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John is a 20-year-old single male working as an apprentice plumber and living with his parents. He has three other siblings. He has a diagnosis of first episode psychosis and has had couple of admissions to hospital in the context of relapse due to non-adherence to treatment. John has a history of significant trauma which he does not like to talk about. He migrated to Australia with his parents at the age of 10 after they fled from a war affected country. In his home country he was a victim of repeated horrific violent crimes which sadly resulted in the death of his sister. He was held hostage during one of these incidences. His parents described him as being mostly resentful, angry and having difficulty establishing relationship with others. He struggles to seek out help from others and resorts to the use of violence at the first sign of feeling he is under a threat. This has impacted on the work a couple of times. His first contact with mental health services was when the police was called to their residence because he was being aggressive towards the family. He reported that his parents were plotting against him and could be seen at times mumbling to himself. He has admitted to having auditory hallucinations. He was commended on an atypical antipsychotic medication during his first admission which he took reluctantly initially but later on stopped, he later complained of side effects from the medication. He resorted to using illicit substances to mask his symptoms which according to him “works better than those horrible tablets”. His parents are also sceptical about the use of medications and have been considering alternatives. According to him he has no desires to stop using illicit substances. This has resulted in a relapse of symptoms and several readmissions to hospital. John has harboured mistrust for mental health services and authority since his first contact. This was further amplified following an incident that resulted in the use of restrictive intervention during one of his admissions.

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