacology, 29(1), 34–40. https://doi.org/10.1089/CAP.2018.0112

Thabrew, H., Stasiak, K., Bavin, L. M., Frampton, C., & Merry, S. (2018). Validation of the Mood and Feelings Questionnaire (MFQ) and Short Mood and Feelings Questionnaire (SMFQ) in New Zealand help-seeking adolescents. International Journal of Methods in Psychiatric Research, 27(3). https://doi.org/10.1002/MPR.1610

Wartberg, L., Kriston, L., & Thomasius, R. (2018). Depressive Symptoms in Adolescents: Prevalence and Associated Psychosocial Features in a Representative Sample. Deutsches Ärzteblatt International, 115(33–34), 549. https://doi.org/10.3238/ARZTEBL.2018.0549

World Health Organization. (2021, November 17). Adolescent mental health. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health

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By Day 3 of Week 1
Based on the YMH Boston Vignette 5 video, post answers to the following questions:

Comprehensive Integrated Psychiatric Assessment

What did the practitioner do well? In what areas can the practitioner improve?
At this point in the clinical interview, do you have any compelling concerns? If so, what are they?
What would be your next question, and why?
Then, address the following. Your answers to these prompts do not have to be tailored to the patient in the YMH Boston video.

Explain why a thorough psychiatric assessment of a child/adolescent is important.
Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.
Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.
Explain the role parents/guardians play in assessment.
Support your response with at least three peer-reviewed, evidence-based sources and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.