Executive Summary
This report analyzes the determinants of Rebecca’s health, the significant life events affecting her health, and the coping mechanisms she can use based on the case study provided. The report aims to assess the factors influencing Rebecca’s mental and physical health and propose effective coping strategies to improve her quality of life. The report identifies social network and economic capability as Rebeca’s mental health determinants. Rebecca’s mother’s impending death weakens her social network, hence diminishing her social support and exposing her to adverse mental health outcomes. In addition, the reduced social support may aggravate Rebecca’s financial struggles, exposing her to psychological and emotional challenges. The report establishes that Rebecca’s mother’s impending death and her cancer diagnosis are the two significant life events impacting her mental and physical health. The two events will likely lead to depression, anxiety and other adverse mental health outcomes. In addition, the stressful events will likely trigger stress activation, which could progressively increase the risk of cardiovascular and infectious diseases. However, Rebecca can cope with the stressors by seeking social support and adopting self-management practices such as physical activity and relaxation. The report recommends that Rebecca should start psychotherapy and seek support to put her mother under palliative care while adhering to her own treatment processes.
Introduction
Mental health is becoming a public health issue in the UK as the number of people with mental health challenges keeps rising. According to the NHS (2024), one in four adults and one in ten children experience mental illness in the UK and this number are expected to increase. As such, it is essential to put in place mechanisms to help people with mental health illnesses to cope. Factors that influence mental health are socioeconomic, cultural, or emotional in nature (Neil, 2019). This report examines the determinants of mental health, the significant life events that may predispose people to mental illnesses, and the coping mechanisms they can use. The report is based on a case study in which Rebecca faces challenges that increase the risk of mental health illnesses. The first part of the report identifies two determinants of Rebecca’s mental health, followed by identification of two significant life events that increase Rebecca’s mental health risk and two coping mechanisms.
Determinants of Mental Health
Social Network Factors
One of the determinants of mental health from the case study is social connectedness. Human beings live in networks of social connections upon which they depend for daily sustenance and support. The social connections provide several benefits related to health and wellbeing, including nurturance, and mutual protection. As Ian (2023) explains, social networks provide complementary health resources, which can be affective or instrumental. Rebecca’s family provides affective health resources in terms of emotional support, love and care and instrumental resources in form of material support in case of an illness. However, her mother’s terminal illness and the impending death is a significant stressor. The fact that her only source of social support is about to die can trigger negative mental health outcomes including depression. Based on Anisman (2021) perspectives, stress directly or indirectly causes illness by activating physiological and behavioral responses that impact on physical and mental health. For instance, the imminent death of Rebecca’s mother can cause anticipatory stress and stimulate psychological disorders and potentially damaging coping mechanisms. As such, Rebecca might feel socially isolated, triggering stress.
In addition, Rebecca’s single parenthood is a potential stressor, aggravated by the impending death of her mother. Ian (2023) points out that marriage buffers against stressful events but the absence of one parent can increase stress. Raising a child with mental disability adds to the stressors already identified because the child requires specialized support and attention, which Rebecca may not be in a position to provide without the emotional support of a significant other. In addition, mothers bear the burden of childcare in cases of separation or divorce, which may be emotionally and physically taxing (Atkins, 2010). The burden of childcare notwithstanding, single mothers also deal with social stigma and judgement in some societies, lowering their self-esteem and predisposing them to depression. Rebecca potentially faces these risks, which may have trigger negative mental health outcomes in the long run.
Economic Factors
In addition, Rebecca is likely to face economic challenges that might reduce her ability to cope with mental and physical health. The fact that she is divorced predisposes her to financial challenges due to reduced income. Therefore, she might encounter challenges in meeting the needs of her children and the cost of her medication and that of her mother. Micheal and Ruth (2014) find a correlation between the income level and health outcomes, stating that low income is associated with negative health outcomes. Rebecca may find it difficult to afford specialized care and education for her child who has a learning disability. In addition, she may find it challenging to afford medical treatment for herself and her mother, including meeting the cost of end-of life care. The challenges of accessing healthcare services may increase the risk of negative psychological, emotional and physical health outcomes (World Health Organization, 2007). Apart from meeting the cost of care, since Rebecca is the primary bread winner for her family, taking care of basic needs such as nutrition and housing can be challenging. She faces many competing needs that could progressively exceed her financial ability to provide her dependents with a quality life. For instance, she might be forced to cut back on spending on basic needs such as food, which means the family’s overall quality of life is likely to reduce. Poorer living conditions could increase the family’s vulnerability to mental health.
Significant Life Events
Her Mother’s Terminal Illness and Impending Demise
Significant life events are events that can fundamentally interfere with the normal course of life, necessitating permanent or temporary adjustment to habitual life (Ian, 2023). One of Rebecca’s significant life events is her mother’s terminal illness and her impending demise. Cohen et al. (2019) indicate that the loss of a loved one is one of the most potent life events that causes mental health challenges such as stress and depression. Lazarus and Folkman’s transactional theory of stress and coping states that individuals may perceive an event to produce significant harm or loss an event may, provoking negative emotions (Biggs et al., 2017). For Rebecca, adjusting to the life of a caregiver for her mother is likely to be challenging because she is already burdened by single parenthood and her own illness. She needs to organize for her mother’s end-of-life care, which can be overwhelming especially because she could be having financial problems as demonstrated by the fact that she needs help herself. As she progressively witnesses her mother’s last days of life, she is likely to accumulate more stress and anxiety. Based on Cohen et al.’s (2019) perspectives, the stress of a significant life event depends on the amount of adaptation one requires to cope with it. Since her mother’s impending demise is uncontrollable, Rebecca will be forced to expend more personal resources to adapt to or prevent the imminent threat. In addition, Rebecca’s children are likely to experience adverse mental health outcomes such as anxiety and depression as they struggle to come to terms with their grandmother’s illness and imminent death. As such, Rebecca has to contend with the impacts of her mother’s death on herself and her children, which can be emotionally and psychologically burdensome.
Breast Cancer Diagnosis
Rebecca’s breast cancer is another significant life event that she faces. Research indicates that cancer patients experience higher levels of depression and anxiety as they adapt to life after diagnosis (Niedzwiedz et al., 2019). Rebecca must be dealing with depression since she was diagnosed with breast cancer, and the depression is likely to increase as she deals with her mother’s illness. Lazarus and Folkman’s transactional theory of stress and coping states that a patient assesses or appraises an event to identify the demands it places on them and their ability to cope with those demands (Biggs et al., 2017). Life events such as cancer diagnosis can be a source of distress especially when the patient finds it hard to accept the results, reducing their ability to cope with post-diagnosis health implications. Multiple stressors, including her mother’s impending death, single parenthood, and caring for a mentally challenged child fundamentally reduce Rebecca’s ability to cope with the breast cancer. In addition, Rebecca is likely to experience hopelessness and uncertainty regarding her survival because of the perception that cancer is debilitating and incurable. These factors, in addition to sleep disturbances, can increase the risk of depression.
Moreover, Rebecca is likely to suffer from stress related with cancer treatment. As Niedzwiedz et al. (2019) explain cancer treatments such as immunotherapy and chemotherapy can negatively impact on individual physical and mental health. However, Rebecca is on remission, which may lessen the severity of depression, anxiety and other psychological health outcomes. There is nonetheless the possibility of fear of cancer recurrence because being on remission does not mean that one is cancer-free. James et al. (2022) explain that the fear of cancer recurrence alongside negative illness perceptions can cause psychological distress among cancer patients. Therefore, Rebecca’s mental health faces several risks in the course of treatment and care as highlighted above. However, not all stressful life events can cause mental illness. Although it is not explicitly stated in the case study, it can be assumed that Rebecca could be resilient during treatment based on her demonstrated endurance of the multiple stressors. From all indications, however, the multiple stressors fundamentally reduce her coping ability, necessitating identification of effective coping mechanisms.
In addition, the stress emanating from Rebecca’s mother’s impending loss and her breast cancer is likely to negatively affect her physical health. Based on Cohen et al.’s (2019) perspectives, prolonged stress activation is associated with physical health challenges such as clinical cardiovascular diseases resulting from dysregulation of lipid and glucose levels, elevated blood pressure among other risk factors. Rebecca is also at an increased risk of infectious diseases due to the stress from the two significant life events. Individuals’ resistance to infectious agents reduces with increased exposure to stressful life events (O’Connor et al., 2021). In addition, Rebecca’s mother and her children are likely to be exposed to stress activation, increasing the risk of infectious diseases and cardiovascular diseases. The negative physical health effects could be particularly detrimental to Rebecca and her mother since the terminal illnesses already take a heavy toll on their physical health. As such, the two significant life events undermine Rebecca’s and her family’s overall health and wellbeing, necessitating coping.
Coping Mechanism Strategies
Social support
In the face of significantly stressful events, Rebecca needs to be resilient to improve her health and wellbeing. According to Giuntoli et al. (2011) resilience is the ability to cope with adversity in a positive way and move forward with life. Building resilience involves increasing capacity to adapt after stressful life events by making healthy choices. Coping is the application of certain mechanisms or behaviors to effectively manage stressful life events (Jane, 2023). Lazarus and Folkman categorize coping into problem-focused and emotional-focused coping whereby the former involves directly managing the stressor while the latter involves regulating the emotions emanating from the stressor (Biggs et al., 2017). One of the coping mechanisms Rebecca can use to minimize the negative mental health outcomes is seeking social support. Such coping mechanism is appropriate because her mother’s death leads to the loss of the much needed social support; an event which essentially becomes a stressor. Rebecca is likely to perceive her mother’s demise as a major stressor because she depends on her for general support. She is likely to perceive her absence as threatening; initiating coping strategies in form of efforts to fill the social gap she will leave. In addition, she needs both material and emotional support to care for her mother, herself and her children. Stephenson and DeLongis (2020) explain that individuals identify and evaluate their coping resources after discovering that a certain event or transaction is threatening or harmful. In Rebecca’s case, her coping resources can be harnessed by building social networks with friends, other relatives, and social groups and organizations. She can reach out to friends or social groups of individuals facing similar life events to hers for encouragement and assurance.
In addition, Rebecca can confide in friends about the various stressful events she is facing to get assistance in household work, parenting and other life activities. However, social support should match the individual’s needs to be effective and make them feel validated. Men and women face differentiated risk of mental health challenges from stressful life events due to differences in gender roles (Cohen et al., 2019). Women are therefore more likely to face risks associated with their care-giving role because they are socialized to perform such roles. Rebecca’s coping strategies can be effective if they are attuned to care-giving, including parenting and caring for her mother. Joining peer support networks of people dealing with cancer as patients and caregivers can strengthen her emotionally and psychologically, and minimize negative mental health outcomes. In addition, peer support networks can offer material support such as information on cancer care, treatment and strategies to improve overall health and wellbeing (Gallagher et al., 2021). However, coping can lead to positive or negative mental health outcomes depending on whether an individual feels they are in control of their situation (Jane, 2023). Rebecca can increase control of her situation by forming more social networks and actively participating in activities that will increase her resilience.
Self-management
In addition to seeking social support, Rebecca can practice self-management, which is an adaptive coping mechanism, aiming to build her resilience in the face of the stressful events. Basing on cognitive adaptation theory, Jane (2023) states that coping is effective when individuals develop a sense of mastery or the belief that they have a sense of control over their illness. Rebecca can develop a sense of mastery through self-care practices such as participating in physical exercise and social activities such as group games. These activities are easier to do because they do not necessarily need the guidance of a professional. Specifically, physical activities such as walking exercises can help to reduce anxiety and depression, and prevent sleep disturbances improving resilience when faced with adversity (Carreira et al., 2021). Rebecca can also routinely participate in meditational exercise such as yoga to calm her mind and body, providing relaxation that has been proven to reduce depression. Other activities she can participate in include getting regular massage to enhance relaxation and help her to manage her depression and anxiety. Participating in these self-care practices improves individual mastery or control over their situation, including the stressors they may experience (Neil, 2019). As such, through participation in these practices Rebecca would gain control over negative emotional disturbances associated with her terminal illness and her mother’s death. Greater control over individual stressful events will promote her resilience to deal with uncertainty surrounding stressful events such as cancer diagnosis and treatment.
Conclusion
Overall, social network or social connectedness and economic ability are the two determinants of Rebecca’s mental health. Her mother’s terminal illness and impending death threaten her source of social support, exposing her to negative psychological and emotional health challenges. In addition, her mother’s loss and her single parenthood increase the financial burden, likely leading to a lower quality of life for the family as well as increasing stress. Rebecca’s mother’s terminal illness and impending death and her breast cancer diagnosis are the two significant life events likely to impact on her mental and physical health. These two events will likely activate stress response, exposing her to the risk of depression and anxiety as well as cardiovascular and infectious diseases. Rebecca can cope with the stressful life events by seeking social support from friends and peer support networks and practice self-care management.
Recommendations
Rebecca should accept that she is faced with significantly stressful life events and adopt the coping mechanisms suggested in this report. However, coping with these events is not easy without the support of professionals and friends. Firstly, Rebecca should talk to a social worker or a counsellor specialized in cancer care that will assess her mental health and provide guidance and support on how to cope with the stressors in her life. Seeking the support of a mental health professional can enhance an individual’s awareness of symptoms of mental health challenges, enabling them to seek treatment such as psychotherapy (James et al., 2022). Such support will also help her cope with fear of cancer recurrence and the anxiety that comes with cancer diagnosis and treatment. Secondly, Rebecca should organize palliative care for her mother as she progresses with her own medication and treatment. If she feels overwhelmed financially, she can seek support from friends, cancer support networks and organizations that offer free medical services. Generally, Rebecca needs social and financial support more than anything else to navigate the responsibilities of taking care of herself, her children and her mother.
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