This case presents the issues of Peter, a man living with his wife, Gail on the edges of a regional town. Read the scenario then respond in your assignment to the following questions.
Peter is a 35-year-old man who lives with his wife and two children, aged 10 and 7 years, on a small property just outside a large regional town. Peter grew up on a farm three hours’ drive north but is now well established in the regional town. He works as a middle level manager in a construction business. He consults a local general practitioner, Dr Mercedes, for a first visit because he has been experiencing insomnia and loss of energy. Peter adds that one of his workmates has recently been diagnosed with leukaemia. Dr Mercedes has only ten minutes allocated to see Peter and performs a quick physical examination and takes some blood. She asks Peter to return in one week. At the second visit to Dr Mercedes, Peter is told that no physical problem was found on his blood tests. The doctor is at pains to rule out the possibility of leukaemia. Peter appears relieved. The doctor prescribes a short acting benzodiazepine, temazepam for his sleep. She asks Peter to return in a month if things have not improved.
A fortnight later, Peter goes to see his old family GP, Dr Bill Holden, who practises in a town close to his parents’ farm, where Peter is staying for a visit. Peter explains that he has felt much worse in the last fortnight. His sleep pattern has deteriorated considerably and although he gets off to sleep fairly easily, he wakes every night staring at the clock at 2am and then can’t get back to sleep for hours. The mornings are his worst time but as the day goes on things gradually improve. In the evenings Peter has felt tense as the time to go to bed comes closer and he knows his night will again be difficult. On questioning from Dr Holden, Peter says, “life has always had its ups and downs’, but that he has never felt like this before. He says he has lost his taste for food and has lost 5kg in weight. His wife had told him that he seemed to have lost interest in all his normal hobbies and appeared to get no pleasure from anything. After further questions from Dr Holden, Peter went on to say that his sex drive had dropped away totally. Bill Holden also checks whether Peter has any significant suicidal thoughts and is relieved to find that Peter has no active suicidal plans at present. Ben went on to explain that lately his wife had tried to cheer him up. He was unable to react to her efforts and constantly felt down. Subsequently Peter’s wife, Gail complained that he always rejected her and was spending more and more time at work. Peter had told her that he was under considerable pressure at work, as his company was trying to secure more building contracts despite difficult economic times. Things had got really difficult between them and last Friday night she had accused Peter of having an affair. He admitted to her that he has sought support from his secretary at work, but denied that a relationship has developed. Gail was very upset and asked him to leave.
The next morning Peter packed his things and drove home to the family farm to stay with his parents. He decided he needed help and that is why he had come to see Dr Holden, whom he had known all his life. After listening to Peter for twenty minutes, Dr Holden tells him he believes Peter is suffering from major depression and that a combined approach of tablets and talking therapy is indicated. Dr Holden tries particularly hard to educate Peter about “depression as an illness” since there is a particular stigma about mental illness in his local community. He informs Peter about the good chance of a recovery from this episode with appropriate treatment.
Structure:
Introduction: state briefly what you intend to do in the assignment (150 words).
Body: Briefly describe the nature of Peter’s problem. Reference any material you have used (200 words).
In a regional area such as the one where Peter lives, what are the barriers to mental health care? Give an account of the local scene for someone with a mental health problem. You may pick the area you are currently working, or research an existing area and use this (200 words).
What do you think are his most pressing concerns? Provide a list of both Peter’s and Gail’s concerns. Also suggest the strengths Peter may already bring to help overcome his problem. Give brief explanations of each concern and identify any interventions that may help him. Ensure you identify the level of evidence of the interventions and provide examples from the literature of research that has demonstrated this evidence (800 words).
Examine the different disciplines that may be able to help Peter and Gail and give examples of the way in which these disciplines could work together (300 words).
Conclusion: Tie all of your findings together and give a concise summary of what you have found (350 words).