A sense of entitlement?

Recently I has a conversation with a patient who had asked me to redo a Centrelink Certificate.  According to the copy he brought in he has chronic back pain and depression that prevent both gainful employment and him actively looking for work.  Horatio (not his real name) tells gets a sore back, sometimes feels a little sad and spends most days in a variety of non-productive pursuits.

I see in his record from a few years ago a psychiatrist letter that deferred making an Axis I diagnosis until he stopped multiple substance abuse. He tells me he has quietened down a little in the last few years.

He tells me he hs given up on beer because it gives him diarrhoea! He has substituted spirits. He was  bit vague on the actually quantity in standard drinks. So I asked how much would he spend on alcohol?

Depends he said on whether he goes to the pub or just visits a mate. Finally after much umming he settled on around $100 a week.  Then add in cost of the tobacco! He hints that it is criminal that the price has risen so much recently. At least he says he doesn’t have to pay for his cannabis as he grow his own.

That would be fine (well not really) if he was gainfully employed. Except he isn’t.

He thought that it was quite alright to use his Centrelink benefits to support his non-nutritional intake and lifestyle choice. I consider whether it would actually achieve anything to challenge his view or should I just copy the previous form and move onto the next patient…….

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