Bill is a 45 year old man 75kg brought into the Emergency Department by his sister after intentionally lacerating one arm and his neck while heavily intoxicated on alcohol.

Bill is separated from his wife and children, he has a history of domestic abuse due to his alcohol consumption and often is verbally abusive to his neighbors. Bill is currently unemployed due to the recent loss of his driver's license for Driving Under the Influence (DUI). His sister lives 4 houses away from Bill and seems to be the only person that he will talk to, she is often away and only sees Bill occasionally.

He is seen in the Emergency Department by the Mental Health Assessment Team (MHAT). Following assessment, Bill is admitted as a voluntary patient to the Mental Health Unit for assessment, observation and monitoring. Bill appears malnourished, dehydrated, and unwashed. He is flushed, ataxic and smells strongly of alcohol. His speech is slurred. He has a productive cough. He is given a provisional diagnosis of Major Depressive Disorder (MDD) and Substance Abuse (Alcohol).

A few hours later, Bill attempts to leave the Mental Health Unit without a medical review or authority. He becomes verbally and physically threatening toward nursing staff who are trying to persuade him to stay and be treated. Security is called and they physically restrain Bill when he lashes out at them and the nurses.

Following further assessment by the Medical Officer, Bill is placed on an involuntary Treatment Authority (TA) under the Mental Health Act 2016 (Qld). By this time, he appears physically exhausted, sobbing and stating that he wants to die.

2. Bills behaviour demonstrates to have a significant impact on his family/friend/neighbours re a person with Mental illness.

2a Identify four (4) behaviours Bill is showing that impact on his family / friends?

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