Case Study: John

John is a 23-year-old male who lives at home with his parents and two older brothers. John has a history of depression and violent behaviour when feeling hopeless. He has attempted suicide twice in the last eighteen months. John is an Electrician by trade and was working with a local company up until six months ago when he was asked to resign because of his inability to get to work on time, to concentrate on his work and being aggressive toward colleagues.He has been living on his savings and the ongoing support of his family. He has been paying off a loan for his car but he is considering selling it as he can't afford the repayments now.

John describes his family as "loving and supportive" he likes all kinds of sport but "hasn't got the energy to get back into anything at the moment" and feels really "angry" at how his life is going at the moment. John has a family history of suicide; his paternal grandfather had depression and died from suicide when John's father was very young. John has been referred by his GP to the local community mental health centre where you work for an assessment of his current risk for suicide and to assist him with strategies to reduce the risk, keep him safe and manage his aggression. John is currently prescribed an antidepressant, which he has been taking for the past two weeks.

John presents to the Centre today, he looks very sad but also angry/ agitated at times, and he is walking and speaking very slowly, except for when he shows anger at his perceived circumstances. He finds it difficult to speak about his illness and what has happened to him over the last eighteen months.During the assessment, John tells you the following: he has a small circle of friends but has never really explained to them about his mental illness. "They wouldn't understand and might think I'm just a loser." My life is not like theirs, they've got a job, I haven't". "They have girlfriends; I don't." "They have things to look forward to, I don't." "My life is non-existent, and I'm really peeved that everyone else seems to have good lives and I don't."

Question 1: Describe the signs which are evident that indicate to you that John could be currently at risk of suicide. In addition, list the risk and protective factors apparent to you in John's history and presentation today.

Signs

Risk factors

Protective Factors

Question 2: To increase your understanding of John's current situation what additional information would you be seeking from John today?

Question 3: Explain what key communication skills and strategies you would need to use when talking to John today. Outline specific questions you would ask John during the assessment interview today?

Question 4: What specific strategies would you implement to manage / deescalate any client violence / aggression.

Question 5: What level of risk of suicide do you assess John at today? Explain why you have nominated the level of risk.

Question 6: Based on your answer to question 3; to reduce his level of risk and to maintain his safety describe five strategies you could include in the initial safety plan you develop with John today?

Put your answers in the table provided below:

GOAL	STRATEGY	WHO IS RESPONSIBLE	REVIEW DATE / TIME	MEASURE OF SUCCESS

Question 7:

1. Explain how you are maintaining a duty of care to John with the actions you have described in your previous answers. Explain why information management is important in this scenario.

b) Complete the incident report (appendix A) attached to this assessment

1. Question 8: Briefly answer the following.
2. What principles of communication are utilised in crisis counselling?

3. What legislation's do you need to apply in workplace management of crisis? (Be specific note exact legislation and how it applies to your practice with the organisation, staff, clients, community).

2. Outline your understanding of the terms negotiation and mediation in youthwork give an example of when you might use these processes.

Appendix 1

Critical Incident Report

The incident resulted in:

Injury to an individual Damage to property/environment A near miss

_________________________________________________________________________

Persons involved in incident/ accident

Client: Staff Member: Volunteer General Public:

Date of incident: ____/_____/_____ Time of incident _______________________

Location of Incident:________________________________________________________

Name of person completing form _______________________________________________

Position of person completing form ________________________Contact no: ___________

Persons involved in incident:(complete details for all involved insert additional details as required)

Surname: _______First name: ________ Age _____

Address: ______________________

____________________________ Postcode:

Relationship to agency:(client, staff, Management, community member) _____________________

Were there any witnesses? Yes No

Name of witness/es: _Contact details: __________

Name of witness/es: _Contact details: __________

Description of incident and background (state relevant Information/ facts leading up to the incident, circumstances, whether the incident was witnessed and other relevant issues):

Was first aid or further treatment required? Yes No

If YES what first aid provided

Who was informed about the incident (Manager, Police, Fire Brigade)?

Actions taken to date: (including date and time of contact that Manager and other agencies were informed, as well as details of support provided):

1.
2.
3.
4.

Follow up action planned:

1.
2.
3.
4.

Does this incident require further investigation? Yes No

(If yes, refer to Manager or management committee

Does the severity of this incident require notification to Work Safe NSW? Yes No

Critical incident report form submitted by:

____________________________________Date: _________________

(Signature of Employee)

Critical incident report form received by:

____________________________________Date: _________________

(Signature of Manager)