Section Nine

Case Study 6

You arrive at work to find out that Rajat, a 48-year-old client diagnosed with chronic schizophrenia, abused his roommate because he thought he was making gestures at him. Rajat was admitted overnight involuntarily when a neighbour who he has a relationship with encouraged him to go to emergency. Rajat was extremely confused and not making any sense. The community he lives is purported to have a high amount of IV drug use. Rajat spends the government provided disability support he gets on rent and the rest on drug use and cigarettes (he has been smoking since he was 8, which he informs you is common in India). He is also obese with metabolic syndrome.

Student questions

  • What are your first steps?
  • How do you develop a safety plan?
  • How do you assess Rajat?
  • What are the results of your assessment and how do they impact care?
  • What about the link with Schizophrenia and drug use?
  • What is the most important aspect you would work on with Rajat?
  • How would you prioritize his care?
  • How does Rajat’s culture impact influence his illness?
  • How do you establish a therapeutic relationship with Rajat?
  • What kinds of strategies can you put in place for him when he is eventually discharged?

Educator elaboration

  • Give Rajat a specific ethnicity and explore culture competence as it relates to mental illness.

Discussion Topics

  • Metabolic syndrome and its impact mental illness and treatment
  • Social determinants of health
  • Mental health and illness legislation