Greg from Badu Island

https://www.ranzcp.org/Publications/E-learning.aspx

Greg from Badu Island is a case study which forms part of modules developed by the Royal Australian and New Zealand College of Psychiatrists (RANZCP).  Module 1: Interviewing an Aboriginal or Torres Strait Islander Patient allows the student to explore their responses to the issues raised in this case study.  This case study also features in Module 2: Developing a mental health management plan for an Aboriginal or Torres Strait Islander patient and Module 3: Formulation of a case involving an Aboriginal or Torres Strait Islander Patient.

Background

Greg is a 44 year old Torres Strait Islander man from Badu Island in the Torres Strait. He is married to Annie, also from the Torres Strait and they live in Mount Isa. Annie has been sick for some time and has recently been admitted to hospital, leaving Greg to care for their six children on his own.

Greg presents to the local children’s health services in a distressed state. They, in turn refer him to the local mental health service for counselling. Greg has just been told that Annie’s older brother, who is terminally ill with cancer, is about to die and that he is required to go back to Badu Island to perform the duties of the Mari-Gethal for his brother in law when he dies. Greg is worried about leaving his sick wife and is having trouble finding local family members who can care for the children.

Greg is, unfortunately, unable to make arrangements to return to Badu Island to perform the duties of Mari-Gethal when his brother in law dies and another person is allocated for the task.

Interview

A few months later, Annie has recovered from her illness and contacts the local mental health service, concerned about Greg’s mental state. She tells you that Greg appeared to handle the tremendous pressure that he was under when she was in hospital in looking after the children, and seemed to cope well with his inability to return to Badu Island to perform the Mari-Gethal duties for her deceased brother.

However, she tells you that Greg significantly increased his consumption of cannabis while she was in hospital. Greg told her it was to help him cope with all the stresses that he was having at the time. He recently has become increasingly suspicious of Annie, and has accused her of having an affair. She is very worried about Greg’s jealous preoccupation about her. Greg has also become increasingly concerned and frightened that people are going to perform sorcery on him because he did not perform the required Mari-Gethal duties for his deceased brother in law. Annie says that Greg has never previously been like this.

Greg agrees to an assessment. Kath, an Aboriginal and Torres Strait Islander mental health worker is present at this meeting.

Setting

The following elements make up the setting:

  • remote community
  • accompanied by an Aboriginal and Torres Strait Islander mental health worker/emotional social spiritual wellbeing worker, Kath
  • Kath has concerns about Greg’s cannabis use, depressive feelings and potential self harm
  • Kath has told the patient in both language and English that she wanted him to talk with the outreach psychiatrist, and tells Greg the psychiatrist’s name.