Case Study
Peter grew up in an intact family environment. He had an uneventful early childhood growing up with his younger sister and his parents in Sydney. Peter's father Jim was an only child. He married Alice and they had 2 children, Peter who is 42 years old and Rebecca who is 35. Peter's mother has 2 older brothers. His grandparents are deceased. There is a family history of mental health issues on the paternal side with Peter's father suffering from a "breakdown" which could have be depression, but never formally diagnosed, and his paternal grandfather father having died by suicide after suffering PTSD from being a soldier in WW2. His sister Rebecca has been diagnosed with anxiety. During Peter's teenage years, he did not complete high school, disengaging from education in grade 11 following a marked decline in his school grades, school refusal, and no longer showing any interest in his preferred career choice of becoming a mechanic. By the age of 17 he was securing casual jobs locally in Sydney. Whilst remaining living with his parents, he started to verbalise abnormal content during his conversations, and aggressive behaviours towards his family members which he was asked to get help for, and which Peter subsequently ignored. Peter had started to be involved in a peer group that were involved in illicit substances which he often used. Over the following 12 months, Peter's verbal, and at times potentially physically aggressive behaviour continued and his parents asked him to move out of the family home as at times they feared for the safety of the family members. Peter moved to Queensland when he was 19, moving frequently and living in shared accommodation. Although he had been in a relationship and fathered 2 children, he never married and has minimal contact with his children (phone only). His last job whilst residing in Queensland was as a courier driver in a rural town. Peter continued to display abnormal behaviours which led to very poor relationships with other male staff because of his verbalisation of his beliefs that they were paedophiles. He also failed to turn up for work on a regular basis which resulted in him being asked to leave. Following his dismissal, he was unable to secure other casual or permanent work and relied upon Centrelink for financial support. During the latter part of his time living in Queensland, Peter was referred to a local mental health service. This referral was precipitated after police had been called following an altercation between Peter and another male at the shared accommodation. Other residents at the shared accommodation had identified to the police that Peter had not been self-caring, was often seen talking to himself and voicing potential violence toward others, and on occasions actual aggressive behaviour. Additionally, he had been heard to voice bizarre content about various males. Placed under the mental health act, and following an assessment was commenced on antipsychotic medications for a diagnosis of schizophrenia. Within 2 months he was unable to be located by the service but had in that time travelled back to his family in Sydney. Over the next 6 years whilst living with his parents, he refused to acknowledge that he was mentally unwell and had been non-adherent with prescribed medications. He had been abusing prescription medications including diazepam and Xanax and socially drinking. An altercation with a maternal uncle resulted in minor trouble with the law after he believed that his uncle Tim was "being a problem" with his mother – Peter assaulted the uncle, and police had been called – the uncle did not file a formal complaint for battery and assault. Due to his parent's age and medical issues, they asked Rebecca if she could have him live with her and her partner, and he moved to Queensland again. However, within a month he started to display aggressive behaviour and told his sister that her partner was a danger to children, believing that he was a paedophile, and that she needed to leave him. He was threatening violence towards her partner. His sister, Rebecca accessed mental health services for Peter, and he has now been admitted to the Acute Mental Health Service for the past 5 days. She has indicated to the treating team that she cannot longer care for Peter and is requesting that alternative accommodation be secured. Peter has expressed a strong desire to reconnect with his passion for working on cars, particularly mechanical repair and restoration. He dreams of one day driving trucks professionally, finding purpose in the structure and independence that kind of work could offer. Rebuilding his relationship with his sister Rebecca is also a key goal, as he recognizes the importance of family and the damage his illness has caused. In addition to these aspirations, Peter has shown interest in outdoor activities such as camping and fishing, and he enjoys watching documentaries about machinery and engineering. He has also mentioned an interest in learning basic carpentry and hopes to develop practical skills that could lead to future employment or personal fulfillment.
Summary of Assessment Requirements
The assessment involves a case study analysis of Peter Goldblum, focusing on his personal, social, and mental health history. The key requirements include:
- Comprehensive understanding of Peter’s background: family, childhood, education, and social experiences.
- Identification of mental health concerns: including schizophrenia, substance misuse, aggression, and non-adherence to treatment.
- Analysis of social and environmental factors: such as relationships with family, employment history, and housing stability.
- Application of mental health nursing principles: planning interventions, understanding psychosocial support systems, and promoting recovery-oriented care.
- Consideration of aspirations and strengths: including career interests, hobbies, and family relationships, to inform patient-centered care planning.
- Use of evidence-based literature: to support analysis and recommendations for nursing practice.
The assessment requires students to critically analyze the case, integrate theory and practice, and develop appropriate strategies to support Peter’s mental health and rehabilitation.
Approach by the Academic Mentor
The Academic Mentor guided the student through the assessment in a step-by-step process, ensuring clarity, critical thinking, and alignment with learning outcomes.
Step 1: Understanding the Case Study
- The mentor helped the student read and dissect Peter’s history, highlighting key events, risk factors, and behavioral patterns.
- Focus was given to family history of mental health issues, social isolation, substance misuse, and occupational challenges.
- The student was guided to note Peter’s aspirations and strengths, which are critical for recovery-oriented planning.
Step 2: Identifying Key Areas for Analysis
- The mentor helped the student categorize information into domains:
- Personal and family background
- Education and employment history
- Mental health and behavioral challenges
- Social and environmental influences
- Strengths, interests, and aspirations
- This structured approach made it easier to organize reflections and analysis clearly.
Step 3: Linking Theory to Practice
- The student was guided to connect Peter’s experiences with mental health nursing theories, including psychosocial models, recovery frameworks, and risk assessment principles.
- The mentor emphasized using academic literature to support observations and recommendations.
- Practical considerations such as housing needs, medication adherence, and family support were linked to evidence-based interventions.
Step 4: Developing a Reflective and Analytical Response
- Each section of the assessment was approached with critical reflection:
- How Peter’s assumptions about his illness influenced his behavior.
- How family dynamics and environmental stressors impacted his mental health.
- How interventions could be tailored to Peter’s strengths and aspirations.
- The mentor encouraged the student to propose realistic nursing strategies, highlighting patient-centered and recovery-focused care.