Posted: September 16th, 2017
Mental Health and Mental Wellbeing WELF 2019
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Assignments – Mental Health and Mental Wellbeing WELF 2019
Assignment 1 – Case Study (2,225 words)
Choose only one case study from the three provided below. As the case manager, this assignment requires you to describe the key factors you would take into account in
making a social work assessment and in developing a case management plan with the client. You are asked to draw on a recovery-oriented approach to mental health
assessment and case management in social work as outlined in the course text book, Bland, Renouf and Tullgren (2009).
This should include the following:
• a brief explanation of a recovery-oriented approach to assessment and case management in mental health social work;
• the key factors in this case that you would take into account in undertaking a recovery-oriented assessment and case management plan, drawing on the 12
dimensions emphasised in the text book. This will include discussion of existing mental health research literature relevant to the case. For example, in the case of
Justine, you would outline what is known about the effects of racism on mental health, and the effects of sexual abuse on mental health, and you would identify how
this might further enhance understanding of Justine’s situation. Please note: you are not being asked to present a case management plan but to speak to the factors
you would consider in making a plan;
• the social work theory or theories that would also guide your approach to assessment and case management with this client and why (e.g. strengths approach,
empowerment approach, feminist social work approach);
• the ethical and legal implications of the case that would need to be taken into account in assessment and case management;
• further information you might require to enable planning for case management – You may need to use some creativity for the additional information you require.
Chapters 6 & 7 of the course text are a good place to start.
The case study assignment can be presented in the format of a report, and you can use the above dot points as headings. However, you need to draw on the relevant
mental health and social work literature for points 2, 3, 4 and 5.
Please note – as a social worker, you are not being asked nor will you be qualified to make a psychiatric diagnosis. You can nevertheless comment on the condition(s)
you think are likely based on your systematic assessment of the case and their implications for practice.
Case study 1
Justine is a 23 year old woman who recently graduated from university with an undergraduate degree. She is currently working at bar in the inner city of Adelaide and
has plans to return to University to do post-graduate studies.
Justine was born in Port Augusta. Her father is an Australian Aborigine and is an electrician. Her mother is of Anglo-Saxon ancestry and is a Nurse. Justine was shy
in her childhood, however, she reports that her home life was ‘happy’ most of the time. However, Justine also says that she was constantly teased by her school mates
during her school life about being of mixed race, and always believed that she was ‘unattractive’. Justine was always very close to her family during her primary
schooling. She was particularly close to her mother, but used to go to her father when she had a ‘serious problem’. When Justine was 13, she moved with her family to
Adelaide and settled in the inner western suburbs. She attended the local high school.
Academically, Justine outshone other students at her new high school and was elected as a student representative. She said that she remembers this period being the
happiest time of her life. However, as she started to receive attention from boys, she described feeling extreme anxiety about how to handle their sexual advances.
Justine tells you that one of the teachers at her school, who was over 50 years old, once made explicit sexual remarks and he touched her inappropriately. She does
not want to talk about this and says, “What happened in the past stays in the past.” Because she has pushed this out of her mind before, she does not wish to bring it
up again.
When at high school, Justine never invited friends over to her house because she was embarrassed by her mixed racial heritage. Justine suggests she had issues with
not being ‘black’ or ‘white’. She never spoke about this to her parents, but she thinks they knew it was an issue for her.
During most of high school, Justine dated Graham. He was her first serious boyfriend. The relationship, as described by Justine, “Was a loving one and the sex was
good.” Graham became rather close to Justine’s parents and was comfortable with her Aboriginality. Similarly to many teenagers, Justine did not discuss her personal
life, including love, romance and sex, with her parents.
Graham and Justine broke up at the end of high school because he wanted to be free to date other girls. On looking back, Justine thinks she coped with the break up
“rather well” and they stayed good friends. When Justine went to University, she had a series of relationships and experimented with bisexuality. Justine has now
been dating John for nearly six months, but she does not feel very committed to the relationship. John usually seems to make an effort towards supporting her, but
Justine said that he often ends up putting her down.
Justine has been a member of a debating club for some time, but more recently she is not enjoying herself. Justine does not like her job; however, she is not
motivated to look for other work. She describes feeling “on the edge” when she is getting ready for work or for her debating club and is starting to use all sorts of
excuses to avoid going to either of them. She doesn’t mix with other employees or her team mates and, in particular, she feels anxious when social functions are sprung
on her without notice.
Justine often does not get home from work until way after midnight and regularly sleeps in until the early afternoon. Justine’s neighbours are starting to worry about
her because she has been walking home from work, at night and alone. She has recently lost all interest in cleaning her apartment, has lost interest in eating and is
paying less attention to her personal appearance. Justine is now avoiding seeing John, her parents and her brother. She has also lost interest in pursuing further
education.
About two months ago, Justine became friendly with a patron of the bar where she works. After a lengthy conversation, he encouraged Justine to seek support from a
social worker at a community health centre – this is you.
Case Study 2
Pamela is in her mid-50s. She grew up in a large family in a farming community. From what she can remember, she often did not go to school because all hands were
needed to keep the farm operating and afloat. Her family were not particularly close and the large number of children seemed more a business arrangement than a ‘real
family’.
Pamela was often physically punished by her father, as were her siblings. With an unhappy childhood, she often blamed her mother for not protecting her and for not
making the home a happy one.
Pamela was an extremely shy child and rarely had friends to play with. She often felt overlooked in her family and unloved. Her yearning for closeness and love found
her marrying at a very young age and having children soon after. She wanted to escape her family and fill the void she experienced in her own childhood. Pamela
thought that if she had children, that she could make the loving family that she missed out on.
Her husband, Giuseppe, is European and about 20 years her senior. They married and soon after moved Adelaide. He had very strong expectations about marriage and
gender divisions within the relationship. It was considered natural for Pamela to tend to household chores, to cook and look after him and to take care of the
children. He was the decision-maker and Pamela had to do as she was told. Although Pamela was originally looking for love, care and support, Giuseppe was cold,
distant and emotionally abusive. Over time, Pamela progressively became anxious, distressed and eventually had a nervous breakdown. Her children were still young.
Pamela often forgot to pick up the older children from school. She started to leave her younger children at home and go wandering during the day. When Pamela went
wandering, she would become disorientated and forget how to get home. One day, the police picked up Pamela in her disoriented state and took her Glenside. At first,
she was detained for three days under the Mental Health Act, which was extended a number of times over a lengthy period. Pamela was diagnosed with schizophrenia and
medicated with anti-psychotic drugs. Eventually, she was released and allowed to return home. However, Giuseppe kicked Pamela out with nowhere to go. This is when
Pamela started living on the streets. As a homeless person, Pamela was in and out of shelters continuously. But, more often than not, she roughed it out-doors. She
had numerous involuntary admissions to Glenside under the Mental Health Act over the next few years and she lost touch with her children. Since marrying and moving
away more than ten years ago, Pamela has not kept in contact with any of her family. She doesn’t even know if her parents are still together, whether any of her
siblings have families of their own and where they might be living now.
Pamela has been referred by a women’s centre to a supported community housing program. The vision is to offer Pamela a unit of her own and to implement continual
supervision and support. You are her social worker.
Case Study 3
Steven is nineteen years old, living with his parents and in his second year of university studying Fine Arts. You are a mental health worker and first meet him when
you go to his parents’ home to carry out an assessment as part of an acute community treatment service following a request from the GP, who is concerned about social
withdrawal and possible psychotic symptoms. Steven’s mother expresses concern that over the last six months he has become more isolated and afraid to leave the house
and has recently stopped attending classes or study groups.
When you arrive, you note that Steven appears dishevelled, and is rather incongruously wearing a couple of frayed woollen jumpers despite warm weather. He is
initially suspicious and reluctant to talk, but after some reassurances agrees to an interview, with reasonable confidentiality achieved by this being conducted in the
kitchen while his mother does some gardening outside.
During the interview, Steven is fidgety, and frequently stands up as if he is about to walk out of the room, but sits down again when you ask him to. His speech
rambles, and he loses the thread of conversation easily. He describes hearing the voice of God, as a stern, clearly heard male voice that seems to be coming from a
point a few feet above his head; the voice generally speaks directly to him and tells him that something terrible will happen if he leaves the house, but sometimes
also provides a steady flow of sentences talking about what he is doing, generally critical in nature. These messages are reinforced by the radio that regularly
transmits messages to him from God. Steven admits that he has recently been smoking up to six joints of marijuana daily, but asks that you not tell his parents. He
has not used any other drugs, and does not drink alcohol.
He is extremely frightened by the voice. He has withdrawn from all of his friends and hides the fact that he hears a voice even from his parents. He is frightened
that he will be rejected as ‘mad’ but at the same time has difficulty accepting that the voice does not come from God. He is resistant to giving up the marijuana
because he claims that it relaxes him.
Case study 3 is from Meadows, G., Singh, B. and Grigg, M. (2007) Mental Health in Australia: Collaborative Community Practice. Oxford University Press: South
Melbourne.
Assignment 2 – Journal (2,225 words)
You are asked to keep a journal demonstrating your learning in this course. The journal involves seven areas of questions that relate to lectures, tutorial sessions
and readings. It will be important to work on your journal as the course progresses rather than leave it until the end of the course.
Internal students are asked to bring their journals to their tutorial class in Week 7 so the tutor can sight them as in-progress. Please note: questions about
practice skills are different for internal and external students.
In order to complete the journal, you need to attend and participate in the whole course because many of the questions pertain to sessions in class (or online
discussions for external students) and you will not be able to complete the journal without attending or participating.
You will need to use academic references in the journal for most of the questions as specified below. At least 15 references in total are required. Use Harvard
referencing style.
Journal Questions
Address the following question areas in your journal. Please note – most questions require the use of references:
1. Historical perspectives on mental illness (Week 2) (225 words)
• How have understandings of mental illness shifted over the course of the 20th century? Give three examples.
• What are some of the implications of this history for people with mental health problems today, that is, how might this history affect people with mental
illness today?
Use references for these questions.
2. Common mental health problems (Weeks 3 and 4) (350 words)
• Describe medical model of mental illness and identify three key strengths and three key weaknesses.
• Describe the bio-psycho-social model of mental illness and identify three key strengths and three key weaknesses.
• Choose one psychiatric condition (for example, schizophrenia, anxiety, depression). Describe its main features, recommended treatments and the key social
factors (i.e. social causes and social consequences) that social workers should be aware of and explain why.
Use references for these questions.
3. Recovery approaches to mental health social work (Week 5) (350 words)
• Briefly outline a recovery approach to social work intervention in mental health. What are its key elements? What should a social worker DO with clients to
ensure a recovery approach?
• How might a recovery approach complement social work values and ethics?
• What are the strengths of a recovery approach and what might be some of its limitations?
Use references for these questions.
4. Lived experiences of mental health problems (Weeks 6 and 11) (350 words)
• What three key points emerged as particularly important for you as a beginning social worker/human service worker in listening to the experiences of the two
individuals who spoke to the class about their mental health problems and experiences of treatment? Why do you see these points as important for workers?
• Identify three ways you could take consumer experience into account when working as a social worker/human service worker?
• In viewing the DVD ‘Off the Rails’ about an woman’s experiences of bipolar disorder, what was her reaction to the onset of mental distress? Name three key
ways she managed her condition. What were important sources of support for her?
5. Practice skills in engagement, assessment and case management (Week 8) (350 words)
Internal students:
• Describe the key skills in engaging with clients with mental health problems.
• Describe the key skills in undertaking a mental health assessment in social work.
• Describe your experience of practicing engagement and assessment in triads. This should include:
• how you handled the fact that you were being observed;
• what you enjoyed about the practice;
• what was difficult;
• how you felt when you received feedback;
• what you think you did well and why;
• what did not go so well and why;
• areas for future development.
External students:
• Describe the key skills involved in engaging with clients who have mental health problems.
• Describe the key skills in undertaking a mental health assessment in social work.
Other than when reflecting on your experience of practicing in the triads, use references for these questions.
6. Legal aspects of mental health (Week 10) (300 words)
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