26 Sep Case study Select ONE case study and: Markin
Case study Select ONE case study and: Marking criteria: Maximum word length: 2000 words Case study 1: Agency:The agency is a community mental health team which provides intensive case management to people with severe mental illness in the community. The team is based on the Assertive Community Treatment model which provides outreach services in the community (from 9am to 9pm, weekdays only). The small multidisciplinary team consists of a consultant psychiatrist, two psychiatric nurses and two social workers. They work closely with the inpatient unit. The inpatient unit and the community mental health team are from the same local health district. You are one of the social workers of the team. Your social work colleague is leaving and has handed you the case. Client:Sue, female, 34 years old, was diagnosed with schizophrenia 11 years ago. Background:She has been on numerous types of antipsychotics for a long time. Her late husband, Nick ensured that Sue was taking her medications previously. When he was her carer, Sue’s psychiatric condition had been well managed. However, Nick committed suicide one year ago. He was the main breadwinner of the family. Since then, Sue has been using Nick’s savings to support herself. She also has not been taking her prescribed medications. Sometimes, she would solicit sex at her place for money. Neighbours had reported to the police many times that Sue had been threatening them verbally. Neighbours also reported that Sue had been singing and shouting loudly in the middle of the night. Sue has two children, Sue (12 years old) and Tommy (7 years old). They live in a public two-bedroom apartment. Sue and her family moved from New Zealand to Sydney 13 years ago. Sue has no contact with her family members for the last 13 years except her sister, Janice. Janice occasionally visits them to see how they are coping. However, Sue believes that Janice is spying and plotting to harm her. Presenting problems:A Department of Communities and Justice (DCJ) child protection case worker (Mary) visited the apartment one week ago and found the place to be very dirty. The case worker also noticed that the children had not been going to school for the last five days. Sue was verbally hostile to Mary when she was questioned whether the children had been going to school. Sue started yelling vulgar words at Mary. Mary ran off and reported the case to the police. The police came and arrested Sue. Sue was then brought to the psychiatric ward for treatment. Meanwhile, Janice helped to look after the children while Sue was in the hospital. The inpatient psychiatrist has assessed that Sue will not harm her children physically and is keen to discharge Sue as soon as possible. The DCJ case worker has opposed the discharge as she believes that Sue needs a longer hospitalization. The DCJ case worker questions the ability of Sue to look after her children. Although Janice would like to help, Janice is worried that Sue’s paranoia against her will grow and may eventually harm her. Case study 2: Agency:The agency is a public psychiatric inpatient unit located in a general hospital. The inpatient unit is staffed by a team of psychiatrists, nurses and one full-time social worker. A part-time psychologist and part-time occupational therapist work on alternate days providing additional services to the unit. You are the social worker of the inpatient unit. Client:Bian, female, 24 years old, born in Australia, was diagnosed with major depressive disorder. She has attempted suicide several times by cutting her wrists and taking sleeping pills. She also takes amphetamine and other substances. She has a family doctor who has been managing her family’s health for several years. The family doctor, Dr Lim has good rapport with both Bian and her mum, Thao. However, mum has problems bringing Bian to see Dr Lim for psychiatric treatment. Thao who has been caring for Bian many years, expresses frustrations over Bian’s multiple self-harm and suicide attempts. Bian recently lost her part-time packing job due to being late for consecutive days and poor concentration at work. Background:Bian was raised by her mum in a single-parent Vietnamese family. Mum was pregnant when she left Vietnam during the war. Bian has never seen her dad since mum’s escape to Australia. Mum never talks about her life in Vietnam. In fact, mum is a quiet person and only has a few Vietnamese friends in Australia. Bian was physically abused by her mum’s partner when she was young. She told her mum before but her mum did not do anything. Thao eventually broke up with her partner when Bian was 16 years old. Bian’s younger step-sister, Zoe has bipolar disorder. Mum is the main carer of Zoe. Bian hates Zoe as mum gives a lot of attention to her. Mum is currently looking after Bian’s 5-year-old son, Ben. Ben has just started pre-school this year. Her teacher, Belinda notices bruises on his limbs. Ben also displays disruptive behaviour in class, often snatching toys from other children and spitting at them. His teacher is concerned about Ben’s behaviour. Presenting problems:Bian was recently admitted to the psychiatric unit for a relapse. She was sleeping poorly and felt that her colleagues were laughing at her for losing her job. Mum was worried about the safety of Bian and brought her to the hospital. Bian thinks that she is fine and wants to go home to look after her son. The Consultant psychiatrist will not discharge Bian in the next two weeks and is very concerned about the safety and treatment of Bian. She was referred to the unit social worker for counselling and discharge care planning. Case study 3: Agency:The agency is a community-based organisation which provides one-to-one counselling services, home-based outreach, group work and case management to youth with behavioural or mental health problems and their families. The agency only employs social workers and counsellors. You are one of the social workers of the community-based organisation. Client:Michael (19 years old) is in year 12. He was first seen by a public youth mental health team three years ago. Since then, he has multiple admissions to the psychiatric unit. His diagnosis has been revised from early psychosis to schizoaffective disorder recently. He was discharged from the youth mental health team to a private psychiatrist for follow-up and psychiatric treatment. He believes that he is not mentally ill and does not take his medications regularly. Background:He is the eldest child of the family. His father, John works long hours as a plumber. Michael’s mother passed away when he was 3 years old. Michael’s two step-siblings – David (16 years old) and Pauline (12 years old). His father has high expectations for Michael to excel academically and be successful in life. John tries to care for Michael as much as possible but his ability to care for Michael is limited by his long working hours. John has experienced frequent headaches, insomnia and fatigue recently. John continues to work long hours to support the family. John’s wife is very critical of Michael. She often yells at him. Michael’s teacher, Mrs Hamilton wants to know the progress of Michael’s treatment and his plans for his studies. She also wants to know how she can support him in school but she has limited information of Michael’s mental health condition. Michael has few friends in school as he often keeps to himself. His classmates also keep away from him as they find Michael odd in his communication and behaviour. Presenting problem:Michael does not have many friends. He recently met a girl named Charlotte. They got along very well. Charlotte was from a well-to-do family and performed well in school. Two weeks ago, Charlotte stopped seeing Michael due to her parents’ objection. Michael was devastated and started drinking alcohol. Last week, he was found sitting on the edge of a school window. His teacher managed to persuade him to calm down and talk through his problems. That night, his father sent him for psychiatric admission. His condition improved quickly and he was discharged in two days. His father wants him to continue his education. He also has huge expectation that Michael would get better quickly. However, Michael is not too concerned about his studies now. Since discharge, he has been lying in bed and staring into the ceiling. He is still feeling sad over his broken relationship with Charlotte. Julia is worried that Michael will harm himself. The hospital social worker referred Michael and his family to the agency to provide case management and other relevant interventions in the community. Michael has been advised to contact his private psychiatrist to book an appointment. ———————————————- End of Assignment Three ———————————-
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