Elsie is an Aboriginal woman in her early fifties who is having problems dealing with the fact that her family is disintegrating around her. She has three grown children: the eldest, her only daughter has left home and has little contact with the family; the second child, a son, is facing a prison sentence for theft, his third offense; the youngest boy, 19 years old, seems to be the mainstay of the family, but is feuding with his mother, so may also leave soon. The father of Elsie's three children has had previous substance abuse problems, and left the home over a year ago. Elsie is on the verge of a breakdown, worrying about her son going to jail, worrying about the daughter she never sees, and the remaining child she may soon lose. She has lost two previous children, but we don't know how. Elsie needs counseling and support services and needs to accept the fact that children grow up and leave home. She must create a new life for herself, such as by community involvement, so that she is not completely alone, or reconcile with Tommy, the father of her children.
Welfare mothers suffer from more psychological distress and psychiatric disturbances than other groups (Rosen, Spencer, Tolman, Williams and Jackson 2002, pp.157-165). Nineteen percent of welfare recipients meet the criteria for one of four DSM-III-R psychiatric diagnoses included in a survey by these researchers. Excessive anxiety and uncontrollable worry about a number of events, which is the problem with Elsie, was found in 7.3 percent of the welfare population surveyed, and was twice as frequent in women as in men.
Because of changes in the Australian health care system, many people are using emergency rooms as the point of access for treatment of their mental health problems (Harrison 2004, pp.21-29). However, the staff in such facilities are not always competent to deal with such problems. This has led to the development of multidisciplinary mental he...