Introduction

Mental wellbeing dictates the state of the human mind and body. It affects thinking patterns, feelings, and even actions. Additionally, mental health helps individuals manage stress, socialize, and arrive at conclusive choices (Prince et al., 2007). Mental health is key throughout the life of an individual- childhood, infancy, and adulthood. As one goes through life, experiences affect mental health status due to challenges encountered, moods, and occupational routines. For instance, life experiences such as sexual abuse, family background, and biological aspects such as genes may affect an individual's mental health. Mental health challenges are common but medics have solutions. One can easily get better and slowly resume a normal life. Furthermore, research shows that social ties play a critical role in the sustenance of good mental health. Social contexts set the pace for actions, behavior, and attitude. Hence, it is normally advisable to change the environment whenever one wants to improve his or her mental health.

Summary of the Service User

Tristan, a 22 to year old male, 6-foot-tall, and an average build, living in a flat attached to his parents’ house and is currently unemployed, due to being sacked from his job due to bizarre behavior, is spending a lot of time isolating himself. Tristan has no main interests and spends a lot of time on his own. His mum and dad do not interact with him very much. His dad has expressed frustration but is not too concerned. Although Tristan did okay in school and college, he deteriorated towards the end of the college course. Tristan doesn't have many friends or much of social life, however, he does have his mum who does the majority of his cooking and cleaning. Tristan has been referred to as the primary health care team for assessment due to his mother’s concerns. Upon mental state examination, Tristan was casually dressed although reluctant to maintain eye contact, with limit facial expressions and closed body language. He also appeared anxious and agitated with a very limited vocabulary. Taking this is into consideration, there was no evidence of thought disorder. When challenged about the bizarre behavior that led to him being fired, Tristan became quite excitable and animated with his speech and body language. He explained the event leading up to him being fired, which seemed quite unrealistic and showed signs of paranoia, as well as appearing to respond to unseen stimuli. Tristan expressed he was not concerned about being fired from his job. After Tristan explained what had occurred, he reverted to closed body language with limited speech, he appeared very unconcerned about what had happened, denying and lack of sleep, loss of appetite, or stress as a result of the incident. Tristan's mum had further concerns, regarding his behavior, as he was displaying signs of being very paranoid, staring or watching neighbors, shouting, and responding when he is alone, particularly in the evenings.

LO1 – therapeutic relationships

The therapeutic relationship refers to the relationship between a healthcare professional and a patient. It is the basis upon which a nurse and patient hope to engage and communicate with each other in order to effect beneficial change in the patient (Abuse, 2013). As with all relationships, it is essential that the therapeutic relationship is mutually respectful, professional, caring, and has clear boundaries. In this particular case scenario, the therapist should help Tristan feel more welcomed. For instance, Tristan can choose the date and place where him and the therapist can meet and discuss issues concerning his health. Tristan is withdrawn from the society, therefore, the therapist can make a point of ensuring that they meet a private place even if it means meeting in the confines of his room. Also, the therapist should note that forming relationships take time, especially relationships that need trust and closeness. The therapist needs to focus on small talks which interest Tristan such as video games and looking for hidden prizes in snowflake boxes. In no single situation should the therapist judge Tristan situation. It is only through genuine a genuine use of polite language that can make Tristan open up to the therapist.

A therapeutic relationship shapes the thoughts, actions, routines, and elevates the mood of the patient. First, the therapist has to be genuinely engaged in the conversation and positively regards Tristan. As seen from this case scenario, Tristan uses monosyllabic words to express himself, without generating enough interest, the therapist will not be able to develop a genuine relationship with him. Therefore, the best way to about it is having unconditional positive affection toward him so that he cannot feel out of place during the conversation.

 

 

 

. In simpler terms, therapeutic relationships map out recommendations and present the patient with immediate solutions to his current predicament. Before the commencement of any psychotherapy, a patient must connect with the medic or therapist. Numerous factors impact the end outcome of fruitful treatment (Patel et al., 2007). The patient has to believe that counseling will lift off his or her challenges. An effective therapeutic relationship forms the basis upon which the therapist communicates the patient’s challenges hence an effective therapeutic relationship should be able to establish mutual trust between the service user and the therapist, lead to a common perspective on the viewpoints of the outcomes of the therapy, mutual and informed decision making.

 A therapeutic relationship is tailored according to the needs of the service user and the patient or service user must perceive it as thoughtful, reassuring non-judgemental behavior integrated within a secure surroundings during which one can feel at ease while conversing about personal challenges (Davydov et .al, 2010). These relationships are to last for short instances or can extend based on the service user's needs. Normally, a therapeutic relationship demonstrates openness, sincerity interest, responsiveness, and the desire to facilitate and support the service user. Consequently, therapeutic relationships foster a sociable atmosphere that enables the effective exchange of information between the service user and the therapist (Keyes, & Lopez, 2009). Therapeutic relationships between the service user and the expert may lead to improved patient fulfillment, sticking to medication regulations, improved quality of life, decreased nervousness and depression levels, and decreased medical expenses. Conversely, if the patient’s condition worsens, then the therapeutic relationship is not effective. Therapeutic relationships have the ability to cultivate and strengthen the association between the medic and the service user. Subsequently, giving supportive surroundings enhances communication between the service user and the therapist. It is vital to note that therapeutic relationships influence service experience (Maroda, 2009). Thus communication between the patient and therapist underpins service user’s perceptions and helps on the development of trust and engagement.

 Effective communication skills assist in the attainment of usable information from the service user (Kieling et al., 2011). Secondly, effective communication skills can gauge the status of the patient and identify a suitable remedy for the patient’s condition and emotions. Communication can be either verbal or nonverbal. In this case, Tristan can be told to nod his head if he does not feel like talking. Also, the therapist can use images to make the therapy sessions livelier. Nonverbal forms of communication are effective because they force Tristan to communicate things he found uncomfortable speaking about. Both forms of communications assist the therapist to spend more time while assessing the patient and getting rid of misunderstandings that might have occurred during the entire therapy session. The service user needs to feel safe and relaxed and return articulate his thoughts and perspectives without regardless of the therapist’s values on issues (Walsh, 2011). The therapist should not treat the patient like a contract but as a person who is in dire need of help. The exchange of decent conversation and the flow of reliable conversation between two the service user and the therapist brings about a solution at the end of the day.

LO3 Health Assessment Strategies and Tools

 In this particular case study, one of the assessment strategies used is observation. As evidenced by the case study, Tristan is unemployed due to a mishap that occurred at work. Through observations, his parents noticed that he is withdrawing from social life and staying within the confines of his quarters day after day (World Health Organization, 2013). Observation is one of the most reliable assessment tools as Tristan's parents can tell whenever their son deviates from normal behaviour (Saraceno et al., 2007). Tristan locked himself away in the confines of his flat and no one from outside could see his activities as the curtains were always drawn. It is hard to tell the state of his mind while he is locked away in his flat. Observation is the first step in obtaining first-hand information from a patient. No one is as close to the patient as his parents are. The only way the parents can retrieve their son's activities is by accurately understanding his behavior and underlying factors influencing those behaviors. Figuring out vital issues helps in the development strategy needed to address these subject matters. Observation is a collective effort in which Tristan’s parents have ensured that the therapist interprets. From the factual information emerging from observation assessment, Tristan needs the help of a therapist so that he can improve his life and resume a normal life. In this specific context, observation gave Tristan’s parents the chance to monitor and evaluate his condition and later document evidence of facts grasped and gotten (Slade, 2009). Sighted activities and happenings in Tristan’s residence created the context needed to evaluate his mental status and defined his challenges based on the observations. This way, the therapist was able to get detailed insights and comprehension of the underlying issues driving him toward depression (Slade et al., 2009). The key is applying observational information to Tristan’s situation and then trying to find a suitable solution to his mental situation. For instance, Tristan lost interest on a day to day activities such as watching television, lost friendships over time, and spent most of his time indoors playing video games. The observation was the only assessment tool that was able to gather these facts over a period of time hence was reliable and effective in the long run.

 An alternative assessment strategy applicable to the Tristan case is interviewing schedules. Observation helps in the collection of information for evaluation purposes. On the other hand, interviewing schedules’ aim is collecting data and then placing them in a relevant context. An interview helps level the playing field for both the patient and the therapist. This is a two-way conversation between the patient and the therapist (Seedat et al., 2009). It is a useful procedure for both Tristan and the therapist. In this scenario, the specialist had to examine Tristan’s situation from his point of view and then dissect each detail. The specialist recounts the facts of the case in order to help the patient put everything in his perspective. Normally at this point, the specialist is trying to observe his patient's behavior and tailor the treatment to fit his personality (Eisenberg et al., 2007). For example, during the interview, Tristan’s clothes were untidy, and his baseball cap hid his facial features throughout the entire interview. The specialist designed his questions to fit observable evidence. During the interview, Tristan was nervous and gave out short monosyllabic answers. However, the specialist never observed any symptoms of a thought disorder.  The interview provided a face to face interaction between the patient and specialist thus establishing a certain objective for both of them (Zivin et al., 2009). Moreover, the interview relied on pre-structured questions based on his parent’s sentiments and the interviewer’s observations and analysis. The interview helped in cementing the familiarity between the Tristan and the specialist which in turn facilitated the development of familiarity. The direct contact Tristan had with the specialist was enough to take not of his animated conversation tone and his excitement. The specialist can detect and isolate the challenges he is undergoing. The professional could observe the physical traits of the service user and then check for extra details that might assist in solving the mental issues the patient is undergoing daily (Kessler et al., 2008). Furthermore, during an interview, the specialist ensured that Tristan’s experience was natural and the conversations revealed the challenges he faced. Occasionally, if the service user needs the interviewer to question him on other issues that are outside the subject matter scope, the specialist can always oblige with the hope that it will still solve the main predicament (Corrigan et al., 2014). A successful interview should be in line with the assessment schedule hence permitting the conversation to flow easily, motivating the service user to disclose more about the situation while at the same time directing him what needs to be done. This way, the specialist ensures that all aspects of the patient are covered and nothing is left unattended to. In simple terms, the specialist has to make the exchange between Tristan and him as natural as possible.

LO4 Principles of Risk Assessment, Risk Management, and Positive Risk-Taking

Principles of risk management entail professional obligation towards the service user. The medical needs are aligned with personal issues and public safety (Reiss, 2013). Medics are supposed to balance the service user's decision making and independence with personal demands, proficiency, and public responsibility. Managing risks must concentrate on decreasing risk while at the same time ensuring that possible benefits are recognized and increased. Each day the mental health medics are supposed to adhere to specified duties stipulated under medical and safety regulations such as protecting his safety as well as that of others (Keyes, 2012). For the sake of proper risk management, the service user and the professional must all play their roles effectively. The family is not left out of the equation as they have a role to play in minimizing risks associated with service users.

 In this case scenario, Tristan’s mental condition is to be handled in the same manner as other medical conditions. The reason for treating Tristan’s mental condition like any other medical condition is to avoid arousing any suspicion from him. This will make him less defensive and obliged to accept any medical evaluation that may be required in the future (Rickwood et al., 2007). The professional is supposed to make his situation sound as normal as possible. Portraying him as crazy will paint the situation as abnormal and hinder the medics from finding a suitable solution. Therefore, just like any medical condition, the specialist is to identify the underlying factors, evaluate the risks, examine the situation, and then present a lasting solution based on Tristan's needs. Supplementing professional efforts to stabilize the condition and bring about an accepted methodology, Tristan and his parents are to be involved in the decision making process (Greenberg, 2014). The risk management mechanisms are to provide both parties with the best solutions which will in turn increases the chances of a positive outcome and create a good rapport between the Tristan and the professional.

 Tristan's case worsens each day and the medic must draw out a risk management plan based on his condition. For illustration, Tristan's mother claimed that his son withdrew from her hence raising her concern. Tristan would avoid meeting his mother whenever he came into his room. Entertainment facilities such television were moved into his bedroom (Lamers et al., 2011). The professional has to address all these issues in his treatment plan in order to minimize the risks. Thus, the mental health specialist has to increasingly give education and therapy based on the facts tabled. There is sufficient information on Tristan's perceptions and the specialist needs to direct his patient on critical matters. Exploring family vulnerabilities will help in unveiling Tristan's perceived control hence enable in the development of coping mechanisms and setting the pace for counseling.

 In Tristan’s situation, the objective is to handle risks in a manner that improves the quality of his social life, to revive family relations he once had with his family members and at the end of it, all stop the condition from worsening. Not all risks are to be effectively managed or moderated effectively, however, some of the risks are predictable (Gilbert, 2007). For instance, the service spends most of his time isolated from the entire world. From this point, the specialist can formulate a plan to make Tristan socialize with the outside world. Positive risk-taking will allow Tristan's family members to critically isolate potential risk factors and benefits to attain the desired result (Milliken et al., 2007). The role of the professional will comprise motivating and supporting all of them in positive risk-taking. As long as Tristan's situation gradually improves, all risks will be minimized and the feedback from both parties will be satisfactorily examined. Hence risks taking should be considered a priority during the entire treatment plan.

LO5 Consider Relevant Legal and Ethical Issues When Delivering and Evaluating Care

 Since patient care is multifaceted and established on ethics and lawful requirements, ethical and legitimate obstacles ought to be considered (McManus et al., 2016). Perceptively, Tristan's deteriorating mental condition should be analyzed from both an ethical and legal angle. According to mental health ethical norms, patient safety, and averting or mitigating any additional damage is a primary priority among the medics. Hence, the ethics and safety of the patient are one of the most emphasized aspects of delivering quality mental health care all over the world. Correspondingly, Tristan is supposed to be handled within a health system that assures him of his safety, prevents any mishaps from occurring, and approaches his condition with systematic efficiency it requires (Lorenc et al., 2012). Thus, Tristan will attend a medical institution with a certified mental health program and reputable clinical governance hence providing a framework that will facilitate the delivery of quality of mental health care according to ethics and legal legislations.

From Tristan’s case, one can tell that he went to a mental facility willingly. In other words, he was a voluntary patient. According to the Mental health Act, if need be a patient can be forcefully detained and medicated without any agreement. However, in this particular case, Tristan's condition can be contained and observed (Pierson, & Hayes, 2007). The specialist examines, diagnoses, and medicates based on first-hand information received from the patient’s parents. However, in this individual circumstance, Tristan's condition has already been gauged and his mother confirms that her son might be hallucinating. Most of the time, the patient wants no one near his personal space. Thus, from evidence, Tristan’s mental condition is not urgent and he is not a danger to the other people hence there is no reason to forcefully treat his condition.

 Under the Mental Health Act, families and friends are advised to critically collaborate with the mental health care medics unless otherwise. In this context, Tristan is still in contact due to the proximity of his quarters (Liotti, 2007). The parents visit him from time to time and are genuinely concerned about his conditions. Lately, he only uses his bedroom and bathroom thus making it hard for his parents to monitor his whereabouts. These actions prompted them to seek the help of a mental institution.  Sometimes, Tristan's parents can spot him peering through his bedroom curtains. His bedroom window looks across the neighbor's' compound and the neighbors complained of Tristan’s stares. This evidence details a containable situation as he does not pose a danger to himself and the community. The isolation graduated to hallucination and at this actual point his parents sort professional help. Isolation from the outside world, Tristan began creating an imaginary situation and then responding to imaginary people. Thus, his parents intervened so that they could seek out help for me.

 After establishing that Tristan's situation falls under a non-emergency category, the law requires a family member or guardian to voice their concerns just as Tristan's mother did. Discussing the situation with a specialist assists the patient to get the much-awaited help that he needs (Abraham et al., 2010). The only solution is bringing about a solution and ensuring that everything returns to normalcy. Tristan can truly change if only the specialist treats his case confidentially and preserve his dignity according to the law availed to protect him.

 Professional mental health specialist practices with sympathy and esteem for the characteristic self-respect, value, and exceptional characteristics of all the patients. A specialist should handle his or her patients respectfully and use dignified language while communicating with the patient (Gu et al., 2015). It is vital to note that a patient’s family members should also be treated with care and respect in order to foster an effective relationship and allow the unbiased flow of information from one person to the next. As stated earlier, mental health is a result of a combined effort between the family members and the patient himself. It would be prudent for the specialist to commit to both the service user and his parents or community for the sake of catering to each and every need that might arise during the treatment. Besides, the specialist principal obligation is dedicated to the service user and other people's concerns should come second (Fonagy & Allison, 2014). The specialist has to look at all the aspects of the situation and then deal with immediate issues first. For example, Tristan might be hiding an important underlying factor from his parents. It is the specialist duty to unveil such issues because it is not normal for one to neglect social life and live in isolation. Therefore the inclusion of the service user's thought into the treatment plan is the best way of letting the patient feel appreciated and catered.

 In the process of trying to find a solution for Tristan, the specialist ends up promoting, advocating and protecting the rights, well-being, and safety. This is in line with mental health regulations (Freedland, 2011). The specialist should have all the privacy guidelines on his or her fingertips so that the patient is assured of a treatment plan which considers and meets all his medical needs both ethically and legally.

LO2 Evidence Base Required To Care for and Support People with Acute Mental Health Conditions

 As earlier stated, the specialist tailors the medical treatment according to the patient's symptoms and wants (Hasson, & Joffe, 2007). The meeting place between a patient and the specialist sets forth the mood for everything. Speaking, language and the kind of the atmosphere surrounding the conversation depends on the meeting location. This is the underlying reason experts consider the meeting location before anything else can happen. Individual personality and the ability to interpret the questions might the first signal of recovery. In an effectual planning process, the patient and the specialist have to be on the same page for the sake of uniformity and engagement (Pope et al., 2011).  More so, in the care planning process, the specialist is to remain objective in terms of assessing the service user’s support plan and then evaluating personal data such as screening and evaluating the information received. Motivating the service user to invite their family members for support purposes and decision making makes the planning process more open and objective oriented tasks. Secondly, holding a conversation with the service user or his relatives builds on the relevant information already availed during the entire medical session. This way, the specialist concentrates on how his or her expertise can bring about a lasting solution to the impending situation. Thirdly, the utilization of a support plan as a fundamental point for the discussion aligns the service user's personal goals with the family's interests and keeps on track all the collaboration effects of the entire plan (Wahlbeck et al., 2010). Lastly, collecting reactions from everyone participated may help in the implementation of a useful implementation plan. For instance, Tristan's parents are to be involved all the way and if the neighbors feel that they can be of value, then they can also be updated on his progress throughout the entire medical treatment plan.

Tristan's recovery plan is inclusive of his daily routines and the manner in which he responds to social settings. Despite adhering to his daily routine, Tristan is in a sensitive situation, that is, he has to ensure that he abandons his usual routine if the recovery plan is to work. The formation of new routines will motivate him to acquire new habits which will then need the direction and application of the specialist concepts and ideas (Almlöv et al., 2011). At this particular point, the role of the specialist has to rely on past notes in order to assess and then evaluate how the patient is feeling.  Habitual change can be enforced by inviting his elder sister and her family to the parental flat (Roche et al., 2014). This way, numerous people create more socializing opportunities for Tristan. Even if he is reluctant, he will be forced to adjust his attitude towards other people. This might be effective in two ways- eliminating loneliness, altering the dynamics of the situation, increases human contact, and decreases Tristan's loneliness. Consequently, increasing contact may lead to a boosted self-esteem and conversational induced atmosphere (Benson et al., 2016). On the other hand, the ability to regulate the outcome. Each therapy session should be about solving Tristan’s challenges. The current situation is already well known and documented by both the parents and the specialist. The perspectives of both parties are accessible and the specialist has settled on a solid plan that would help his patient achieve the desired result (Blow et al., 2007). At the very least, the specialist can begin taking notes of the patient’s progress and the steps he is making in realizing a social life and reduced anxiety. Also, the specialist should ensure that Tristan has access to basic mental health facilities. The need for a group-based approach during the implementation of the treatment plan delivers care based on prior recommendation and it can then be facilitated through the mental healthcare of the specialist who takes notes of everything and approves only suitable recommendations. Assessment of each session is supposed to unveil a new problem and let the specialist deal with it as soon as it arises. The trick is getting rid of each and every underlying problem that might be fuelling the surface symptoms. Anti-social behaviour does not emerge suddenly hence the need to treat the patient

 In summary, mental health is pivotal in the management of emotions, actions, and even lifestyles. Normally, humans are social beings and any deviation from a social aspect should be a deviation from normal behavior. Tristan's antisocial behavior and withdrawal from public spaces seem to be driven by unemployment. He is not remorseful for his mistakes and is not accountable for his actions. Therapeutic relationships establish the foundation for trust, effective communication, and bonding for both the patient and the specialist. The service user has to be assured of the specialist's commitment and confidentiality so that he can feel free to open up and reveal everything to the specialist. The exchange between the specialist and the patient has to be mutual and respectful in order to detail the extent and severity of the patient's situation. Observation and interviewing are some of the data collection methods applied to this particular case study. 

 

 

 

 

 

 

 

 

 

 

Reference

Abraham, A., Sommerhalder, K., & Abel, T. (2010). Landscape and well-being: a scoping study on the health-promoting impact of outdoor environments. International journal of public health, 55(1), 59-69.

Abuse, S. (2013). Mental Health Services Administration. Results from the, 2, 013.

Almlöv, J., Carlbring, P., Källqvist, K., Paxling, B., Cuijpers, P., & Andersson, G. (2011). Therapist effects in guided Internet-delivered CBT for anxiety disorders. Behavioural and Cognitive Psychotherapy, 39(3), 311.

Benson, J. D., Szucs, K. A., & Mejasic, J. J. (2016). Teachers’ perceptions of the role of occupational therapist in schools. Journal of Occupational Therapy, Schools, & Early Intervention, 9(3), 290-301.

Blow, A. J., Sprenkle, D. H., & Davis, S. D. (2007). Is who delivers the treatment more important than the treatment itself? The role of the therapist in common factors. Journal of marital and family therapy, 33(3), 298-317.

Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest, 15(2), 37-70.

Davydov, D. M., Stewart, R., Ritchie, K., & Chaudieu, I. (2010). Resilience and mental health. Clinical psychology review, 30(5), 479-495.

Eisenberg, D., Golberstein, E., & Gollust, S. E. (2007). Help-seeking and access to mental health care in a university student population. Medical care, 594-601.

Fonagy, P., & Allison, E. (2014). The role of mentalizing and epistemic trust in the therapeutic relationship. Psychotherapy, 51(3), 372.

Freedland, S. J. (2011). Screening, risk assessment, and the approach to therapy in patients with prostate cancer. Cancer, 117(6), 1123-1135.

Gilbert, P. (2007). Evolved minds and compassion in the therapeutic relationship. The therapeutic relationship in the cognitive behavioural psychotherapies, 106-142.

Greenberg, L. (2014). The therapeutic relationship in emotion-focused therapy. Psychotherapy, 51(3), 350.

Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical psychology review, 37, 1-12.

Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical psychology review, 37, 1-12.

Hasson, N., & Joffe, V. (2007). The case for dynamic assessment in speech and language therapy. Child Language Teaching and Therapy, 23(1), 9-25.

Kessler, R. C., & Ustun, T. B. (2008). The WHO mental health surveys. Global perspectives on the epidemiology of mental disorders.

Keyes, C. L. (Ed.). (2012). Mental well-being: International contributions to the study of positive mental health. Springer Science & Business Media.

Keyes, C. L., & Lopez, S. J. (2009). Toward a science of mental health. Oxford handbook of positive psychology, 89-95.

Kieling, C., Baker-Henningham, H., Belfer, M., Conti, G., Ertem, I., Omigbodun, O., ... & Rahman, A. (2011). Child and adolescent mental health worldwide: evidence for action. The Lancet, 378(9801), 1515-1525.

Lamers, S. M., Westerhof, G. J., Bohlmeijer, E. T., ten Klooster, P. M., & Keyes, C. L. (2011). Evaluating the psychometric properties of the mental health continuum‐short form (MHC‐SF). Journal of clinical psychology, 67(1), 99-110.

Liotti, G. (2007). Internal working models of attachment in the therapeutic relationship. The therapeutic relationship in the cognitive behavioral psychotherapies, 143-161.

Lorenc, T., Clayton, S., Neary, D., Whitehead, M., Petticrew, M., Thomson, H., ... & Renton, A. (2012). Crime, fear of crime, environment, and mental health and wellbeing: mapping review of theories and causal pathways. Health & place, 18(4), 757-765.

Maroda, K. J. (2009). Psychodynamic techniques: Working with emotion in the therapeutic relationship. Guilford Press.

McManus, S., Bebbington, P. E., Jenkins, R., & Brugha, T. (2016). Mental Health and Wellbeing in England: the Adult Psychiatric Morbidity Survey 2014. NHS digital.

Milliken, C. S., Auchterlonie, J. L., & Hoge, C. W. (2007). Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. Jama, 298(18), 2141-2148.

Patel, V., Flisher, A. J., Hetrick, S., & McGorry, P. (2007). Mental health of young people: a global public-health challenge. The Lancet, 369(9569), 1302-1313.

Pierson, H., & Hayes, S. C. (2007). Using acceptance and commitment therapy to empower the therapeutic relationship. The therapeutic relationship in cognitive behavior therapy, 205-228.

Pope, W. B., Young, J. R., & Ellingson, B. M. (2011). Advances in MRI assessment of gliomas and response to anti-VEGF therapy. Current neurology and neuroscience reports, 11(3), 336-344.

Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M. R., & Rahman, A. (2007). No health without mental health. The lancet, 370(9590), 859-877.

Reiss, F. (2013). Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Social science & medicine, 90, 24-31.

Rickwood, D. J., Deane, F. P., & Wilson, C. J. (2007). When and how do young people seek professional help for mental health problems?. Medical journal of Australia, 187(S7), S35-S39.

Roche, M., Haar, J. M., & Luthans, F. (2014). The role of mindfulness and psychological capital on the well-being of leaders. Journal of occupational health psychology, 19(4), 476.

Saraceno, B., van Ommeren, M., Batniji, R., Cohen, A., Gureje, O., Mahoney, J., ... & Underhill, C. (2007). Barriers to improvement of mental health services in low-income and middle-income countries. The Lancet, 370(9593), 1164-1174.

Seedat, S., Scott, K. M., Angermeyer, M. C., Berglund, P., Bromet, E. J., Brugha, T. S., ... & Karam, E. G. (2009). Cross-national associations between gender and mental disorders in the World Health Organization World Mental Health Surveys. Archives of general psychiatry, 66(7), 785-795.

Slade, M. (2009). Personal recovery and mental illness: A guide for mental health professionals. Cambridge University Press.

Slade, T., Johnston, A., Oakley Browne, M. A., Andrews, G., & Whiteford, H. (2009). 2007 National Survey of Mental Health and Wellbeing: methods and key findings. Australian & New Zealand Journal of Psychiatry, 43(7), 594-605.

Taylor, S. E., & Stanton, A. L. (2007). Coping resources, coping processes, and mental health. Annu. Rev. Clin. Psychol., 3, 377-401.

Wahlbeck, K., Braddick, F., Gabilondo, A., McDaid, D., Lang, G., & O’Sullivan, C. (2010). European Pact for Mental Health and Wellbeing. Die Psychiatrie, 7(02), 74-80.

Walsh, R. (2011). Lifestyle and mental health. American Psychologist, 66(7), 579.

World Health Organization. (2013). Mental health action plan 2013-2020.

Zivin, K., Eisenberg, D., Gollust, S. E., & Golberstein, E. (2009). Persistence of mental health problems and needs in a college student population. Journal of affective disorders, 117(3), 180-185.