Contents

Introduction......................................................................................................................................2
Organizational of writing paper..................................................................................................5
Demographic data and general health history of the patient.............................................5
Information and documentation of mental health history and assessment findings
(MSE)..................................................................................................................................................6
Mental health history.................................................................................................................6
Mental Status Examination (MSE)..........................................................................................7
Management of the patient..........................................................................................................9
Medication..................................................................................................................................11
Psychological............................................................................................................................12
Identification of nursing diagnosis and intervention for the patient..............................12
Medical intervention................................................................................................................16
Conclusion.....................................................................................................................................17
Referrence......................................................................................................................................17

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Introduction
Psychiatric mental health problems are serious public health throughout the world. It has
become an integral part of the 2030 Sustainable Development Goals agenda, which aims
to reshape the globe. In most countries, it is a significant contributor to health issues.
Huremović, (2019) claims that Psychiatric mental health problems are among the major
causes of diseases and disability worldwide. Psychiatric mental health problems can
cause problems in your daily life such as at school or work or in relationships. Chattu et
al., (2018) states that Psychiatric mental problems are a major cause of loss of
productivity and well-being given that mental health is crucial for economic growth, The
World Health Organization defines Psychiatric mental health problem as health conditions
involving changes in emotions, thinking or behaviour (or combination of these) According
to Martini et al., (2022) psychiatric mental problems are associated with distress or
problems functioning in social work and family related activities.
Every nation in the world has a population of those who struggle with mental illness.
Different countries have higher rates of mental illness than others; Malaysia, for example,
has a rate of one in five instances. Malaysian Medics International (MMI) reported that
Malaysia has a national average of 1.27 psychiatrists per 100,000 people, which is
significantly more than the World Health Organization's (WHO) recommendation of one
psychiatrist per 10,000 people (Martinus, 2021).In October 2020, the Malaysian mental
health Association report revealed that incidences of psychiatric mental health problems
increased two fords during the COVID-19 lockdowns resulting in more Malaysian seeking
help for mental-related illnesses (Dere, 2021). Physical health, employment, familial,
social, and other aspects of a person's life can all be impacted by mental illness. In
actuality, today's demands on daily life contribute to the development of mental health
issues like anxiety, depression, and other conditions. The doubling of mental cases in
Malaysia during the past ten years may have been caused by several circumstances,
including unemployment, financial hardship, marital issues, drug usage, and other
external factors. Treatment of psychiatric mental problems depends on which mental
disorder one has and how serious it is (Flaskerud, 2017). This paper presents a case
study of a patient with psychiatric mental problems whom I nursed during my clinical
practice. This paper will explore the case of a 29-year-old female patient diagnosed with
relapsed schizophrenia. Schizophrenia is a serious mental illness that affects how a
person thinks, feels, and behaves. People with schizophrenia may seem like they have

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lost touch with reality, which can be distressing for them and for their family and friends.
The symptoms of schizophrenia can make it difficult to participate in usual, everyday
activities, but effective treatments are available. Many people who receive treatment can
engage in school or work, achieve independence, and enjoy personal relationships. It’s
important to recognize the symptoms of schizophrenia and seek help as early as possible.
People with schizophrenia are usually diagnosed between the ages of 16 and 30, after the
first episode of psychosis. Starting treatment as soon as possible following the first
episode of psychosis is an important step toward recovery. However, research shows that
gradual changes in thinking, mood, and social functioning often appear before the first
episode of psychosis. Schizophrenia is rare in younger children.
Schizophrenia symptoms can differ from person to person, but they generally fall into
three main categories: psychotic, negative, and cognitive.
Psychotic symptoms include changes in the way a person thinks, acts, and experiences
the world. People with psychotic symptoms may lose a shared sense of reality with others
and experience the world in a distorted way. For some people, these symptoms come and
go. For others, the symptoms become stable over time. Psychotic symptoms include:
 Hallucinations: When a person sees, hears, smells, tastes, or feels things that are
not actually there. Hearing voices is common for people with schizophrenia. People
who hear voices may hear them for a long time before family or friends notice a
problem.
 Delusions: When a person has strong beliefs that are not true and may seem
irrational to others. For example, individuals experiencing delusions may believe
that people on the radio and television are sending special messages that require a
certain response, or they may believe that they are in danger or that others are
trying to hurt them.
 Thought disorder: When a person has ways of thinking that are unusual or
illogical. People with thought disorder may have trouble organizing their thoughts
and speech. Sometimes a person will stop talking in the middle of a thought, jump
from topic to topic, or make up words that have no meaning.
 Movement disorder: When a person exhibits abnormal body movements. People
with movement disorder may repeat certain motions over and over.

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Negative symptoms include loss of motivation, loss of interest or enjoyment in daily
activities, withdrawal from social life, difficulty showing emotions, and difficulty functioning
normally. Negative symptoms include:
 Having trouble planning and sticking with activities, such as grocery shopping
 Having trouble anticipating and feeling pleasure in everyday life
 Talking in a dull voice and showing limited facial expression
 Avoiding social interaction or interacting in socially awkward ways
 Having very low energy and spending a lot of time in passive activities. In extreme
cases, a person might stop moving or talking for a while, which is a rare condition
called catatonia.
These symptoms are sometimes mistaken for symptoms of depression or other mental
illnesses.
Cognitive symptoms include problems in attention, concentration, and memory. These
symptoms can make it hard to follow a conversation, learn new things, or remember
appointments. A person’s level of cognitive functioning is one of the best predictors of
their day-to-day functioning. Cognitive functioning is evaluated using specific tests.
Cognitive symptom

Several factors may contribute to a person’s risk of developing schizophrenia, including:

Genetics: Schizophrenia sometimes runs in families. However, just because one family
member has schizophrenia, it does not mean that other members of the family also will
have it. Studies suggest that many different genes may increase a person’s chances of
developing schizophrenia, but that no single gene causes the disorder by itself.
Environment: Research suggests that a combination of genetic factors and aspects of a
person’s environment and life experiences may play a role in the development of
schizophrenia. These environmental factors that may include living in poverty, stressful or
dangerous surroundings, and exposure to viruses or nutritional problems before birth.
Brain structure and function: Research shows that people with schizophrenia may be
more likely to have differences in the size of certain brain areas and in connections
between brain areas. Some of these brain differences may develop before birth.
Researchers are working to better understand how brain structure and function may relate
to schizophrenia.
ms include:

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  Having trouble processing information to make decisions
 Having trouble using information immediately after learning it
 Having trouble focusing or paying attention

Organizational of writing paper.

This paper is organized into five six distinct parts. Part one is the introduction, which
entails a thorough discussion of the background and the main objective of this paper.
The next part is demographic data and the general health history of the patient, this part
will include the basic characteristics of the patient such as gender relationship occupation
and general medical history social history allergies and medication the patient is taking
recently or has been taking. The third part will contain discussions of the patient’s mental
health history and MSE findings. The fourth part contains a discussion of patient
management. Patient management means the responsibility for managing the primary
healthcare of a patient and coordinating access to the necessary medication or allied.
Measures are taken to ensure the patient is stable, relieved and ready to go and live her
life will be discussed in this part. The fifth part of this assignment is the Identification of
nursing diagnosis and intervention for the patient. In this part, a step-by-step approach to
ensure the treatment of the patient will be discussed. The last part is the conclusion, in
the conclusion part I will sum up all that has been covered.

Demographic data and general health history of the patient.

The patient is a 29 –year old lady, married Malay, with a history of treatment- resistance
schizophrenia. The patient was brought to the hospital and her boyfriend after they
noticed behavioural changes in four days in the last week. The patient has been taken to
the hospital a couple of times last year, the last one was from 4/06/2021- 24/06
2021.Tab.Clozapine and propanol seemed to be the only medication that was working on
her producing reasonable improving and enabling her to be allowed to go home for home-
based care. However, with time she developed neutropenia from tab.clozapine and
tab.propanol and this resulted in a major relapse. The results of the investigation indicated
that the patient had an intellectual disability with behavioural issues. Her boyfriend
explained that she had disorganized behaviours around the house, and she also tried to
take others people’s belongings. In the interview, she explained that the reason why
wanted to take other people's belongings is that she wanted to buy a new house in Johor
where her father stays. The patient was still mumbling and smiling to herself. The

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patient claimed that she had male and female voices commanding in nature asking her to
kill everyone. She claims that she hears such voices when she is half asleep her
boyfriend also explained that sometimes she got agitated and punched him a couple of
times. She said she was married but they are not on good terms. Her husband works as a
construction worker and the patient expressed that her relationship with her husband was
not that good. Her husband always scolded her for being slow in doing house chores.
Currently, her husband is her neighbour. The patient had a history of not taking her
medication. Her husband used to supervise her taking medication but since they have not
been on good terms no one is there to supervise her taking the medication. She is aware
of this because when she asked why she explained that she forgot to take them and there
was no one to remind her. She spoke loudly, quickly, and haphazardly when giving a
presentation to the day program, though. She had a tangential line of thought, and her
insights and judgment were lacking. It was clear that she needed additional in-patient
treatment because of her persistent psychosis and aggressive behavior. She has a bad
feeling that someone has bad intentions for her. Other symptoms that could be noted in
the patient include delusions, hallucinations and poverty of speech/ incoherent speech.

Information and documentation of mental health history and assessment findings

(MSE)
Mental health history
Interventions included the general physical examination and routine investigation along
with the formulation of case history in the health care centres she visited where she was
admitted since diagnosis. Our patient’s medical history was generally unremarkable. The
patient has been in and out of the hospital many times over the years and her last one
was from 4/06/2021- 24/06 2021. The patient was well until recently when her boyfriend
and her uncle noted some changes in her behaviour, she got disorganized, punched her
boyfriend and destroyed her neighbour’s properties. Tab. Clozapine is an atypical
antipsychotic drug that is used when traditional antipsychotics fail to treat schizophrenia.
Her mental health history indicates that the client in this case study was treated with
Clozapine but with time she developed neutropenia from clozapine and propanol and this
resulted in a major relapse. The results of the investigation indicated that the patient had
an intellectual disability with behavioural issues. There is no history of any compliance
with trauma, alcohol and drug dependence. We discovered the patient was alert and
vibrant during our first interview but had trouble speaking, her speech was mumbled.

6
During conversations, she frequently looked aside and laughed suggesting the presence
of perceptual disturbances.

Mental Status Examination (MSE)

According to Martin et al., (2019), the mental state examination (MSE) is an integral and
essential skill to develop a psychiatric evaluation. The undertaking of an accurate MSE is
important in eliciting signs and symptoms of apparent illness and associated risk factors.
The table below is a summary of the MSE conducted on the patient.

Component Element assessed Findings.

Appearance Body habitus, grooming Malay lady in her 20s, medium build, in
and general habits, posture and eye neat hospital attire. Her hair was well
behaviour contact tied and she was wearing spectacles.
She was cool and calm and had good
hygiene. Her eye contact was good,
she maintained 40% while speaking
and 60% while listening. This displayed
interest and confidence. Overall her
appearance and general behaviour
were good

Motor activity Physical and emotional Although she had a history of being
reactions aggressive, she was calm and
cooperative. However, we noted that
the patient tried a little hard to change
the body posture and lethargic
movements of the limps

Mood and affect Patient’s emotional state. The patient had restricted effects and
was sad She was calm and cooperative
during conversations.

Speech volume and tone, soft-loud The quantity of her speech was
monotone, weak, strong reduced and she mumbled words all
mumbled speech through the interview sessions.

Thought form of thinking, the flow of She had through disturbance as

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process thoughts evidenced in the poverty of speech.
The patient also had thought blocking,
there were some incidents during the
conversations when were blank
intervals in the tangibility of her brain.

Thought content what is the patient thinking The patient was delusional, she said
about she heard different voices in her head
both male and female which instructed
her to kill from time to time.

Perceptual Hallucinations The patient had no hallucinations or

disturbances, perceptual or thought disturbance.

Sensorium and stability of consciousness Her stability/consciousness and

cognition and attention/ concentration/ concentration were low. This is
memory because she was disturbed by female
and male voices in her head that were
instructing her to kill someone.

Patient's awareness and The patient was aware and understood

insights understanding of illness and that
need for treatment.
her illness needed treatment
because when she was asked why she
had not been taking her medication,
she explained that she forgot to take
them and there was nobody to help her
remember since they were not on good
terms with her husband who used to
assist and supervises medication.

Judgment Patients' recognition of She had poor judgment, the patient was
consequences of actions taking other people's belongings and
when asked why she explained that she
wanted to go and buy a house in Johor
where her father lives. She had
intellectual disability behaviour issues

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 Table 1.0 Findings during the mental examination of the patient.

Management of the patient

According to Cetin-Karayumak et al., (2020) schizophrenia progresses according to
different phases. Management of a patient diagnosed with schizophrenia highly depends
on the stage of the disease. Management of this patient involved many aspects including
pharmacological, social, psychological, and educational intervention and reducing the
impacts of relapse schizophrenia on the quality of the patient’s life. The patient was
brought to the hospital by her boyfriend and her uncle after her behaviour changed, she
was aggressive and punched her boyfriend, mumbling and smiling to herself and trying to
take other people's belongings. She has been diagnosed with treatment-resistant
schizophrenia. A decision was made to admit her for closer monitoring given that the
schizophrenia had become resistant to the medication that she was using.

The management of the patient was based on the identified needs of the patient. In this
case, the priority patient needs include delusions, poor judgment, poor insights and
incoherent speaking (she was mumbling and smiling to herself). To deliver quality patient
management goals were set. It was expected that by the time the patient will be
discharged from the hospital she will be able to express her thoughts and feelings
coherently. It is also expected that she will be able to converse with one or two other
persons about structured activities with neutral topics and exhibit reality-based mental
processes. Within three days, the patient will meet with the nurse for two to three five-
minute sessions to discuss observations about the surroundings. By the time of
discharge, the patient will be able to communicate in a way that is understandable to
others with the aid of medication, careful listening, and she will learn one or two
distraction techniques that help them manage their anxiety, which will help them think
more clearly and communicate more logically. A summary of the patient's management
strategy is provided in the table below.

Categories of patient what was done Goals

management

Coordination of care Nurses maintained safety by taking the Coordination of

necessary safety measures to reduce the care among

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 likelihood of patients harming themselves nurses was
suicide, or homicide. This was made easy by established to
putting expectations in the nursing care plan, ensure that all
this ensured that everyone on the unit is patients’ needs
following the same behavioural expectations. were met and to
We also planned for a high quality of life, help her recover
independence, and optimum recovery by faster.
using community services and support
networks after discharge.

Health teaching Given the fact that the patient had been The main aim of
admitted to our hospital several times, we health teaching
decided to create modify, and present to was to equip the
clients health education on topics like stress patient with
management, coping techniques, and the knowledge and
control of delusions and hallucinations. We skills on how to
also informed patients about antipsychotics deal with her
and anticipated recovery times. Present the condition once
client with all open drugs. Keep an eye out she was
for and report any early signs of probable discharged from
first-generation antipsychotic side effects the hospital.
such as tardive dyskinesia (TD) and
extrapyramidal side effects (EPS).

Milieu Therapy Reduce arousal-provoking factors and The main goal of

excessive loudness to control the this therapy was
surroundings. A private room can be to reduce arousal-
necessary for the customer. To reroute provoking factors
aggressive behaviour, encourage physical and excessive
activity. Utilize prescription drugs, isolation, loudness to
or restraint to prevent physical injury during control the
acute psychosis with agitation. Promote surroundings
involvement in groups that focus on stress
reduction, mindfulness, social skills, and
personal grooming. If the client is irritated,

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 refrain from competitive sports or activities.

Therapeutic As earlier said, relapse schizophrenia can The main goal of

relationship and also be managed using therapy sessions. To this was to
counselling ensure the therapy sessions were productive, empower the
we ensured that we developed relationships patient to delve
with the patient so she to be able to open up deeper into
about what she was going through. short, issues she was
to-the-point statements and a firm, composed facing and open
demeanour to clearly define expectations in up, for us to able
straightforward, concrete words with to help her get
repercussions were used to equip her with back to her
the right knowledge and skills normal life as
soon as possible.

Medication
Antipsychotic drugs are the mainstay of relapse schizophrenia patient management. With
the creation and introduction of the first antipsychotics, the treatment of schizophrenia
underwent a significant change in the middle of the 1950s. It is still unknown if the more
recent antipsychotics decrease the risk of the neuroleptic malignant syndrome, a rare but
serious and potentially fatal neurological disorder that is frequently brought on by an
adverse reaction to antipsychotics. Antipsychotic users frequently experience side effects.
When taking atypical antipsychotics, especially olanzapine, patients are more likely to
experience extrapyramidal side effects than those taking typical antipsychotics. Some
atypical are also linked to significant weight gain, diabetes risk, and metabolic syndrome.
According to Flowers et al., (2019) it is important to understand that majority of
antipsychotic medications can take 7 to 14 days to fully take effect. The positive signs of
schizophrenia, as well as social and occupational functioning, may be helped by
medication. Antipsychotics, however, are unable to appreciably reduce the unpleasant
symptoms and cognitive impairment. The most effective drugs, according to the available
research, are risperidone, amisulpride, olanzapine, and clozapine. However, according to

11
Correll, Rubio and Kane, (2018) continued antipsychotic use in patients lowers the chance
of recurrence.

This patient was started on Tab.Clozapine 25mg daily and the dose will be titrate base on
daily observation regarding her symptom.

Psychological
Combination of therapy and medication is Due to issues with reimbursement or a lack of
training, psychotherapy is also highly recommended but is not frequently used in the
treatment of schizophrenia. As a result, psychiatric medication is frequently the only mode
of treatment. Various psychosocial interventions are important for relapse schizophrenia
patients because they are usually under stress due to their medical conditions. Nursing
interventions can assist patients in managing these situations because many patients
struggle with social retreat and decreased social interaction. Training in social skills and
other forms of therapy are both possible in mental health nursing. We assisted the
patients in learning various treatment approaches, such as by offering chances for
socialization. Additionally, we supported patients in learning coping mechanisms so they
can better manage their stress.

Identification of nursing diagnosis and intervention for the patient.

Like any other mental disease, diagnosing relapse schizophrenia is conducted using the
guidelines of DMS-5. The DMS stands for the diagnostic and statistical manual of mental
health disorders. We formulated nursing care for this relapse of schizophrenia based on
the priority problems and came up with the most appropriate nursing intervention to
manage the symptoms.

Nursing diagnoses/ outcome Nursing intervention

Impaired verbal communication. -We Determined whether the patient’s speech

The patient exhibited poor incoherence was persistent or if it arose more
communication function. She was suddenly, such as during a symptom flare.
mumbling and smiling to herself
-Despite how confusing the spoken words may
from time to time.
seem, we first, listen for themes (e.g., fear,
sadness, guilt).

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 -We determined the patient’s length of treatment
for their psychosis.

-Nurses introduced techniques that could

lessen anxiety and quiet voices and "worrying"
thoughts by teaching the patient to do the
following :

 Focus on worthwhile pursuits.

 Adopt the skill of thinking positively
instead of negatively.
 Learn to convert illogical thoughts into
rational arguments
 Breathing exercises were done.
 Self-read out loud activities.

 Staff, family, or other supportive people

were sought for assistance.
 Played some soothing music and used a
calming visualization.
-Therapeutic techniques were employed to
understand the patient's concerns.

Impaired social interactions. The - Assessed if the medication had reached

patient was sad upset and therapeutic levels.
agitated. It was also discovered
-we took the patient to a ward that was free of
that the patient spends a lot of
stimuli ( loud noise, crowding)
time alone. She had poor social
support, the patient used to stay - We avoided touching the patient during
alone at her boyfriend’s house. interviews or when giving her instructions.

- Because the client was delusional, we provided

some simple concrete activities to help keep
away delusional thinking from reality in the

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environment.

-We gave the patient a chance to practice

developing their social skills in a relaxed setting.
Initial social skills instruction could cover
fundamental social skills including acceptable
distance, maintaining eye contact, remaining
cool, and using a moderate voice tone.

- Coping Skills Training was introduced to the

patient as she advanced (nurse, staff or others).
The patient

 Defined the skill that has to be acquired.

 Practice the skill.
 Practice skills first in a secure setting
before using them in public.
 Provide constructive criticism on how
talents are being used.
-Eventually, we engaged other patients in social
interactions with her by introducing card games,
group sharing activities and singing songs. This
was made to make the client feel safe when
interacting with others.

Nurses can assist with educational needs as

well. To further understand the disease, this may
entail collaborating with both the patient and their
family members or caregivers. Nursing
interventions also include finding efficient
methods for calming the patient down if they
become irritated and assisting them in
developing better communication skills. You must
teach family members both how to make the
patient feel more at ease and how to prevent

14
 unintentionally escalating the current condition.

Interrupted family process, the -On learning that the patient was not on good
patient had some issues with her terms with her husband and that she had moved
husband who was always nagging to her boyfriend's house, an assessment of the
her for her slowness when level of knowledge about her conditions and
conducting household chores. medications that had been used to treat the
patient.

We informed the patient’s boyfriend in simple

terms about the psychopharmacologic therapy,
dose duration indication of side effects and toxic
effects.

We also taught the patient's family about these

symptoms and warning of relapse

The patient’s family was also equipped with

knowledge and skills on disease treatment
strategies, nurses can best intervene when they
understand the family's experience and needs.

The disturbing thought process, According to Salvatore et al., (2018) a patient

the patient was experiencing can be free from delusional thinking when
delusions that she was hearing thinking is focused on reality-based activities.
both male and female voices in
-We tried to comprehend how important these
her head and this largely affected
views were to the patient at the time they were
her thought process.
presented.

- Different nurses on duty expressed

understanding of the patient’s emotions and
reassurance of their presence and acceptance.

- We determined the emotions that go along with

illusions. For instance, the patient was afraid
because she thought to think someone wanted

15
 her to hurt others

We engaged in the patient's interactions based

on the surroundings. This helped distract the
patient from their fantasies by involving them in
activities that are grounded in reality (e.g., card
games, simple arts and crafts projects etc.).

Medical intervention
There is not much proof that their use is consistently beneficial after two or three years.
The following medications were used to manage the patient.

 Clozapine: Clozapine is a psychiatric medication (anti-psychotic type) that works

by helping restore the balance of certain natural substances in the brain. This
medication was administered to the patient for a period of one week and the nurses
kept monitoring and charting notable changes in the patient. Before this drug was
administered to the patient, she had problems with her sleeping patterns and was
hallucinating. The patient responded well to the medication because after one
week in the hospital, she was able to sleep well. According to Prisco, Iannaccone
and Fabrazzo, (2015) clozapine help a patient think clearly and positively about
themselves. This medication is administered through the mouth. The family of the
patient were advised that after taking the medication the patient can show side
effects such as dizziness, headache, shaking, vision problems drooling and
drowsiness. The short-term goal of administering this medication to the patient
was that she would remain calm and that she would be able to acknowledge risk
factors within 24 hours after admission. Nurses kept monitoring the patient after
administering the medicine to see if any of the above-mentioned side effects got
worse. The doctors had looked at the patient's medical history before
administering Clozapine to the patient.
 Lorazepam: According to WebMD, (2019) this medication is used to treat anxiety
and produce calm effects. It belongs to a group of drugs called benzodiazepines.
When the patient was brought to the hospital, her uncle and boyfriend explained to
the physicians that she was agitated and at times she punched her boyfriend. The
purpose of administering this medication was to help the patient calm down and be

16
 more cooperative which was important for the effectiveness of nursing care. This
drug works by enhancing the effects of a certain natural chemical in the body and
is taken through the mouth with or without food. Some of the side effects of taking
this medication include loss of coordination dizziness, headache, shaking, vision
problems drooling and drowsiness. After administering the medication the patient
was monitored to deal with any side effects that got worse. This medication had
positive effects on the patient as it calmed her.
 Valium: Valium is a medication used to treat anxiety and seizures in patients with
relapse schizophrenia. According to Thornton, (2019) it works by calming the brain
and nerves, it belongs to a class of medication called benzodiazepines. Side
effects that are associated with this medication include dizziness, blurred vision,
unsteadiness, tiredness and drowsiness. If any of these effects last long or get
worse, the patient needs to tell a doctor promptly.
 Syrup Lactulose: This medication is used to help increase bowel movement per
day, it works by increasing stool water content and softening the stool. This
medication is taken by mouth usually once a day. Side effects associated with
taking this drug include gas, stomach pain, burping vomiting, muscle cramps/
weakness, irregular heartbeat, seizures and mood change (Nagasawa, Sato and
Kasumi, 2019). Patients are encouraged to call a doctor promptly if any of these
symptoms last longer or become more severe. This medication was given to the
patient to help increase the number of bowel movements and the number of days
she has bowel movements.
The patient's look is consistent with her mental diagnosis because her general health and
temperament have improved as a result of her pharmacological medication and
consultations. The patient made remarkable progress as compared to the mental state
evaluation from the time of admission one week before the time of the present
examination. Although the patient's symptoms have been managed and improved, there
is cause for concern that she may relapse if her circumstances, such as her recent loss of
employment and change in living arrangements, become excessive and worsen her
problematic behaviours.

Conclusion
Psychiatric mental health problems are among the major causes of diseases and
disabilities worldwide. Psychiatric mental health problems can cause problems in your

17
daily life such as at school or work or in relationships. The main aim of this paper was to
develop a case study of a patient with psychiatric mental problems whom I nursed during
my clinical practice. Our case study in this paper involved a patient diagnosed with
relapse schizophrenia who was still under medication in the hospital Discussion
conducted in this paper revealed that Relapse Schizophrenia is among the most severe
and impairing medical diseases. Even when the symptoms have faded away, relapse
schizophrenia required a lifetime of therapy. Both the patient and the family are
overwhelmed by the illness. It is crucial to remember that every patient is different, and
there is no one-size-fits-all treatment plan that can meet their needs. To satisfy the unique
needs of each patient, typical psychiatric therapies must be modified. This study highlights
the significance of having a thorough awareness of the patient's mental health history as
well as the current history presenting the condition for doctors in order to manage
psychiatrically related mental illnesses such relapse schizophrenia. This is important as it
provides them with information that helps them to make decisions on the kind of nursing
management that the patient should be offered. To conclude, health workers can do a
case study on mental health to determine and understand mental health issues in real life
context. This case studies are important because they can be used by other health
practitioners. This paper discussed the demographic data, the history of the patient’s
psychiatric illness, symptoms, mental health history of the patient and nursing
management for the patient.

5349 words

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