Case study: Using the three pillars of harm minimisation
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, (DSM-5®). American Psychiatric Pub.
Case study: Using the three pillars of harm minimisation
This case study is not just asking you to work on the individual in the case. What we want you do is take the issues presented by the case and examine, using the three pillars of harm minimisation, the individual, social and government responses. We want you to first read the case below:
Ian is a 55 year old married man with three kids (two boys aged 2, 15; a girl aged 17) who has been previously married before with two kids (both grown up). He lives in Tamworth, New South Wales and works at a steel fabrication company as a foreman. He left school at 14 but later went to TAFE and completed his high school diploma and a Certificate IV in Building and Construction.
Since the age of 12 Ian has smokes marijuana and drunken alcohol, although he states this was never more than a few drinks on the weekend until he reached 18 and he smoked only one or two cones a day. He has also been a heavy tobacco smoker since the same age quickly reaching a carton of 40 day. During this time Ian regularly missed school preferring to hang out with his mates fishing. This led him to leaving school before completing his high school diploma. After leaving school, Ian became involved in petty crime but was never incarcerated. Once 18, he realised he needed to change and found work in a warehouse where he met his first wife. It was at this point, and after the birth of his son now 30, that Ian began to drink much more heavily. This was partially due to the financial stress caused and also because his first wife nearly died during labour. The second child was born three years later, without problem. However, by this stage the marriage had ended and Ian was already in relationship with his now second wife. At the time she was working as a practice manager in a GP surgery and was the main money earner. This created some tension with Ian and he began to drink even more. While there was no threat of violence in the home, Ian did occasionally get into bar fights after work before going home. He had also been having times where he had forgotten what he had done the night before after particularly heavy bouts of drinking. Ian has also at times forgotten to pick up his two older kids from school, saying he was too busy at work, but in fact had been at the bar. He was also getting quite frustrated with his two year old whom he says never stops crying.
More recently Ian has been under threat of losing his job, due to a downturn in the manufacturing sector. He believes this may also be related to him missing a few days from time to time due to a back injury he sustained at work. He has been taking opioid medication for this problem ever since. His back problem has also been leading to problems with his marriage as his wife caught him taking prescription sheet from her work when he picked her up one day. He admitted to her he had been taking more medication than prescribed and was going to a number of doctors to get it. He also admitted he was dabbling with heroin, which he was getting from a friend whom he had visited in Sydney a year earlier. His wife was naturally dismayed especially when she realised he was injecting and had been doing so for some time. She asked him if he had been sharing needles which he denied, but she was not convinced. He has not sought help for any of his problems in the past but feels it is time to do so now.
Re-read: The National Drug Strategy 2010-2015 to remind yourself of the areas that fall under each pillar.
Introduction (250 words/10% of grade)
1. Summarise Ian’s issues and identify the areas of concern for him, his family and society in general (250 words).
2. At the conclusion of your summary produce a three column table which lists all of the issues under the headings of harm minimisation (harm reduction, supply reduction and demand reduction). Within each column, note where an issue may emerge from the case e.g., Hepatitis C, HIV, job loss, family breakdown etc.).
Example of table (not part of the word count)
Harm Reduction Supply Reduction Demand Reduction
Clean needles e.g., needle exchanges, needle drop boxes, policy behind this and so on
Family help Policing
Regulation e.g., safe drinking, gambling policies School based programme
Public awareness campaigns
Main essay (2250 words/70% of grade)
1. Take an example from each of the three pillars you identified in the table from your introduction adding further context to this example. (250 words)
2. Critically examine each example providing evidence to your argument. In each example provide commentary on how it affects the individual, the family and society including government drawing on peer-reviewed material, government policy, regulation andframeworks and non-government responses through charities and peak bodies (1500 words).
3. Link the three issues back to the case and then expand further to include the broader issues this brings. So, this should identify the personal and family costs to the individual in the case, what society may think about the areas you have chosen e.g., do people support needle exchange programmes, and examine critically the policies, regulations and frameworks that drive the interventions in the areas (500 words).
Conclusion (500 words/20% of grade)
1. Provide some possible solutions to the plight of the person in the case (200 words)and,
2. Suggest gaps or barriers to achieving this (200 words).
3. Finish by providing a set of common resources that could be given to Ian or his family or to helping agents (100 words + relevant appendices).
Style and referencing
Use APA 6th Edition throughout and provide at least 20 peer reviewed references that are data based research. You can include as much gray literature as you consider relevant (government reports, webpages, policy documents etc.