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Mental Health Issues

Assessment 2: Case Study (25%)

Word Count: 1500 -1700 words
Your primary objective is to view this assessment from the perspective of mental health issues.

CASE STUDY


You are a Homeless Outreach Support worker for TeamHealth Aboriginal Corporation, working with the Homelessness Outreach Support (HOS) Program that supports those who are homeless, or at risk of becoming homeless, and their families.
You have secured stable accommodation for your clients, and you now must assist and support them to access mainstream agencies to address mental health issues.
You have been allocated a family that consists of a mother (Alira), son (Jarrah), and daughter (Yindi). The mother has been a survivor of domestic violence, experienced from her partner for the last five years. She states she has now left this partner but is reluctant to discuss this due to stigma and shame. Alira presents as highly anxious, tells you she has trouble sleeping and has recurring nightmares due to the violence she was subjected to. Yindi (12yrs old) has been diagnosed with depression and anxiety, is withdrawn and does not seem to be coping well. Jarrah is unable to sit still, especially in calm or quiet surroundings and constantly fidgeting. He is unable to concentrate on tasks, has excessive physical movement, excessive talking, interrupts constantly and acts without thinking. Alira said she believes her son has ADHD.
All three family members look tired and undernourished.

This research assignment has three parts:
Part 1 – Read the case study and outline the following.

  • How does Colonisation impact Indigenous Australians (including the Stolen Generation)?
  • Why is it important to understand Indigenous Australian culture when working with consumers?
  • What are the risk and protective factors for Aboriginal mental health?

Part 2 – Research

  • Apply critical thinking and judgement in identifying appropriate help and supports suitable for Alira’s, Jarrah’s and Yindi’s needs.
  • Name the supports and interventions that you will use and explain your choices.

Part 3 – Critical Reflection
It has now been three weeks since you first met your clients.

  • Critically reflect and evaluate on the decisions that you have made including the organisation/s and resources you chose to support your clients’ needs.

Answer

Part 1

  • Since colonisation, some of the government laws, practices and policies were enforced which further resulted in the abolition of generations of Aboriginal as well as Torres Strait Islander Children across Australia from their communities and families (Mohammed & Berzenji, 2022). Under the acts of the respective parliament of Australia, stolen generations are represented as those children of Australian Aboriginal and Torres Strait Islanders who were forcibly removed by state government agencies, and Australian federal, and church missions. It has been acknowledged from the Inquiry report of Bringing Them Home that members of the Stolen Government suffered psychological, physical and sexual abuse, disruption of family life, sexual and labour exploitation, grief and suffering, racism and the major loss of the culture, indigenous identity, community, and heritage. However, there are 30% of the Aboriginal people are suffering from psychological distress.

Evidence showed that several children experienced inhumane, harsh and degrading treatment. It was taught to the children to believe that they are relinquished by their families because they are unloved as well as unwanted (Bradford, 2020). The living condition of the children harsh and sparse, they were further only provided with basic literacy, numeracy and life skills which were limited their employment prospects to the roles and responsibilities such as labourers or domestic servants. Children are often served with harsh punishments for minor transgression or inconvenience. They were further also vulnerable to exploitation and sexual abuse which results in trauma, depression, pain and suffering.

It has been studied by the Australian Institute of Health and Welfare that abolished children were less likely to acquire secondary education and were more likely to have police records. This is because they were now growing up with a healthy family secret and proper education and environment. However, the impact of the past Stolen Generations as well as the forcibly ongoing abolishment of the children resulted in increased mental pressure on the people, especially at a time when government departments and federals follow the whole procedure.

Hence, it can be evaluated that colonization had a major impact on the Indigenous Australians, involving the Stolen Generation who were removed by the Australian federals from their families and communities from 1910, until the year 1970s. However, this practice has a disturbing impact on the children and their families, as they have experienced trauma, pain, depression, loss of culture and identity and other mental health issues. The effects of colonization on indigenous Australians involve social disadvantage, health disparities, and institutional racism.

  • It is essential to understand the Indigenous Australian Culture while working with the Indigenous Australian consumer because it further allows respectful service delivery and cultural safety. This further means recognizing as well as respecting the diversity as well as unique experiences and perspectives of indigenous culture (Dunstan et al., 2020). With a greater understanding of the Indigenous culture, it will become reliable for the caretaker and the service provider in tailoring their service in a more appropriate manner, and will also help in meeting the requirements of the clients. However, acquiring an education regarding the histories of Aboriginal and Torres Strait Islander people comes with a lot of opportunities. One of the opportunities is enhancing the in-depth understanding related to cultural diversity and how can it plays a crucial role in the lives of people.

However, to provide help to the Aboriginal and Torres Strait Islander people, it is crucial for the service provider to understand that they are still experiencing social injustice and inequality because of the lack of cultural understanding, racism and discrimination. Therefore, values, cultural beliefs, and world-views of people influence the thinking, interactions and behaviours of people with others. Hence, it is essential to reflect without any judgement before, during as well after the time of the interaction with individuals whose values, beliefs, experiences, and world-views are different. Acknowledgement, as well as respect for the indigenous family structures, are crucial areas for the improvement of healthcare services. According to the case study, enhancing understanding regarding the families will help the homeless outreach support worker of the Team Health Aboriginal Corporation in addressing their mental health issues.

  • Risk factors are referred to the characteristic and attribute of an individual which primarily increases the chances of developing the disease as well as incurring a major injury. However, on the other hand, proactive health factors are those in which commitment is provided by the provider to the patient, and where both work together to keep the health of the patient stable and secure. According to the case study, Risk factors for the Aboriginal mental involve loss of cultural identity, trauma, social disadvantages, pain, sexual abuse, mental illness, and others. However, trauma is considered a huge factor in Aboriginal health and if it will remain unsolved then it can debilitate a person and then can be passed on to the next generation (Hartwig et al., 2022). The mental health of the person can become worse if they will get discriminated against on the basis of race o culture. Moreover, a physical health problem can contribute to the feeling of exclusion as well as inadequate, and due to this reason some individuals might stop exercising as well as socialising. hence it was identified that 23% of the Aboriginal people are diagnosed with both mental health conditions as well as other long-term health conditions.
  • Whereas, proactive factors for the mental health of the Aboriginals involve community connections, strong cultural identity, support of the close ones, and acquiring access to culturally appropriate services.

Part 2

  • An allocated family consisted of the mother (Alira), daughter (Yindi), and son (Jarrah). Alira was a survivor of the domestic violence that has been done by her partner for the last five years. However, domestic violence is referred to as a serious threat for many women, as it is the violence that is primarily committed by someone who is in the domestic circle of the victim. This can include, partners, ex-partners, immediate family members, friends and other relatives. In the other words, it is the pattern behaviour of an individual that is used for the purpose of gaining control over an intimate partner. However, it is required by the health worker of Aboriginal Corporation to learn the warning signs, this is because individuals who experienced domestic violence, sometimes try to cover up the abuse for several reasons. This is the reason it is crucial to acquire the learning of physical signs, emotional signs and behavioural signs of an individual (Sawrikar, 2019). This will further help in mitigating the problem of domestic abuse. However, Alira is in need of the support and assistance of someone who will help in the whole recovery process from the domestic violence.

Yindi is diagnosed with depression and anxiety which are serious mental health problems. However, Aboriginal and Torres Strait Islander Health workers and health practitioners are playing a significant role in reducing the anxiety of an individual by enhancing the quality of communication of the clients through a cultural brokerage (Ridley et al., 2020). They further work towards assisting the general practitioners in enhancing the better understanding and responding to the concerns of the clients and further help them in improving their understanding regarding their illness and treatment. Hence, the needs of Yindi must be provided with the proper and appropriate treatment for depression such as by providing her with a better education, a change in lifestyle, social support and psychological therapy.

Jarrah on the other hand is suffering from ADHD which is the most common neurodevelopment disorder of childhood. Children with this type of disorder face problems in concentrating on tasks, excessive talking, excessive physical health, doing acts without thinking, and other problems. However, the healthcare worker can provide him with this by performing fun activities with him. It is important to provide the child with the opportunity of letting out the energy and make time for physical exercise breaks. It is further crucial to help the child in getting a good sleep routine and provide him with healthy food options.

  • Consumers as per this case study are the individuals who acquire mental health services from the provider of mental health services. In this case study, the consumers are Alira, jarrah and Yindi. They are a family, in which Alira suffered from domestic violence which further cause the mental illness, Yindi is suffering from depression and anxiety, and Jarrah is from ADHD disorder. However, there must be the adoption of a national-recovery-oriented framework because it aims at providing help to the families and supporting them in understanding the experiences and recovery processes of their families. This framework further helps victims in understanding their own needs by providing them with better therapy, counselling, guidance, education, support services, advocacy and peer support. According to the case study, it is essential for Alira to get peer support as well as advocacy so she will be able to fight with his partner who domestically abused her.

However, Yindi is suffering from depression and anxiety, so she should be provided with the psychotherapy interventions such as behavioural therapy, supportive therapy and medications (Scherer et al., 2019). With the help of these interventions, it will become more reliable for Yindi in the process of recovery.

An intervention for the ADHD child who is Jarrah is behaviour therapy which must be taken before going for the medication (Hartman et al., 2019). However, to support the ADHD child is crucial for everyone around him to develop a positive attitude towards each other, this will have a positive impact on his health. It is required by the healthcare worker in creating and maintaining a structure where the child will be able to perform activities and feel comfortable.

Part 3

  • Dealing with different kinds of mental health problems is not an easy task for me. However, evaluating the situation of the whole family in detail, enhanced my understanding of the problem each individual in the family was facing. I acquired that mother was going through domestic violence which impacted her mental health negatively, daughter, on the other hand, was suffering the depression and anxiety and the son with an ADHD problem. After a critical evaluation of their situation, I provided them support by adopting a national recovery-orientated framework and by providing them therapies that will help in the recovery process. they will be further provided with counselling, peer support, guidance, advocacy and other support services.

References

Bradford, C. (2020). The stolen generations of Australia: Narratives of loss and survival. International Research in Children’s Literature13(2), 242-258. https://www.researchgate.net/profile/Clare-Bradford/publication/346452721_The_Stolen_Generations_of_Australia_Narratives_of_Loss_and_Survival/links/5fc31d3892851c933f72229e/The-Stolen-Generations-of-Australia-Narratives-of-Loss-and-Survival.pdf

Dunstan, L., Hewitt, B., & Nakata, S. (2020). Indigenous family life in Australia: A history of difference and deficit. Australian Journal of Social Issues55(3), 323-338. https://onlinelibrary.wiley.com/doi/am-pdf/10.1002/ajs4.90

Hartman, C. A., Rommelse, N., van der Klugt, C. L., Wanders, R. B., & Timmerman, M. E. (2019). Stress exposure and the course of ADHD from childhood to young adulthood: comorbid severe emotion dysregulation or mood and anxiety problems. Journal of clinical medicine8(11), 1824. https://www.mdpi.com/2077-0383/8/11/1824

Hartwig, L. D., Jackson, S., Markham, F., & Osborne, N. (2022). Water colonialism and Indigenous water justice in south-eastern Australia. International journal of water resources development38(1), 30-63. https://www.tandfonline.com/doi/pdf/10.1080/07900627.2020.1868980

Mohammed, A. B., & Berzenji, L. (2022). The stolen generation and its effects upon identity of the Aboriginal people in Sally Morgan’s My Place. resmilitaris12(2), 5315-5327. https://resmilitaris.net/menu-script/index.php/resmilitaris/article/view/666

Ridley, M., Rao, G., Schilbach, F., & Patel, V. (2020). Poverty, depression, and anxiety: Causal evidence and mechanisms. Science370(6522), eaay0214. https://www.nber.org/system/files/working_papers/w27157/w27157.pdf

Sawrikar, P. (2019). Child protection, domestic violence, and ethnic minorities: Narrative results from a mixed methods study in Australia. PloS one14(12), e0226031.  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0226031 Scherer, N., Verhey, I., & Kuper, H. (2019). Depression and anxiety in parents of children with intellectual and developmental disabilities: A systematic review and meta-analysis. PloS one14(7), e0219888. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0219888

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