Mental Illness – What’s eating Gilbert Grape
What psychiatric disorder does the character (s) in the movie you are watching exhibit? Please explain citing specific behavior relevant DSM IV-TR criteria. The character in the movie “What’s Eating Gilbert Grape” one of the main characters suffers from autism, which is characterized by a withdrawal of the child into self and into a fantasy world of his own (Townsend, 381).
According to the DSM-IV-TR the diagnostic criteria for Autistic Disorder that the character in the movie demonstrated were lack of societal or emotional reciprocity, failure to develop peer relationships appropriate to developmental level, marked impairment in the use of multiple nonverbal behaviors, stereotyped and repetitive use of language or idiosyncratic language and stereotyped and repetitive motor manners (such as hand flapping). 2. List 2 nursing diagnoses and appropriate nursing interventions and outcomes for the character in the movie.
The following nursing diagnoses, interventions and outcomes would be effective for the character in the movie: a. Impaired social interaction r/t neurological alterations. In order to allow the patient to become comfortable with the staff then the following interventions should be used: assign limited staff to work with patient while ensuring warmth, acceptance and availability; provide familiar objects for the patient while supporting the patients attempts to interact with others; give positive reinforcement (food or familiar objects) for eye contact and gradually replace with social reinforcement.
A short-term goal would be that the patient carries a conversation with one of his caregivers within one month. b. Disturbed personal identity r/t inadequate sensory stimulation. A few interventions would be: assisting patient to recognize separateness during self-care activities such as dressing and feeding to increase the patient’s awareness of self as separate from others; assist the patient in learning the name of body parts to assist the increase in their awareness of self as separate from others.
A long term goal could be that the patient will develop ego identity by recognizing physical and emotional self as separate from others by the end of six months. 3. What societal or cultural attitudes are reflected in the depiction of mental illness, its treatment and the role of the nurse and other mental health care providers? In the movie “Arnie” did not receive any type of medical treatment for his autism. His family lived in a small town and didn’t have much financial backing or knowledge of his mental impairment to seek medical help.
But when he was around in his town everyone starred at him and shy-ed away from him as if they were scared or intimidated. In today’s society the societal/cultural attitude can vary from welcoming to perceiving that persons with mental illnesses are aggressive and will physically harm or injury anyone that they are not used to. I think that many people still think this way because of characteristics such as perceived aggression, temper tantrums and quick changing moods. 4. What ethical questions have arisen in the movie you are watching?
Some of the ethical questions that arose in my mind were dealing with the lack of medical attention, the lack of education and the lack of purpose. Throughout the film Arnie never seemed to be educated appropriately for his learning capabilities, he never received medical attention and seemed as though he may have been unsure of his purpose in life. Granted the film is unable to portray his entire life, he may have received education but I am almost sure that medical attention was never sought. 5. Does your knowledge of the field of psychiatric nurse change your response to the film, its characters or its characteristics?
Explain. My knowledge of psychiatric nursing doesn’t change my response to the film because I am aware that there are people like Arnie who have mental disorders who live in these rural areas that can’t afford medical attention. This movie predicts this scenario perfectly. And in these rural towns there are people who still prefer not to be around people with mental disorders for whatever their reason may be; as they are unaccepting of it. I believe that being a psychiatric nurse should encompass being open to everyone else’s opinions and realities.
As we would like for everyone to be treated as a person at all times, there are situations where this doesn’t happen. 6. How would you use the film to help clients, families, populations, or health care staff better understand mental illness or its treatment? This film could be used to help people who are impacted or curious about Autism because it provides a clear picture and understanding of what caring for an autistic child entails. It could also help them to understand that even though they have this mental disorder that they are still people and have emotions as we do.
Hopefully this can help them to learn to treat them as they do anyone else. 7. If you were this “character’s” case manager, what strategies would you apply in helping them manage their care? If I were Arnie’s case manager I would suggest that seek medical attention throughout the year, attend a clinic in their area frequently if they are unable to locate a physician that can treat Arnie, and possibly utilize the many at home services or group services provided to help Arnie gain social skills and learn how to interact with others in a more socially acceptable way.
If you were prescribing meds for this client, what would you prescribe? If I were to prescribe medications for Arnie I would suggest that he use Risperdal and Abilify as I think that they would help control his aggression, deliberate self-injury and quick mood changes. As with any medication there are side effects that I would warn his family about when these medications were suggested.
References American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed. ). Washington, D. C. : American Psychiatric Publishing. Townsend, M. C. (2012). Psychiatric mental health nursing: Concepts of care in evidence-based practice (7th ed. ). Philadelphia, Pennsylvania: F. A. Davis Company.