Quality of Care Report - Ballarat Health Services

One Family’s Journeythrough ourPsychiatric ServicesJohn is a 22 year old man who lives athome on a farming property with hisparents, Colin and Jean(not their real names).He attended school at nearby Araratuntil he was 15 years old, then stayedat home, helping his dad out on thefarm.Colin and Jean state that John hasalways been a bit of a loner, mixingpoorly with other people and spendinga lot of time in his room, surfing theinternet and playing music. They say heis always talking to himself.Over the last few weeks, John’s parentshave noticed that he is not sleeping,spending all of his time locked in hisbedroom, always on the computer andplaying music very loudly. He hasbecome more and more withdrawn anduncommunicative.He has started eating and drinking verylittle, and seems very suspicious of hisparents.When Colin asks John to help out onthe farm, John becomes verballyaggressive towards his father, stating “Iknow what you are all trying to do toMental illness accounts forover 25 per cent of thedisability burden from allhealth problems across thepopulation as a whole.The economic impact ofmental illness in Victoria hasbeen estimated at $5.4billion annually.In 2006, mental illness was akey factor in 25 per cent ofall people on a DisabilitySupport Pension in Victoria.me!” He then storms out of the houseand runs off across the paddocks.When John doesn’t return home bydark, Colin and Jean go looking for himand find him in a pump station shed.He is curled up in the fetal position andhumming loudly. They take him homeand put him into bed.They contact their local generalpractitioner . in Ararat, who agrees todo a home visit.Following a lengthy consultation, thedoctor notes that John has beenhearing voices for a number of years,and believes that he is being controlledby people over the internet. He believesthat people wish to harm him becausehe has special powers.Psychiatric services provide24 hour 7 day a weekservices across the region.Experienced clinicians areavailable to provideassistance. (Telephone1300 66 13 23 local call)He is sleeping poorly and his dietaryintake is inadequate.The doctor recommends that John havea psychiatric assessment to provide adiagnosis and possible treatmentoptions. Whilst John is reluctant to dothis, his parents manage to get him toagree to the assessment. The doctorcontacts the Ararat Psychiatric Serviceto arrange the assessment.The details of John’s presentation areobtained from the doctor and theduty clinician arranges for anassessment to be done thefollowing morning at the farm.The doctor has given John asedative so that he cansleep overnight.All referrals forwarded bygeneral practitioners toPsychiatric Services lead to acomprehensive assessment.A recently developedprotocol “Working andCaring Together” outlinesthe collaboration betweenPsychiatric Services and theclient’s general practitionerin care and treatment.Following the assessment, anappointment is made for John to see aPsychiatrist in Ararat.John and his parents are given anoutline of the possible treatmentprogram and provided with strategiesto minimise the effects of the voicesand thoughts. They are given a 24 hourcontact telephone number and thefindings of the assessment arecommunicated to the generalpractitioner.John attends the appointment with thePsychiatrist in the company of hisparents.A comprehensive mental stateexamination and review of John’s lifehistory is taken.The Psychiatrist informs John that he issuffering from paranoid schizophreniaand outlines a treatment plan whichinvolves taking anti-psychoticmedications and undergoing a range ofpsycho-social treatment interventions,which will be provided by themultidisciplinary team.Mental Health Clinician Marice O’brien taking a triage callQuality of Care Report 2007-08 16