Question

In December 2017, 9-year old Jack and his mother (Harriet) were visiting their extended family in Melbourne. They were shopping in the city on 21 December when a driver drove his car into pedestrians at the corner of Flinders and Elizabeth streets. Jack and his mum witnessed this event (in which 18 people were injured, with an elderly man subsequently dying from his injuries). They were not in harm’s way (with the car traveling away from them and the driver quickly apprehended. However, Jack and his mum had multiple conversations about how they each thought they could have been killed during the attack. Two days later, Jack and his mum returned to their home in Brisbane.

Jack lives in an intact family consisting of his biological parents, Harriet and Peter, and his older sister Natalie. He is in Grade 4 at the local primary school and has lots of friends. He is also close to his parents and his grandparents (who are involved in his care during the week).

Immediately following his return home, Jack experienced nightmares on a few occasions about cars driving towards him. After the first nightmare, Jack’s dad (who has a history of anxiety and depression) encouraged Jack to sleep in the parents’ bedroom on a camp mattress. Despite mum’s suggestion that it is time for Jack to move back to his own bedroom, he is still sleeping in his parents’ room. Jack’s mum and dad have had many arguments about this situation. Peter’s (dad) perspective is that:

Jack is a very sensitive child who (even as a newborn baby) is more easily upset than other children;

Jack has been exposed to a traumatic experience in which he could have been killed;

Loving support (including avoidance of going into Brisbane city) is required to prevent Jack from developing ongoing mental health problems following this exposure; and

He (dad) could not cope if he lost one of his children.

From Harriet’s (mum) perspective:

The experience was upsetting but she and Jack were not hurt and were never likely to have been hurt (as she has discussed with Jack);

Peter (dad) needs to talk about the attack less; and

Jack is a healthy boy who seems to be handling the experience well.

Question: How likely do you think it is that Jack might develop a diagnosable mental health problem following his exposure to the attack in Melbourne? [Note, you are not being asked to identify possible mental health problems]. Identify 8 factors (a mixture of risk and protective factors – does not need to be 4 of each, but rather 8 in total) to justify your answer, and explain why each is either a risk or a protective factor.

Answer 1

The factors which could lead to Jack developing a diagnosable mental health problem are:

1) He was an eye witness to a devastating road accident at a very tender age.

2) He has nightmares of cars rushing by. He found it difficult to sleep alone.

3) His father was a patient of mental illness himself, thereby showing his genetic inclination towards it.

4) As a child too, he was more sensitive than others and therefore he would be more prone to having after effects of such a traumatic incident.

5) The flashbacks that he was having, were being catered to in an escapist way, in which he was not really getting empowered to face them.

6) Jack was learning a flight response in which he was getting dependent on his parents to seek comfort and this was making him weaker.

7) He did not get any biological help from a doctor therefore his changes in the brain have not been traced.

8)None of the parents were talking about the events and helping him process the memories. Therefore, the memories were not disappearing from his mind.