Indigenous Health and Social Determinants ICHB305
- Subject Code :
ICHB305
Case Study 5: Marr Mooditj
Claudette, an Aboriginal woman aged 27, has presented to an Alcohol and Other Drug service for an initial assessment in Perth.Claudette has been working in hospitality in Perth for over 10 years and completed a Certificate IV in Hospitality when she was 22. Despite this, Claudette has moved from job to job, struggling to get recognition for her skills, or be promoted in the various workplaces she has worked.
Claudette has struggled to make any meaningful connections with colleagues and is not supported in requests for cultural leave. She has overheard comments in the break room all those funerals she goes to, thats probably contributing to her not getting a promotion.
Claudette has become despondent about her workplace environment, and lack of opportunity, and has started using alcohol and other drugs to cope. Claudette had previously attended the service for a meet and greet session, where she met Wanda, the practitioner assigned to her case. Claudette has been directed by her parents to address her ongoing benzodiazepine and alcohol use.
Claudette is taking 7-10 Xanax tablets per day and regularly consumes half a bottle of bourbon in combination. Claudettes family have experienced a two month wait due to demand during the pandemic. Wanda asks questions about how much and often Claudette uses alcohol and other drugs before she focuses on the reasons for her substance use. Claudette states that alcohol and other drugs help her escape her negative thoughts and feelings and ongoing frustrations. When Wanda talks to Claudette about any mental health diagnoses she has had in the past, she notices resistance starting to build within her. Claudette says that she struggles with negative thought patterns and feels sad and numb most of the time. Wanda determines that her alcohol and other drug use is the most significant issue that needs to be addressed. Wanda also believes that Claudette has experienced significant childhood trauma that remains unresolved.
Case Overview:
Claudette is a 27-year-old Aboriginal woman living in Perth who has worked in hospitality for over 10 years.
Has completed a cert IV in Hospitality when she was 22.
Despite her qualifications, she has experienced repeated workplace discrimination, limited opportunities for career advancement and a lack of cultural support.
She feels isolated and undervalued, so she has turned to alcohol and benzodiazepines to cope.
Directed by her family, she seeks support from an Alcohol and Other Drug service.
Has previously attended a meet and greet session where she first met her assigned case worker, Wanda.
Her initial assessment by Wanda fails to focus on the deeper causes of Claudettes substance use.
Her case reveals signs of trauma, mental distress and resistance to discussing mental health struggles.
Precipitating factors:
She struggles to make meaningful connections with coworkers and is unable to befriend anyone at work.
Managers do not support cultural leave, unable to attend events that have cultural significance and meaning to her.
Coworkers talk behind her back, showing no sympathy about the number of funerals she has to attend.
Workplace discrimination and racism
Emotional distress
Delay in help, a two-month wait post-pandemic
Unresolved childhood trauma
Because of these factors, she has turned to alcohol consumption and drug use.
Substance use to cope regularly has 7-10 Xanax tablets per day and half a bottle of bourbon each day
Precipitating factors and SDoH (racism):
Interpersonal racism:
Racial discrimination
Comments from her coworkers
Exclusion
Structural racism
Employment inequality
Cultural leave denial
Lack of policies in place about racism
Institutional
Lack of cultural leave policies
Long wait for treatment/therapy
Internalised
Claudette feels not confident, out of place, feelings of sadness and numbness
Examples:
|
Structural |
No promotion despite qualifications; lack of cultural leave; long wait times for services. |
|
Interpersonal |
Colleagues' racist comments; exclusion from workplace social life. |
|
Institutional |
Inadequate workplace policies to support cultural identity and obligations. |
|
Internalised |
Claudettes low self-worth and despondency. |
Perpetuating factors:
Internal-
External-
Behaviours-
Perpetuating factors and SDoH (racism):
ICHB Assessment 2: Case Studies Marking Rubric Semester 2, 2024
|
Criteria |
Sub-criteria |
Insufficient (0 49%) |
Pass (50 59%) |
Credit (60% - 69%) |
Distinction (70 79%) |
High Distinction (80% +) |
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|
Content (65%) |
Case overview (10%) |
Missing/ Confusing/ Incorrect. |
Insufficient overview of the case. |
Overview given but does not fully explain case. |
Identifies key points of the case in question. |
Overview of the case succinct and identifies key points. |
|||||||
|
Predisposing (10%) |
Missing/ Confusing/ Incorrect. |
Some missing or poorly described historical and/or genetic/ epigenetic elements that contribute to the current circumstance. |
Historical and/or genetic/ epigenetic elements that contribute to the current circumstance identified. |
Historical and/or genetic/ epigenetic elements that contribute to the current circumstance described. |
Historical and/or genetic/ epigenetic elements that contribute to the current circumstance identified, described and linked to other Ps. |
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|
Precipitating (10%) |
Missing/ Confusing/ Incorrect. |
Some missing or poorly described |
Current triggers (origin of behaviour or health challenge) identified. |
Current triggers (origin of behaviour or health challenge) described. |
Current triggers (origin of behaviour or health challenge) identified, described and linked to other Ps. |
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|
Perpetuating (10%) |
Missing/ Confusing/ Incorrect. |
Some missing or poorly described |
Internal and external experiences that maintain the situation identified. |
Internal and external experiences that maintain the situation described. |
Internal and external experiences that maintain the situation identified, described and linked to other Ps. |
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|
Protective (10%) |
Missing/ Confusing/ Incorrect. |
Some missing or poorly described |
Strengths, social supports, cultural values, beliefs and positive patterns of behaviour identified. |
Strengths, social supports, cultural values, beliefs and positive patterns of behaviour described. |
Strengths, social supports, cultural values, beliefs and positive patterns of behaviour identified, described and linked to other Ps. |
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|
Overall structure (15%) |
Very poor organisation; jumps from point to point illogically. |
Some organisation; difficult to understand next logical step. Informationdescribed with littleanalysis. |
Discernible structure presented in logical way. Some evidence-based solutions or suggestionspresented. |
Discernible narrative structure. Evidence-based solutions or suggestionspresented. |
Organised to flow seamlessly. Comprehensive evidence-based solutions or suggestionspresented with actionable, innovative ideas. |
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|
Cultural integrity (20%) |
Awareness (10%) |
No awareness of biases, discrimination, and/or inequities presented. Only dominant cultural rules |
Minimal awareness of biases, discrimination, and/or inequities presented. Mostly dominant cultural rules |
Emerging awareness of biases, discrimination, and/or inequities presented. Other cultural perspectives |
Identification of biases, discrimination, and/or inequities presented. Dominant cultural rules presented discussed in cross-cultural awareness |
Questions of biases, discrimination, and/or inequities presented. Dominant cultural rules presented discussed in cross-cultural awareness. Various cultural perspectives presented with openness and appreciation |
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|
Appropriate writing in reference to First Nations peoples (10%) |
Unable to demonstrate use of capital letters as required and appropriate use of terminology, or writing without othering peoples/cultures |
Inconsistent use of Capital letters as required and appropriate use of terminology, or writing without othering peoples/cultures |
Always uses capital A for Aboriginal, I for Indigenous and where otherwise necessary. Writes without othering |
Writes with respect for culture with First Nations perspectives included |
Writes with respect and sensitivity for culture. An Aboriginal voice provided via either direct quotes or in reference to other materials where authorship/authority is explicit. |
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|
Academic skills (15%) |
Referencing & Sources (15%) |
Limited citations or referencing or sources of information. |
Major errors in chosen citation and referencing technique such as missing references or citations. Sources of information are untrustworthy and/or obvious bias. |
Few errors in chosen citation and referencing technique such as missing references or citations. Some sources of information are untrustworthy and/or obvious bias. |
Copyright considered for any images and clear match between information and source. Full and correct References on last slide. Most sources of information are credible. |
Citations are not distracting throughout presentation. Full and correct References on last slide. All sources are highly credible and relevant. |
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