Mental Health Social Work - Don - Fiona - Chloe - Reflective Writing Assignment Help

Mental Health Social Work Don Fiona Chloe Reflective Writing Assignment Help

Assignment Task:

A comprehensive assessment in mental health social work has many aspects. Please identify and discuss the various aspects and potential challenges of assessment.

Scenario One:
Background: Don is a 25-year-old, single unemployed male living in private rental accommodation in Morphettville, in receipt of Newstart Allowance. Don reports he lost his job working at the mussel factory several months ago and to receive his benefits he is required to apply for 20 jobs per fortnight, reports he has not completed this obligation this fortnight and is due to report today. Don is aware that he will be suspended from his payments unless this obligation is completed. Don reports a history of regular employment having previously been employed at a chicken factory until 3 years ago. Don reports his 10-month relationship with Tina, whom he describes as a "Junky", ended 2 months ago. In regards to this relationship, Don states, "it feels like the last year has been a lie". Don reports being consumed by confronting memories of his childhood over the past month.

He states he believes he was "touched" by a priest when he was 5 years old and feels this also happened to his brothers. Don reports having images of his brother coming out of the toilet at church crying and then he (Don) took a knife and when the priest came to him during church, he tried to stab him in the throat. Don reports the priest then grabbed the knife and ran out of the church. Don reports he does not know if these memories are real and feels this means he may be a "murderer". Don reports he does not want to ask his family about these memories as he feels they will deny this happening as they don’t want him to think he is a murderer. Impression: 25-year-old male presenting in the context of voiced suicidal ideation in the context of alcohol use. This is on the background of reported childhood trauma, emotional regulation difficulties, and ETOH++ and THC++ addiction. Nil evidence of psychotic symptomology present. Author unable to exclude the presence of a pervasive mood disorder due to excess/dependent ETOH and THC use. If symptoms continue post-cessation of intake of these substances, further assessment by mental health services may be required. Don would benefit from DASSA support to address alcohol and THC dependence.

Reason for contact:
Don attended RAH ED with sister, Anne, reporting feeling suicidal ideation. Anne was concerned about his safety. Don had consumed some alcohol this evening prior to attending the ED.

Symptoms
Sleep: finds it difficult to fall asleep but will sleep soundly once fallen asleep;
Appetite: reports he does not really eat and reports never being a big eater. Observed to eat whilst in hospital.
Energy: reports he "doesn’t have any";
Motivation: Poor;
Concentration: states he "doesn’t have any".
Don reports he does not find much enjoyment in activities, states he does "nothing" all day, reports surfing the internet, gaming and spending time on Facebook.

AOD
Reports having "cut down" his alcohol use to 3 x binge sessions over the past 2 weeks, but unable to quantify. Reports a history of excessive ETOH use with consumption of a minimum of 8 beers per day. The author observed a notable tremor to hands consistent with alcohol withdrawals during today’s contact. Reports smoking 20+ bongs per day for the past 3 x years. Reports a history of IV use "gear", denies use at present

Suicidal ideation
Reports having fleeting thoughts last night to take "heaps of panadol" in the context of intoxication and not being able to stop thinking about voiced memories of stabbing the priest. Denies any plans or intention to kill himself. Reports he has previously impulsively taken 12 x panadol (over 12 months ago) with no effect. States he had intended to die at the time, "but it didn’t do anything so I just moved on like always". Reports he did not think that he would act on his thoughts as his step-
dad killed himself when he was 7 and would not do this to his sister. States, "I know the damage that can cause". However, he also voiced that sometimes he felt that he had nothing to look forward to, “just heaps of problems”.

Scenario Two:
Fiona lived in a small town in rural South Australia. She was 17 years old when she was first diagnosed with schizophrenia. Following a visit to her doctor, she was referred to a psychiatrist in Adelaide. Fiona is now 25 years old. Two years ago, she moved into a unit in Mount Gambier with another person who is also a client of the local mental health unit. Fiona’s parents try to visit on a semi-regular basis, but the visits seem stilted and often end on a sour note.

Fiona had not been taking her medication on a regular basis for the last several months due to unpleasant side-effects. She has been cutting back on her cigarette intake which also seems to have affected her response to the medication. Added to this, a male friend supplied Fiona and her friend with some ecstasy tablets a month ago. Three weeks ago at a party, Fiona experienced a severe psychotic episode, becoming a danger to herself and others. The police and ambulance were called to the residence and Fiona was taken to the outpatients’ department of the local hospital. A local GP was called, Fiona was detained under the Mental Health Act, and taken to a hospital in Adelaide. Two days ago, Fiona was discharged and returned home. She has now stabilized on new medication. Fiona has been referred to the local mental health unit. Fiona needs to settle back into routine with her housemate. She is also required to attend fortnightly teleconferences with the psychiatrist from
Adelaide. What is your assessment of Fiona?

Scenario Three:
Chloe is a 10-year-old child. She has recently moved to Victor Harbor. Until recently, Chloe was living with her mother in Adelaide. Her parents separated when she was a baby. Chloe lived with her mother, Kate, for the first 10 years of her life. During this time, Kate had multiple partners, several of whom were violent towards Kate. Chloe witnessed this on numerous occasions. Kate says she no longer wants Chloe living with her as Chloe is too aggressive and “shows no respect”. She states that Chloe has been stealing food and money from her for the last year or so. Ten weeks ago, Kate “dumped” Chloe at her father, Peter’s, house saying, “I’ve had enough of her.
You can deal with her now.” Chloe currently lives with her father who is on a methadone program and who is suspected of conducting several break-ins at the local medical clinic, during which time drugs were stolen. Charges are pending. Peter’s mother lives on the same street as Peter and is assuming quite a deal of
the parenting responsibility for Chloe at the moment. She is in a new relationship and sometimes feels “very wearied” by the extra load this is placing on her and her partner.

Peter has a support worker visiting him regularly, arranged by the local community mental health team. He is periodically hospitalized with psychotic episodes (about once per year). He describes himself as “highly motivated to stay off the drugs and to be a good Dad to Chloe”. Both Peter and Chloe seem ambivalent regarding the involvement of Peter’s mother, but see it as a “necessary evil” until Peter can get himself into a more stable and confident position regarding his life and his parenting of Chloe. While Chloe is generally very cooperative and obliging in class, her teachers also report that she can be very “vague” in class quite often. Several times a week, Chloe complains of stomach pains and asks to go home. The referral to the local CAMHS has come from the GP whom she saw for the stomach pains. In the process of examining Chloe, the GP discovered that Chloe had begun to dig at hidden parts of her arm, drawing blood. In the first two months of you seeing them, counseling appointments for Chloe and Peter have often been canceled. Sometimes they simply do not turn up. Twice Peter rang in saying the car had broken down and asking for another appointment. When they do come, Chloe has been most responsive to sessions of play therapy, using symbols and sand play, and is just beginning to explore
non-verbally the threatening and frightening parts of her life. Neither she nor Peter find it easy to speak about their situation. Peter’s mother says she is willing to be involved, but has thus far not attended any appointments. However, she has been quite open to conversations on the phone. What is your assessment of Chloe’s situation?

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