NRSG263 / NRSG 263 Principles of Nursing:
Mental Health
Assessment Task 2 – Case Study Presentation
Case Study Two – Trevor
Major Depressive Disorder, Mental State Examination, Risk Assessment, Recovery-
Oriented Care & Mental Health and Wellbeing Act
Australian Catholic University | 2026/2027 Updated
Introduction
Trevor is a 48-year-old man living with major depressive disorder. He has experienced
depressive symptoms since adolescence and was formally diagnosed during adulthood.
His history indicates longstanding psychosocial adversity, including bullying and peer rejection
during adolescence. During university, he began using alcohol and cannabis as a way of coping
with low mood and attempting to gain social acceptance.
Trevor currently lives with his wife and their two daughters. Over recent months, he has
experienced persistent sadness and hopelessness, reduced motivation, withdrawal from activities
he previously enjoyed, and difficulty functioning within his occupational and family roles. His
GP has therefore referred him to a community mental-health service. Studocu
This presentation will address:
1. Two factors that may have contributed to Trevor's mental-health difficulties.
2. His appearance, behaviour, speech and thought content within the Mental State
Examination.
3. Two priority risk domains and appropriate nursing responses.
4. Recovery-oriented collaboration with Trevor and his family.
5. Application of the relevant Mental Health Act framework.
1. TWO CONTRIBUTING FACTORS
Factor One – Bullying, Peer Rejection and Social Adversity
, Trevor experienced repeated bullying and rejection from peers during adolescence.
Adolescence is an important developmental period for the formation of identity, belonging, self-
esteem and interpersonal relationships. Persistent rejection during this period can contribute to
negative beliefs about the self and difficulties developing a sense of social connection.
In Trevor's case, his history suggests that these experiences may have contributed to:
low self-worth
social isolation
difficulty developing trusting relationships
negative self-perception
vulnerability to persistent depressed mood
It is important not to describe bullying as the single cause of Trevor's major depressive disorder.
A more accurate biopsychosocial formulation is:
Developmental vulnerability + repeated social adversity + later stressors + individual
biological/psychological factors → increased vulnerability to depression.
This is consistent with ACU's emphasis on examining multiple factors that affect mental health
across the lifespan. Australian Catholic University
Factor Two – Substance Use as a Maladaptive Coping
Strategy
Trevor began using alcohol and cannabis during university in the context of low mood and a
desire for social acceptance. Studocu
This is clinically relevant because substance use can interact bidirectionally with mental-health
problems.
Trevor may initially have experienced the behaviour as a coping strategy, but persistent use can
contribute to:
poorer emotional regulation
impaired sleep
reduced motivation
relationship difficulties
impaired occupational functioning
reduced engagement with treatment
worsening overall mental-health outcomes
Mental Health
Assessment Task 2 – Case Study Presentation
Case Study Two – Trevor
Major Depressive Disorder, Mental State Examination, Risk Assessment, Recovery-
Oriented Care & Mental Health and Wellbeing Act
Australian Catholic University | 2026/2027 Updated
Introduction
Trevor is a 48-year-old man living with major depressive disorder. He has experienced
depressive symptoms since adolescence and was formally diagnosed during adulthood.
His history indicates longstanding psychosocial adversity, including bullying and peer rejection
during adolescence. During university, he began using alcohol and cannabis as a way of coping
with low mood and attempting to gain social acceptance.
Trevor currently lives with his wife and their two daughters. Over recent months, he has
experienced persistent sadness and hopelessness, reduced motivation, withdrawal from activities
he previously enjoyed, and difficulty functioning within his occupational and family roles. His
GP has therefore referred him to a community mental-health service. Studocu
This presentation will address:
1. Two factors that may have contributed to Trevor's mental-health difficulties.
2. His appearance, behaviour, speech and thought content within the Mental State
Examination.
3. Two priority risk domains and appropriate nursing responses.
4. Recovery-oriented collaboration with Trevor and his family.
5. Application of the relevant Mental Health Act framework.
1. TWO CONTRIBUTING FACTORS
Factor One – Bullying, Peer Rejection and Social Adversity
, Trevor experienced repeated bullying and rejection from peers during adolescence.
Adolescence is an important developmental period for the formation of identity, belonging, self-
esteem and interpersonal relationships. Persistent rejection during this period can contribute to
negative beliefs about the self and difficulties developing a sense of social connection.
In Trevor's case, his history suggests that these experiences may have contributed to:
low self-worth
social isolation
difficulty developing trusting relationships
negative self-perception
vulnerability to persistent depressed mood
It is important not to describe bullying as the single cause of Trevor's major depressive disorder.
A more accurate biopsychosocial formulation is:
Developmental vulnerability + repeated social adversity + later stressors + individual
biological/psychological factors → increased vulnerability to depression.
This is consistent with ACU's emphasis on examining multiple factors that affect mental health
across the lifespan. Australian Catholic University
Factor Two – Substance Use as a Maladaptive Coping
Strategy
Trevor began using alcohol and cannabis during university in the context of low mood and a
desire for social acceptance. Studocu
This is clinically relevant because substance use can interact bidirectionally with mental-health
problems.
Trevor may initially have experienced the behaviour as a coping strategy, but persistent use can
contribute to:
poorer emotional regulation
impaired sleep
reduced motivation
relationship difficulties
impaired occupational functioning
reduced engagement with treatment
worsening overall mental-health outcomes
