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Schizophrenia Case Study

Schizophrenia Case Study

Introduction: Contracted Case Analysis
This case highlights a female diagnosed with schizophrenia. The letter written by the sister of the patient indicates 10 years of ongoing symptoms and heavily criticizes the Australian mental health care system. The sister has described feelings of degradation, stress, and discomfort, for herself as well as her mother, as caregivers for the patient. There is clearly not the possibility of a sufficient amount of care available to the patient, which may be the result of a small family. The patient was also left unattended at multiple instances by medical authorities as well as family.

Duty of Care/ Human Rights
As we can see, the patient was not in the proper state of mind to be able to properly self medicate, nonetheless, she was given, by medical authorities, the opportunity to do so. This was plainly not an accurate judgment on behalf of the nurses and doctors seeing as her condition escalated into something much more severe. In this case, the sister of the patient has challenged the current structure in the Australian mental health system in regards to duty of care being more, if not equally important than the right to privacy of a mentally ill person. This is an idea that has been challenged in many countries for many years.

In Indonesia, people with mental illnesses can be restrained against their will, and with no legal basis, be involuntarily treated. There is absolutely no requirement for a legal review of the need for hospitalization and there is no need for consent of the patient or a guardian to be admitted into, and detained in a hospital. (Imansyah et al., 2009). Here we can see the extreme opposite of our case, where the subject is given too many liberties, resulting in a detrimental effect on her health. It is difficult to find the appropriate balance between violation of human rights and fulfillment of the duty of care. However, it is important to act in accordance with the constitution. In doing so, a recommendation would be for the family members present to take a stronger and more present role in guardianship. If this is not possible, the state and medical authorities should assign a professional caregiver for the patient.

The Economics of the Mental Health System in Australia
From the gathered knowledge of the patient, there is an apparent need for psychiatric care that is currently not being met. The patient’s sister repeatedly mentions the financial aspects of the health care system and how it has had a negative effect on the patient. An economic overview and research study performed by Victoria University in Melbourne, Australia indicates that “unmet need and met non-need” is an omnipresent problem , of an informational kind, that is present in the Australian mental health care system. (Dossel et al, 2008) This indicates that there is a disproportionate sum of funds allocated for mental health care, as oppose to other types of diseases, and that the patient shares a similar problem as many others.

In this case, we have seen the patient become de-hospitalized on multiple occasions, even with the disapproval of the patient’s family, which evidently had a negative result. As realized per study of the mental health care system of Norway, it is safe to assume that in most cases, de-institutionalization occurs because of fewer beds, not fewer patient’s actually treated (Pederson et al., 2009).

With that said, a study performed by the Australian government prior to this University study, in regards to the total expenditures on health care in 2000-2001, indicated the following: Out of the seven disease groups that account for the greatest health expenditure in Australia, mental disorders were allocated the lowest percentage of funds, 6.1%. At the same time, mental health was considered as a national health priority area (AIHW, 2004). In the seven years prior, the changes in mental health expenditures showed the least growth. However, these expenditures did not include fund allocation to community mental health services. When included, growth was 43%, trailing only oral health and nervous system disorders.

This evidence backs the idea that the problem lies not within the funding but rather of the informing the subjected publics where they are able to utilize this funding. As an administrator, a recommendation would be to more efficiently spread the available human resources to match needs of patient’s. A low turnover rate coupled with the proper human resources are used as caregivers or secretaries, the important part is to build a comfortable, beneficial relationship for patient’s with mental disorders such as schizophrenia.

Recommendations for Alternative Treatments
In the case of this patient, the family has made it known how they felt when the patient’s sister wrote, “we learnt that there were and still are, no resources available, apart from anti-psychotic medication.” Further analysis shows the willingness of the patient’s family to explore alternative treatment. However, the resources needed to fulfill these possibilities are not currently presented to the general public, resulting in an unaware and negligible state. As far as this case is concerned, the patient has apparently never experienced any other type of treatment other than medication through prescribed drugs.

The opinion of the family goes not unaccompanied as many professionals believe medication should not be the sole, nor the most common, method of treatment for mentally ill patient’s. An established, researched, and effective intervention for mental disorders is cognitive behavioural therapy. (Nareem et al., 2010). Ever-growing is also the application of psychological, social, and biological approaches to schizophrenia. This leads me to a specific type of treatment that seems would benefit the subject at hand.

With careful economic and historical analysis of the illness, as well as the role of drug companies, it has become more evident that hallucinations and delusions are understandable reactions to various life events, as well as inevitable and unexpected circumstances (Read et al., 2004). Whereas many psychiatric trainees are taught that you cannot speak with, and reason with a disease, there are new techniques that suggest otherwise.

Studies show that within a 6 week period, as well as 2 year period, an alternative treatment called soteria, designed as a drug-free treatment environment, was equally, if not more successful than antipsychotic drug treatment in reducing psychotic symptoms. Soteria is an approach that includes non-professional staff that offers minimal interference and high levels of support. It is a community based therapy and it involves non-professional workers being with the client, doing things with the client, and giving importance to the individual’s life history (Carlton et al., 2007).

Conclusion
As a member of the senate, it is clear to me that the family cannot be blamed for the lack of support, and currently, everything that can be done in regards to funding, is seemingly being done. Because, in this case, patience is something that is hard to ask for, I would like to allocate funds into raising the awareness of alternative treatments. This is why I would recommend giving the soteria approach a chance. Not only would the patient in this case feel revived as she would be experiencing something completely new, but it would solve the housing problem the family has experienced and allow for the mother and sister to contribute as frequently as they are able. I believe this result will be successful and could be replicated on a national basis.

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