Substance abuse and unpredictable behaviour 

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URN: USQ 654321 Family Name: Wilson Given Name(s):Gavin James Address: Unit 1, 2 Smith’s Road, Nelsonville. 2222 Date of Birth: 14/02/2001

MENTAL STATE EXAMINATION

General appearance	Gavin is a 20-year-old Caucasian, aggressive and almost unpredictable in nature. He is very friendly or at least manages to have friends despite being bullied in school. In his appearance, he seems like a bright young man who also looks distracted and restless. He seems to be relatively thin and slightly paler since he first joined grads school, according to his friends. He also seems to be having poor hygiene recently and appears to be not hygiene maintained.
Behaviour	Gavin has happened to have developed unpredictable behaviour and is found to be verbally aggressive on several occasion. He does not seem to have a positive relationship with his family members like he states he used to be and almost borderline wishes to commit suicide.
Speech	Gavin’s speech seems to be a bit distracting and incohesive at times, have a consistently soft volume at all times during the conversation. Gavin seems to be well articulated and seems to be showcasing his brightness through his choice of dictions and way of using them in his sentences for a successful convey of what he feels.
Mood and Affect	Although generally, he seems to be calm and naturally stable however since he relocated to Sydney, he feels consistently isolated and lonely. Gavin seems to have nobody in there and almost feels abandoned and therefore he is constantly dreading his isolation and seems to be affecting his current state of mind and mood.
Thought process	The thought process for Gavin seems to be consistent and does not showcase any sorts of disruption of flow in his thoughts.
Thought content	Having no relatives in Sydney makes him a recluse and almost abandonment feelings have swallowed him entirely. He also thinks people are not cordial enough with him the way he is with them, and seems to be having a thought of self-harming and at one point he had voiced his desire to kill himself. He thinks that he does not have the same bondings with his siblings like he used to, especially since he had joined grad school to pursue chemistry.
Perception	Substance abuse and unpredictable behaviour  consequently
Cognition	Gavin’s latest or any old memories from the past seem intact and in place Seems to be distracted and poor concentration IQ is definitely on the brighter side since he is reportedly been doing well until he started attending his grads school
Insight	His strange behaviour seems to be a bit unclear as to whether he acknowledges his problems or not, however, he clearly seems to be admitted to have a deteriorated relationship with his family members, especially with his siblings, since had moved out to Sydney.
Judgment	Gavin seems to be having an impaired judgement and does not have a proper sense of stable opinion, as it is stated by his friends he had been voicing his views and have found to be argumentative at all times, especially in his chemistry classes.

 

 

 

 

 

 

 

 

 

SYMPTOM	INTERVENTIONS
1. Substance abuse	Use of behaviour modification technique would be incorporated to ensure that Gavin is collaboratively working with the medical professional or in this case the commune nurse. This intervention technique would help him modify his behaviour where the desired behaviour would be encouraged with positive reinforcement and the use of punishment and extinction would be incorporated to ensure that his problematic behaviour is slowly reduced (Guthrie et al. 2018). Making sure that Gavin is introduced to applied behaviour analysis where the commune nurse would be able to analyse his attributes based on radical behaviourism and that covert behaviour is subjected to the same conditions as overt behaviour (Kingston, Marel & Mills, 2017).
2. Unpredictable behaviour	Listening to Gavin and having him alone for the assessment is always better. The aspect of having him assessed away from the rest would allow him to open up. Having a potential escape route open would help the strategy to potentially develop better intervention strategies for someone like Gavin (Kourgiantakis et al. 2020). Avoiding any sorts of physical intervention is always recommended since he has a sense of unpredictable behavioural problems and has shown a different sense of behavioural developments over the years, reportedly according to his friends and families (Mitchell, 2017).
3. Physical aggression and self-destructive attributes	Being sensitive and understanding with Gavin would be of great help. Having a cultural understanding and how he seems to view the world would help the commune nurse to conduct the assessment effectively. Avoiding any sorts of negative or discouraging conversation would help them have a better assessment (O’Donnell, Savaglio, Vicary & Skouteris, 2020). Being encouraging and avoiding any sorts of power struggles would help have the nurse conduct better interventions and have him refrain from any sorts of aggression or any consequent self-destructive attributes (Roush et al. 2017).

 

 

NURSING REPORT (Using the S.H.A.R.E.D. handover tool)

Gavin is a 20-year-old Caucasian, aggressive and almost unpredictable. He is very friendly or at least manages to have friends despite being bullied in school. In his appearance, he seems like a bright young man who also looks distracted and restless.

He seems to be relatively thin and slightly paler since he first joined grads school, according to his friends. He also seems to be having poor hygiene recently and appears to be not hygiene maintained. Gavin has been consistently showing deterioration in terms of his mental state since he had moved to Sydney for pursuing Chemistry. He feels considerably deteriorated and mentally abandoned, although he tried to stay connected with his family members, since he does not know anybody in the new city, he feels isolated and seems to be using drugs more than ever. Since high school, during his final year, he started using substances and has been abusing with the same, something that had both affected his mental and physical health, to have taken him into a state of distraction and a considerable amount of aggression. He almost feels defensive of his disposition and is considerably showing frustration towards his chemistry professor and in front of the entire class.

Gavin seems to be having a history of mental illness. Gavin’s father has been suffering from depression and his younger sibling is suffering from ADHD. Gavin’s granddad, Alfred’s father had committed suicide right after his service in the Vietnam war. Gavin’s paternal grandmom had been suffering from depression and anxiety since she had lost her daughter, Ann from an accident, something that had developed traumatic experience with death. During his final year in high school, he started using illegal substances and started taking random drugs, something that had had a severe impact on his behavioural development.

Gavin is diagnosed with substance abuse behavioural problems and is diagnosed with severely bipolar with his attributes. He also seems to be diagnosed with severe depression that had refrained him from maintaining good hygiene. Gavin had been developing strange behaviour and looking at his behavioural development and monitoring his reactions, the conclusion has been made that he might be experiencing multiple personality disorder. One moment he seems calm and then the next moment he seems to be aggressive and self-destructive. The risk factors that lie in Gavin are his recent development of drinking habits since he had moved into Sydney to pursue his study in Chemistry at the university level. He also seems to be consistently using illegal substances and reportedly had been doing the same since he was in his final year in his school. He has been showing symptoms of being self-destructive and at one point head found to be voicing his desire to kill himself (Tsakalidis, Liakata, Damoulas & Cristea, 2018).

With the necessary intervention methods, Gavin is expected to be recovering from his behavioural switches and physical aggression that out the people in his surroundings almost into an immediate shock and alert. The commune nurse seems to be seeing progression and would let Gavin have a self-assessment very soon. Daily review by the registrar and the medical consultant and the commune nurse have been conducted while the medical officer had suggested having Gavin mentally counsel as frequent as possible while monitoring his progress.

REFERENCE LIST

 

Guthrie, S., Lichten, C. A., Van Belle, J., Ball, S., Knack, A., & Hofman, J. (2018). Understanding mental health in the research environment: A rapid evidence assessment. Rand health quarterly, 7(3). Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5873519/

Kingston, R. E., Marel, C., & Mills, K. L. (2017). A systematic review of the prevalence of comorbid mental health disorders in people presenting for substance use treatment in Australia. Drug and Alcohol Review, 36(4), 527-539. Retrieved from: https://onlinelibrary.wiley.com/doi/abs/10.1111/dar.12448

Kourgiantakis, T., Sewell, K. M., Lee, E., Adamson, K., McCormick, M., Kuehl, D., & Bogo, M. (2020). Teaching Note—Enhancing Social Work Education in Mental Health, Addictions, and Suicide Risk Assessment. Journal of Social Work Education, 56(3), 587-594. Retrieved from: https://www.tandfonline.com/doi/abs/10.1080/10437797.2019.1656590

Mitchell, A. J. (2017). The Mini-Mental State Examination (MMSE): update on its diagnostic accuracy and clinical utility for cognitive disorders. In Cognitive screening instruments (pp. 37-48). Springer, Cham. Retrieved from: https://link.springer.com/chapter/10.1007/978-3-319-44775-9_3

O’Donnell, R., Savaglio, M., Vicary, D., & Skouteris, H. (2020). Effect of community mental health care programs in Australia: a systematic review. Australian Journal of Primary Health. Retrieved from: https://www.publish.csiro.au/py/PY20147

Roush, J. F., Brown, S. L., Jahn, D. R., Mitchell, S. M., Taylor, N. J., Quinnett, P., & Ries, R. (2017). Mental health professionals’ suicide risk assessment and management practices. Crisis. Retrieved from: https://econtent.hogrefe.com/doi/abs/10.1027/0227-5910/a000478?journalCode=cri

Tsakalidis, A., Liakata, M., Damoulas, T., & Cristea, A. I. (2018, September). Can we assess mental health through social media and smart devices? Addressing bias in methodology and evaluation. In Joint European Conference on Machine Learning and Knowledge Discovery in Databases (pp. 407-423). Springer, Cham. Retrieved from: https://link.springer.com/chapter/10.1007/978-3-030-10997-4_25

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