Case Study 3 - Jacob

Jacob is a 23-year-old single male who chose to move to Sydney instead of going to university in his hometown. He has been working as a bricklayer apprentice for the last few years and will soon get his trade certificate.

"Then I could bid on city jobs and make a very comfortable living".

Jacob no longer has contact with his parents, who he says are very disappointed in him. When he wants a bit more spending money, he works on cars and motorcycles on the weekends. He reports an active social life with his friends and all of them do some kind of drug or another. Last year Jacob tested positive for HIV.

"I'm not really sure how I got it. I'm always very careful about my needles, so someone must have spiked the dope. I don't want to go into it, but I was really pissed off and angry when I got the news. HIV is clearly a Liberal conservative plot to wipe out the workers."

Jacob cannot rely on his parents for financial assistance or to tap into any health insurance as a student dependent. Furthermore, he does not believe he could get health insurance now. Jacob has prescriptions for AZT and protease inhibitors, but he has not been able to take them consistently because they are too expensive.

"Either way you look at it, I'm screwed."

Jacob prefers "smack" and he also likes to do "speedballs" when he can score these drugs. He loves the rush. Jacob says he doesn't do any other drugs but has tried them all. Occasionally he will drink some Scotch, but lately his stomach has been really giving him trouble. Jacob says that sometimes it will feel like multiple stab wounds in his gut that can go on for hours and scares him. Jacob has seen his doctor, and she prescribed some Demerol and an antacid. He's pretty sure it's related to his HIV.

Jacob tells you quite frankly that when he gets too bad and too sick from the AIDS he'll take himself out.

"Hey, I think of suicide from time to time. If it gets really bad, I mean, if the AIDS thing and life gets too unbearable, I know I don't have to take it."

How do you prepare notes/questions to interview Jacob as a Mental Health / AOD Support Worker?

What services do you think Jacob requires and which ones require you to refer Jacob to another professional?

How do you follow up on a referral/?