Need Questions Answered (MENTAL HEALTH SUBJECT)

Assessment 1– Research Case Study 1

Scenario – Background

Gui works in an Alcohol and other Drug (AOD) facility just outside of Melbourne. The facility is in a beautiful bush setting with trees, native bird life, lovely outdoor recreational facilities and tables and seats to enjoy the fresh air and scenery. The clientele is comprised of a number of age groups with individuals there for the first time and others back for further treatment. Young people under 18 years are not represented highly among the live-in clientele who generally come from all age groups and backgrounds and present with both alcohol and drug problems – sometimes both at the same time. Most clients are only day attendees. There is no real trend, except for a slight spike of men over fifty being treated for alcoholism.

Lubna, who is the Director of the facility, is Gui’s boss. One day in the tea room, Lubna beckoned Gui over to have a private chat about a new resident named Courtney. She was admitted due to several life threatening binge drinking episodes – all within the past six months. After her last hospitalisation, her father agreed with clinicians that an alcohol treatment facility was needed to assist.

Gui had read Courtney’s referring notes and knew a little bit about her. She was 17 years old. Her mother passed away unexpectedly when she was 15, and now it is just her and dad. Still at school, she busses every day from her small rural hometown to the high school in the larger regional city nearby. Courtney would often arrive at school looking very tired and frequently went to sick bay to see the nurse. Generally she was quiet and well behaved, but an average student with little motivation. She has a few good friends at school, including some young people who lived in the town centre. Because her friends got up to lots of fun on the weekends Courtney tried to organise sleepovers whenever she could. Because her dad thought she needed some fun in her life he agreed she could go. This went okay for a while, but on the last two weekend sleepovers, which were three months apart, she had been hospitalised due to binge drinking. After the first incident she told her dad it was just an accident and would never happen again. Three months later he decided to let her go again, believing she had learnt her lesson. But it did happen again, and this time she was flown to Melbourne by air ambulance in a critical condition – only just making it.

However, that day on her morning walk through the grounds, Lubna had run into Courtney. She was sitting under a tree in the middle of some thick bush far away from the main building; an out of bounds area for all clients. Lubna said hello, and shouted out to be careful of the bull ants – which were notorious at that time of the year. Lubna soon noticed that Courtney was crying and seemed to be in some distress. Courtney seemed a little embarrassed at first, but quickly said sorry, got up and started walking to Lubna. They kept walking along the bush track and although unusual for Courtney, she instantly trusted Lubna and started to talk about the past few years.

Gui was curious about how Courtney had disappeared from the main area without staff knowing, and was immediately concerned about her state of mind. After talking to Courtney, Lubna was also eager to share her concerns with Gui.

Courtney mainly talked to Lubna about her mother’s death, living with just her dad and her boredom and loneliness, but she also opened up about her treatment at the facility. She didn’t like being in the same area as alcoholics, especially some of the older men whom she found gross and smelly. She felt unsafe around one man in particular who seemed to stare at her a lot. Courtney admitted to abusing alcohol, but she was no alcoholic and was upset and ashamed to be creating such a fuss for everyone.

She talked about how mean she was to her dad and how guilty she now felt. She normally had no feelings at all for her dad, usually feeling quite numb, if not slightly irritated with him. Her constant irritability was creating a giant wedge between them – but she couldn’t stop. Although he cooked her favourite meals on most nights, she often refused to eat, going to her room to be alone. Courtney’s father was worried because he thought she was losing too much weight; a constant cause of friction between them. She told Lubna he had got it all wrong – she was just fine, looking way better now that she had lost all her puppy fat – and some more.

Courtney used to go horse riding with her mum, and was quite a good rider. They were members of the local pony club, but she hadn’t ridden since her mother’s death. Her membership had now run out and no amount of coaxing from her dad would convince her to return. She confessed to Lubna that she snuck the occasional bottle of wine from her dad’s cellar under the house, but he didn’t really seem to notice. Her dad had always let her have a few sips of alcohol since she was a little girl, so she didn’t think it would matter. Courtney felt school was a drag because she couldn’t see how an education would make any difference to her life. Lubna could tell that Courtney’s feelings of sadness and hopelessness stopped her from trying to do well. But, Courtney could see no future for herself in the small country town she called home.

Courtney had pretty much lost interest in everything except for her few good friends – and drinking. She constantly worried about everything, biting her fingernails to the quick. About a year ago, Courtney’s dad had set up a visit for Courtney with the local doctor because he had noticed a change in her personality. The doctor thought she was just going through the normal process of grieving after the death of her mother and would come good soon. No additional counselling or support was arranged for her. Because Courtney always showed up at school and managed to ‘just’ pass most of the time, she was no real problem at school – flying low under the radar…

Gui listened attentively as Lubna conveyed Courtney’s sad story, thinking about how they might be able to help her. Lubna was also quite concerned and was thinking about the suitability of their normal treatment process for alcoholism. Someone from Alcoholics Anonymous (AA) visited every day to run sessions with the clients, but attendance was voluntary and young people tended to avoid it. It was policy at the facility that clients who presented with a drinking problem should abstain completely. No alcohol or drugs were allowed on the premises at any time.

What did current research tell them about young people and binge drinking? Could parent’s do anything to prevent it? Why did some young people turn to binge drinking while others coped with the ups and downs of teenage life, even the loss of a parent. They both needed to find out more. With the conversation over, Gui returned to his clients, but agreed to carry out the research into evidence-based practice for clients like Courtney.

Part A

1. What do you think are the reasons, Gui and Lubna found it necessary to find out more about how to assist Courtney?

2. Gui wants to learn more about how to effectively treat young binge drinkers, but how can he be certain the information he finds is credible and trustworthy? Describe two ways to evaluate the validity of information sources. (Up to 80 words)

3. Conduct research on the internet and find four websites that are credible sources of information on mental health for Gui. State the name of the organisation/institution and include their web address.

4. Conduct research on the internet and find four websites that are credible sources of information on AOD for Gui. State the name of the organisation/institution and include their web address.

5. Explain the following terms. Indicate which term applies to the work Gui is about to undertake, and why?

i. evidence-based practice

ii. continuous quality improvement

iii. research

6. From your internet research identify two current evidence-based trends in mental health and/or AOD treatment. Examine core issues, such as:

• Patterns of use

• Implications for safety

• New treatments

• What is known and what is still to be learnt

(Up to 100 words)

7. For one of your selected evidence-based trends in mental health and/or AOD treatment, find out how the following research principles were applied:

i. where and how and the research was conducted

ii. the rules of evidence

iii. cultural considerations

iiii. ethical considerations

8. Research may be conducted for a number of reasons, including:

i. comparison

ii. hypothesis testing

iii. trend identification

iiii. own knowledge extension

v. to strengthen quality of own practice.

For each reason above, provide further detail on its purpose and benefits.

9. Of the above, which purpose applies to the research being conducted by Gui? Explain.

10. To be credible, Gui’s research must demonstrate processes that support the analysis of information. Explain how Gui could use the following processes to support his research:

i. comparing

ii. contrasting

iii. challenging

iiii. reflecting

v. distinguishing the relevant from the irrelevant

vi. using interdisciplinary connections

11. Explain how you think Gui should go about finding and evaluating his information. (Up to 80 words)

TASK 2

Gui asks you to assist him in his research. He had conducted some preliminary reading on young people and alcohol abuse, discovering there has been extensive research studies done both in Australia and overseas. Gui needed some clarity around his research objectives and a few questions answered.

1. Identify and write up two research objectives for Gui based on his work requirements. (Up to 50 words each)

2. Conduct research to answer the following questions that have been puzzling Gui:

i. Does excessive use of alcohol affect the academic performance of young people?

ii. How does a young person’s personality affect their likelihood of developing alcohol abuse problems? Is there any research that could link to Courtney’s personality profile?

iii. To prevent alcohol abuse problems in their teens, is it better for parents to start their children early on alcohol to make it a normal everyday thing, or, should they hold off as long as possible?

iiii. What are some school-based prevention strategies that could be incorporated at Courtney’s high school?

v. Should young people with alcohol abuse problems abstain completely from drinking? If not, then what should happen?

vi. Is comorbidity connected to young people who abuse alcohol?

vii. Is Courtney suffering any signs of a mental illness, or is her doctor right in thinking she was just going through normal grieving and would recover soon?

3. From the research you conducted for Gui, compare and contrast the different sources of information you found into a systematic but simple table. Prioritise the research findings into numerical order from most to least relevant information based on Gui’s research objectives.

(The simple table should be developed using word processing software in landscape orientation to fit in the columns.) Your table should include:

i. a priority numbering system with ‘1’ being most relevant

ii. the name of the research

iii. the web address

iiii. the body who conducted and/or funded the study

v. the strength of the information

vi. the currency of the information

vii. the reliability of the information

viii. the key findings of the research.

4. Write an informal email to Gui (of about one page), explaining:

i. the ways your research findings could be utilised in the treatment facility, including the feasibility, the benefits, and don’t forget the risks

ii. any current practices at the facility that you recommend should be changed

iii. two areas that still require further research and evaluation

iiii. two recommended actions to assist in the treatment of Courtney from a comorbidity perspective.

v. the duty of care to be applied along with all evidence-based new practices