Subject Code : HCS310
Country : Australia
Assignment Task
 

Case Study Analysis

Scenario 1:
David is 18 years old and has just completed year 12. He is an only child and lives with his parents. He has recently recovered from a first episode of psychosis and is being supported in the community by the community mental health team. His mental health has shown moderate improvement in response to oral Olanzapine (antipsychotic medication), but he has marked weight gain which is concerning him. David lost his job in hospitality recently which he believes is due to his ex-manager believing that he was ‘unpredictable’. You are David’s mental health worker and a member of the community care team.
You are meeting David for the first time.  How can the biopsychosocial model help us to better understand David’s current situation?  
What effects might discrimination and stigma have had on David and his family at this point? 

Scenario 2:
You have been meeting with David regularly for some months, but he has begun to avoid your meetings together. The last time you arranged to visit him at home, he was not there. David’s father said that they had organised a family camping trip for that weekend and that David had been organising all of the camping gear that week.  It has continued to be hard to connect up with David because he forgets your arrangements to meet. In the course of visiting another community client near where David lives, you encounter him walking alone in the street and can see that there has been a deterioration in his mental state - that is, he appears withdrawn, has some low grade persecutory beliefs, and tells you things that might mean a worsening of auditory hallucinations.  David’s father calls you later the same day with similar concerns for David’s well-being.
In assessing David, what risk factors are important to identify?
What strengths and protective factors are evident within the scenario for David and his family, in terms of David’s continuing care?  

Scenario 3: 
Six months later David's parents contact you. There has been an incident where David was caught driving dangerously whilst intoxicated, this happened during the day outside the local shopping centre. His family has been told by a friend that David has 'personality issues'. David's family are increasingly contacting your service and the hospital with concerns about David's mental state and risk, but feel unheard.
What effects might discrimination and stigma have had on David and his family at this point?
In looking at David’s situation, what actions need to be considered to assess David’s safety? 
What would be an appropriate response to David’s parents? In discussing this you will need to consider your responsibilities as David’s worker. Also, identify duty of care/legal issues and that may exist and ethical factors that may arise?  
 

Scenario 4:
Three months later David is admitted to hospital in a floridly psychotic state, and intoxicated with amphetamines. He is aggressive to police prior to and during the admission and is secluded for three days on admission. David is supported to detox during his hospital admission and the same oral antipsychotics are reinitiated. His response to the medication is partial. Although David's response to inpatient care is partial, he is returned home after three weeks.
Admission to hospital can be traumatic, disorientating and disempowering. Inpatient hospital settings can be quite impersonal and very routine based.  As his community team worker what actions could you take in supporting David at this time? This can include areas to advocate on David’s behalf to maximise him being treated respectfully; are there rights that need to be protected and what needs to be included in planning for David’s future return to his community.
 

Scenario 5: 
David's abuse of drugs continues, and he ceases taking his medication. David's family can’t cope. David is unable to secure or maintain employment.  David has continued to live 'on the edge' and moves out of home, moving frequently until finally, he moves into a poor quality and unsafe rooming house. 
Reflecting on the experiences of David and his family, describe strategies that you can implement in your role as a mental health worker within the community mental health team to minimise discrimination and combat stigma for your clients and their families.

 

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  • Posted on : September 28th, 2019
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