Local Mental Health Unit - Psychotic Symptoms - Ben Case Study Assignment Answer

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Task: Ben is a 25-year-old single male currently residing as an inpatient in the local Mental Health Unit where he has been a patient for the past 14/7. Prior to this admission, you had been case-managing Ben in the community for the past 9 months. He was admitted with worsening psychotic symptoms over a 4/52 period in the context of poor compliance with his oral medication that he puts down to due to increased stress at home and work. He has been re-established on his medication with good effect and you are seeing him today to review him and discuss his discharge plan before he is discharged home in 2/7 time. Ben is not religious, works part-time as a laborer for his uncle (who is a bricklayer). Ben lives with his parents and his younger sister in the family home. Presenting Complaint: Ben reports increased paranoid ideation in the preceding 4/52 stating ‘they’ are watching him, following him and talking about him. When asked who ‘they’ are he refuses to identify them, stating that if he does “they’ will come after you too”. History of Present Problem: Ben reports first being diagnosed with first onset psychosis at the age of 22. He was studying Engineering at University and was half-way through his final year leading up to mid-year exams when he first became unwell. At this time he experiences paranoid ideation heard voices of a commentary nature. He was treated by the local First-Onset Psychosis Team and made a good recovery over time in the community. Eventually, he was discharged to ongoing treatment via a private psychiatrist and his GP and everything had been going well until 11/12 ago when he experienced a full relapse of symptoms whilst on a family holiday overseas. He had returned to Australia and had been an inpatient in the local Public Adult Inpatient Unit for almost 2/12 at that time and had subsequently been assigned a Case Manager to oversee his progress following this episode. He had initially made slow but steady progress in the community and had started to work for his uncle as a laborer to earn some extra money. This had initially gone well, however, some of the other workers on the building site had started to make fun of him leading to his becoming increasingly stressed and subsequently more disorganized in his thoughts and actions. He also reported beginning to feel quite paranoid about his co-workers and began to suspect that they were planning to harm him or his family. He reports that his poor compliance with medication was accidental and he did not mean to not take them. Ben states that although his paranoia has receded over the past fortnight he has experienced increasing anxiety, feelings of helplessness and worthlessness, as well as feeling overwhelmed by his situation, saying “I did my best last time and it all just fell to pieces; what’s the point in trying now if that’s what’s going to happen?”. Case Study: Tom Dennison: Tom is a 22?year?old single male, who has been an inpatient for the last 11 days and is due for D/C in 2/7 to return home to his parents’ home.

• You are his Case Manager and have visited him on the ward to start work on his Recovery Care Plan.
• Tom has been diagnosed with Schizoaffective Disorder, has had 2 recent inpatient admissions in the last 6 months.
• Tom is currently experiencing intense Derogatory Hallucinations on a frequent basis telling him he is useless and stupid.
• This has been an ongoing issue causing him distress and contributes to his anxiety.
• He has been experiencing thoughts of harming himself in the context of themes of hopelessness and helplessness because of these voices.
• Tom lives with his parents, who provide considerable support.
• Tom enquires assistance with some activities of daily living due to his level of motivation.
• Tom has noticed that he can become uneasy and anxious in crowded public places, though is able to control this, using mindfulness techniques.
• Tom has become socially isolated and has few friends but is keen to develop a new social network.

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