Discuss the treatment procedures for mental illness and anxiety and type of care given to the patient in the following case scenario.

SCENARIO: John Short

 

John Short is a 45-year-old gentleman admitted to your assessment unit after he presented at A&E with cuts to his wrists and neck. He had cut himself with a kitchen knife following what he described as a “panic attack” where he “lost the plot”. He is settled, his wounds have been dressed and overall were not life threatening. Following assessment John was offered an informal admission to the local inpatient assessment unit. John has no previous contact with primary or secondary mental health services.

 

John works in the office of a delivery company and says that there has been asked to do more and more in the past few months as people have left or retired from their posts and he has not been coping well. John was also informed that the company were planning on outsourcing some of their work, and as a result there might be redundancies in the near future. John describes feeling increasingly stressed over this time, unable to concentrate, worrying that he might lose his job and ruminating on how this would affect the family.

 

John is married with two small children 10 and 5 years old. During his admission assessment he described his wife as loving and supportive and is worried that he “has put her through hell” and that he has “behaved stupidly”. He feels he has let his children down even though they did not see him harm himself or witness any of his distress and worry. John reflected on feeling increasingly anxious on heading out to work, worrying about his job security, so much so that he has not been sleeping well. John said that he feels he has been depressed for a short while but felt unable to talk to anyone about this. His wife is very worried about him, and he stated that she has told him many times that, “we can cope John, your job is not as important as your health”. John stated that he has been “stupid” and that he has “ruined everything”. He wishes he could turn the clock back to a time when he was “on top of things at work”. He worries that he might panic again and is scared of what he might do.

This is John’s first day on your unit, and this is his first 1-1 session with you since his admission. He is happy to talk to you.