Mr. John Gray is a 28 year old single male admitted to the unit a week ago after an episode of intentional self-harm. John is the son of a grazier from a farming community north of Brisbane who is...

Mr. John Gray is a 28 year old single male admitted to the unit a week ago after an episode of intentional self-harm.  John is the son of a grazier from a farming community north of Brisbane who is expected to take over the family farm. The farm has been severely affected by the longstanding drought conditions in the district.
You are the nurse assigned to John’s care for the afternoon shift. On handover you were informed John did not get up for breakfast again, went to lunch reluctantly only because he was compelled to but ate almost nothing, and returned to his bed immediately afterwards.
Vital Signs:
•    Blood pressure 125/75
•    Temperature 36.3
•    Pulse 66
•    Respirations 18.
John has a rope burn mark on his neck caused by the breaking of the rope with which he attempted to hang himself and some bruising and broken skin on his arms and legs from the subsequent fall but no serious physical injuries. The areas of broken skin were covered with a non-adherent dressing and tape. The occupational therapist reported John was still choosing not to take part in any activities, including small group games or one-on-one activity.
When you go to introduce yourself to John, you find him lying on his bed with the covers pulled up high. He appears reluctant to engage in conversation with you. When you address him to introduce yourself, he grunts and turns over to face the wall away from you.

Medications:
•    Venlafaxine 75 mg bd
•    Multivitamin once daily
•    Vitamin B once daily daily