Assignment Task:
Case Study:
Grant is a 45-year-old Caucasian male currently living in a boarding house. His is currently unemployed after working a succession of unskilled labour jobs (e.g. cleaner, kitchen hand, gardener) in his life. He receives the Disability Support Pension from Centrelink. Grant's mother, Claudia, contacted the local Community Mental Health team after she noticed a recent deterioration in Grant's mental health. Grant recently asked to stay with her at his grandmother's house as he did not feel safe in the boarding house. Claudia is currently living with her mother (Grant's grandmother) and has become her full-time carer following the recent death of Grant's grandfather. Claudia felt she could not refuse, especially since he had no one else to turn to. She said he had always been a loner. However, once he moved in, Claudia reports that he spent most of his time in his room smoking marijuana and talking loudly and his behaviour was becoming more aggressive. He had accused her of stealing from her own mother and had threatened to evict her from her parents' house.
When Grant spoke with the case-manager from the Community Mental Health team, he presented as dishevelled and unshaven, unkempt in appearance, with baggy clothes and appeared exhausted. He was cooperative during the interview but kept mumbling incomprehensible statements in addition to the answers to the questions. Despite his current situation, he reported to the case-manager that he had recently returned from a trip to Queensland with his girlfriend Jenna. He reported that whilst it felt so good to be on holiday there, he did not like being forced to stay there. On further questioning, it was difficult to ascertain details of when his trip to Queensland was in relation to when he moved back in to stay in the family home, nor he was able to say where Jenna was or how he met her or any details about her.
Grant also reported that he is currently sleeping rough as he did not feel safe in the boarding house. Later in the meeting he also stated that he was living in his grandparents' house to keep tabs on his mother and protect his grandmother from his mother. Grant described that the recent death of his beloved grandfather caused him much grief and distress and became very teary and upset when talking about his grandfather to the case-manager. He said that his grandfather was his rock and father figure. Grant reports not knowing his own father, who struggled with his own mental health issues and was an alcoholic and left the family when Grant was 5 years old. He stated that it was his grandfather who kept the family together and took care of everyone.
Grant said he believed that his mother was being abusive to her own mother by putting her to rest in the bed in the afternoon and said he was considering whether his grandmother would be better off in his care. He felt that he was the only one who truly cared for his grandmother and thought that he and Jenna would do better job looking after her. Grant continued to express his hostility towards his mother who he believes tried to detain him in Queensland against his will to stop him rescuing his grandmother. He says that luckily his mates in the boarding house spoke to him via telepathy and gave him instructions on how to get back into Victoria. However, in the last week, they seem to be talking about him in a negative way and siding more with his mother, possibly colluding with her to get a share of the inheritance. He had been up all night arguing with them to leave him alone.
Respond to the following:
Q1. How would you describe the client's state of mental health in terms of their key presenting signs and symptoms and related possible diagnoses? Make sure to consider multiple possible diagnoses or mental states that might fit some or all the symptoms.
Q2. What is the key predisposing, precipitating, perpetuating and protective factor in each case?
Q3. What are four specific, evidence-based and suitable initial treatment and support options for the client?
Q4. What are four specific, evidence-based and suitable ongoing relapse prevention and support strategies for the client?