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Scenario: Rob is in his mid-30s. It is noticed that he
is talking to himself. He is restless and suspicious of others.
They may be plotting to kill him. On questioning Rob, he admits
to hearing 'voices' which he believes are originating from outside
his head when he is alone.
This is characteristic of psychosis (loss of the sense
of reality) and may be due to drug or alcohol abuse, schizophrenia,
acute mania, a depressive psychosis,
alcohol or drug withdrawal, or some
other confusional state (see the section on 'drowsiness').
Advice:
- Protect yourself (and, if possible, the client) against potential
harm by having another person assist in the removing of potential
weapons. Determine an 'escape' route.
- Be 'involved' with the client, but also sufficiently detached,
so as not to threaten or frighten him/her with undue intrusiveness,
opposition, overfamiliarity or intimacy. Avoid touching the client.
- Speak quietly, firmly and distinctly. Give the client an adequate
hearing.
- Ask tactfully if the person has had thoughts of injuring either
themselves or others.
- Contact a doctor, psychiatric service (Table 6),
ambulance or the police. Stay with the person until further help
arrives, attempting to calm and reassure.
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