Question
Joshua is an 18 year old man and has been a resident at Wings since he was 13. Prior to his arrival at Wings, Joshua
Joshua is an 18 year old man and has been a resident at Wings since he was 13. Prior to his arrival at Wings, Joshua was in foster care from 7-13 years. He had a good relationship with his biological mother (and foster mother), though she suffered from schizophrenia. Josh never mentions his father and becomes angry or withdrawn when asked about him. Joshua entered residential care as his foster mother developed a mental health issue (depression) and found it too hard to look after Joshua and his foster brother, Mark. On presenting at Wings at 13, Joshua was engaged in high school, attended weekly tutoring and karate classes. He had no alcohol or other drug issues, displayed some erratic behaviours and poor hygiene, but did not have mental health issues at the time. Joshua displayed normal, challenging teenage behaviour. Joshua was initially placed with his foster brother, who often absconded from Wings and was involved in riskier behaviours such as teenage drinking. Joshua was initially shocked by the behaviours of the young people around him and experienced bullying. He became quiet and withdrawn at first, but soon started to copy the behaviour of the other young people. He started absconding, drinking heavily and chain-smokes. He quit school and social activities which he enjoyed in the past. When Josh was 17, things took another turn when he started hearing voices and seeing what he calls "shadows". These shadows are dangerous, and Joshua says that if he looks at the shadows for too long, they will kill him. Joshua was diagnosed with schizophrenia and put on medication which manages the hallucinations but also makes Joshua feel very tired and angry. He often says that life is not worth living. Joshua also started becoming very aggressive towards female members of staff, and things escalated when Joshua assaulted one member of staff, breaking her nose. The reason he gave for this behaviour was that he thought the staff member had come into his room without warning, finding him trying to walk in women's shoes (which Joshua had done in the past but had given up for a while). After this incident, Joshua was asked to leave Wings for 3 months. These 3 months have now passed, and you are asked to assess Joshua's current needs. Joshua presents for the meeting in a very dishevelled state and with strong body odour. He seems to find it hard to concentrate and seems to have trouble staying awake as he talks to you.
After debriefing about the meeting with Joshua with your supervisor you decide that it might be beneficial to use an assessment tool to get further insight into what is happening for Joshua.
Before meeting with Joshua again you decide that you would like further information about Joshua's background to make sure you can work in cooperation with other services involved to meet Joshua's needs.
After some time Joshua discloses to you that he has taken himself off his meds altogether, as they made him feel like a "zombie" (he does a pretty good impersonation of the walking dead). The bad side is that he is now hearing voices again, and they are telling him to do bad things, including hurting himself and other people. Write a short script outlining how you would brief Joshua about the assessment including any legal obligations
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