Read three (3) case studies. For each case study you are required to:
-develop a safety plan for each person, and
-discuss how you would address trauma issues in relation to each person by answering the seven (7) questions that follow.
Case Study 1
Mary-Jane is a 29 year-old woman who has been diagnosed as Borderline Personality Disorder (BPD) and is self-harming. She has made two suicide attempts in the past. She experienced severe physical (from infancy) and sexual abuse (from the age of 4) from her parents, and was removed from their care by the State child protection authority at age 8. Mary-Jane had multiple foster placements due to her aggressive and sexualised behaviour, and was sexually abused by a relative of one foster carer at age 13. She has had several admissions to a mental health inpatient facility from age 14, and also spent 6 months in juvenile detention at age 16 for assault. She has been a polydrug user (alcohol, benzodiazepines, opiates and cannabis) since age 17. She has a history of abusive relationships, and her two children have been removed from her care 3 years ago due to physical and emotional abuse by both Mary-Jane and several of her partners. She has presented to your service as homeless and expressing thoughts of killing herself. The only person she sees as supportive is one of her sisters.
Case Study 2
Amira is a refugee from a country which has experienced a long period of civil war, with various factions in the country fighting for control. Amira’s husband and two eldest sons were killed in front of her when the militia raided their village. Amira and her two younger children managed to escape, and with other survivors from their village made their way to a refugee camp in a neighbouring country. Amira spent five years in the camp, during which time her two children died from malnutrition and disease. Amira was also sexually abused in the camp. Amira came to Australia to live with a cousin three years ago. There are few members of her community in the town she is living in, and Amira struggles with learning English. Her cousin has brought her to your mental health service saying that Amira is becoming more withdrawn, is neglecting personal care, not eating, and saying she wants to die and be with her husband and children. This began after Amira saw a programme on television about war atrocities in her country.
Case Study 3
Phillip is a 25 year-old who was removed from his family at the age of 7 because of severe physical abuse and neglect. Phillip lived with his grandparents until age 13, when he ran away due to sexual abuse over 3 years by a friend of his grandfather. His grandfather refused to believe Phillip when he disclosed, and gave him a severe beating for ‘lying’. Phillip’s grandmother is frightened of her husband, but has secretary maintained contact with Phillip and gives him money when she can. Phillip has mostly lived on the street since then. He has used a variety of drugs to cope, and has worked as a sex worker to finance his drug habit. Last week he was beaten up by a client who refused to pay, and was also diagnosed with Hepatitis C. Phillip has been coming to the drop-in centre for homeless people where you have worked for some months, and you have a fairly good relationship with him. Today he has presented saying he has come to say goodbye: he cannot see the point of living any more.
For each of the above case studies, you are required to:
- Develop a safety plan for each person according to your organisation’s requirements
- Discuss how you would address trauma issues in relation to each person by answering the questions below.
Your safety plan must include:
- Resources and strategies to minimise the risk of suicide, and
- Any other services and/or individuals who could form part of the plan.
- What coping resources and strategies would you collaboratively develop with the person to minimise the risk of suicide?
- What other services and/or individuals could form part of the safety plan?
- What are the risk factors and possible triggers for suicide in each case study?
- How would you determine the level of risk?
- How would you respond to the person’s suicidal thinking?
- How would you respond to disclosures of trauma by the person?
- How would you ensure that you do not re-traumatise the client in your interview?