Reference no: EM133629178

Read the scenario below and answer the question that follows:

Justine had tried many different types of medication to treat her clinical depression which had become so bad that she was no longer able to work. Each medication she had tried had either been ineffective or caused severe side effects. When Dilini, the mental health worker who had been supporting her over the last few months, visited her the following day, she told her that she was at the point of almost giving up.

Dilini calmly responded by telling her that there were still other options. "What other options?" exclaimed Justine, "I've tried everything."

"Would you consider seeing a psychiatrist?" asked Dilini. "Psychiatrists are for crazy people. I don't want everybody to think I'm crazy" replied Justine. "In any case, I'd be terrified." Justine had always shied away from seeing a psychiatrist. Dilini calmly explained to Justine the role of a psychiatrist and then accompanied her the following week to the GP to get the require referral. She even sat with Justine after she had visited the GP while she rang and booked the appointment.

As there was a six week wait to see the psychiatrist, Dilini used the time over the course of the next three visits to tell Justine what questions the psychiatrist might as her and then they role played the upcoming visit several times. With each successive role play, Justine became more confident and fluent with the answers she provided. She also began to think of questions she would like to ask.

When the day of the appointment finally arrived, Justine was still quite anxious. Dilini reminded her of the role plays they had undertaken and how well Justine had not only answered questions but had thought of really good questions to ask also. The appointment went well and the psychiatrist gave Justine a prescription for a mediation which was primarily used to help people with sleep disorders. He also provided her with a sample pack of medication which would last her for the first four weeks by which time she would know if it was working. After the failure of the medications, she had tried previously, she remained skeptical but thought it was worth one last try.

Following the regime specified by the psychiatrist, she started with one tablet per day and gradually increased the dosages over four weeks. To her delight the medication began to work and her mood began to improve a little and then significantly. She started attending social events once more and even began enjoying and looking forward to them. She also felt more positive at work and able to work her way through problems when they arose.

When the sample pack ran out, she took the prescription for the medication to her local pharmacist to get another four weeks of tablets dispensed. She was surprised to learn that the medication was not included on the Pharmaceutical Benefits Scheme (PBS) and that each script would cost her $140 which she simply could not afford. She returned home despondent and rang Dilini.

"What can I do?" I can't afford $140. Dilini suggested some possible options. Low cover extras health insurance with pharmaceutical rebates was one. There was also a generic version of the medication which was $40 cheaper. There was also a PBS safety net which Justine had not known about which placed a threshold for spending on pharmaceutical scrips for both concessional and general patients. As a concessional patient, Justine would only need to spend $316.80 per year. Dilini didn't tell her the amount.

She simply told her of the scheme and where on the internet she could find more specific detail in relation to the threshold and spend amounts. She then watched as Justine looked it up on the internet on her phone and broke into a broad smile.

Feeling much better about things, Justine conducted her own research on the internet about the medication she was taking. She found data indicating that over 100,000 people in Australia were currently taking the

Thinking about advocacy and self-advocacy:

Suggest an appropriate referral for Justine to provide her with the knowledge and skills she needs to lobby the government to add the medication to the PBS.

Identify two barriers that Justine faced when pursuing self-advocacy in relation to her situation and how she overcame or might overcome each barrier.

Identify three ways in which Dilini supported Justine in relation to self-determination.