Case study scenario
You are a Registered Nurse in an Accident and Emergency Department. Jack was brought in by ambulance after his mother found him semi-conscious at home. Medical assessments revealed Jack consumed an overdose of over the counter medications. Jack is alert, orientated and engaging with you. During your discussions with Jack, you gather the following information.
Jack is a 21-year-old man. He lives with his mother Sally, and younger brother, Cam, who is 15 years old. During your conversations with Jack, he reports he has a good relationship with his mother. However, Jack feels more distant from his mum since his dad died suddenly 11 months ago. Jack reports his mum has been working two jobs and extra hours to pay for the family bills. Jack says he doesn’t see her much as she leaves home at 6 am and gets home around 8 pm most nights –on the weekend she is too tired and doesn’t talk much. 
Jack is an apprentice mechanic (works 4 days a week) and studies part time as part of his apprenticeship (1 day a week). Jack has told you he is behind in his studies and has failed one assessment and hasn’t submitted two others. He says he has been feeling very tired, unmotivated, and has noticeable lower energy for two to three months now. Jack says he used to go to the gym and play soccer but he just can’t find the enthusiasm to go anymore. Jack has also taken a few sick days from work over the last month. He is becoming increasingly anxious that he may lose his apprenticeship due to not submitting his work and reduced attendance at work. Jack has been in a relationship with Jill, a 20-year-old female, for two years. They met through a friend. Jack states that Jill and has been upset and distressed with him during the last two months as she feels that he has become increasingly distant, frequently cancels time together, and often doesn’t return her phone calls or text messages. He also has stopped using social media and his friends are concerned about him.
On the night of the overdose, Jack and Jill met for dinner. They had an argument about the state of their relationship and Jill left dinner half way through visibly upset. Jack walked home and on the way went to the bottle shop for some additional beer – he tells you he thinks he drank all 6 bottles in his room when he got home – no one else was home at the time. He reports that he became increasingly anxious, agitated and distressed after consuming the beers. He took an impulsive and intentional overdose of medications. He states he can’t remember which tablets he took or how many. Jack states he has been experiencing ruminating thoughts of suicide since his dad died. He mentions there is some ‘heavy duty’ machinery at work that he could use, but hadn’t had the opportunity because everyone’s there early. The first anniversary of his dad’s death is approaching and he was thinking that it would be the best date to do it. He misses him terribly. He hasn’t been able to talk to his mum because she is busy working and he doesn’t want to burden her anymore – he knows she misses him too and he feels guilty. He feels like a failure because of work and not submitting his assignments and feels like he is letting his family down. The last month has been especially difficult as he feels overwhelmed and Jill has mentioned ending their relationship. At the current time, Jack tells you “he just wants to end it all”.

1. Depression and suicide are significant areas of concern in Australia.

a) Investigate and outline the incidence of both depression and suicide in Australia.
Depression and suicide should be addressed separately.

b) Critically discuss one community group identified as ‘at risk’ of depression and one different community group identified as ‘at risk’ of suicide. 
Ensure your answer demonstrates why these identified groups are thought to be at risk applying contemporary literature.
In response to the case study answer the following questions. (Remember to refer to the literature)

1. Critically discuss three (3) factors that may have contributed to the development of the client’s mental health concerns and risks.
2. Legal and ethical considerations in health care can generate in-depth discussion from varying perspectives within the multidisciplinary team. 
   The case study presents areas of risk regarding harm to self and others. 
   Define and discuss the ethical principles of beneficence and non-maleficence and aspects of the Mental Health Act 2014 W.A., which are relevant to the areas of risk in the case study.
3. Identify a high priority mental health risk from the case study, and provide two (2) relevant nursing interventions.
   Explain the rationale and the potential impact on the client for each intervention associated with the risk identified (Note: the interventions should be within the nurse’s scope of practice). Remember to support your discussion by referring to contemporary literature.
4. Identify a mental health problem/ issue/ need from the case study, and provide two (2) relevant interventions. Explain the rationale and the potential impact on the client for each intervention associated with the problem/issue/need identified (Note: the interventions should be within the nurse’s scope of practice). Remember to support your discussion by referring to contemporary literature.