Mei: signals on the tram

The case (fictional)

Mei is a 22-year-old architecture student in Melbourne who grew up in Kuala Lumpur. Her flatmate brings her to the university counselling service because she is "not herself".

Over the past five weeks Mei has stopped going to studio and rarely leaves her room. Before that, the flatmate noticed her becoming quieter for a month or two. Mei says strangers on trams pass "signals" about her, and that a lecturer has put a device in her laptop to read her designs. For several days she has heard a man's voice describing what she is doing ("now she is opening the door") when no one is there. Her speech is sometimes hard to follow, jumping between topics. She has lost weight and lies awake listening. She describes her mood as "scared, not sad".

She has smoked cannabis most evenings for about a year, more during exams; she last smoked two days ago. She denies other drugs. A maternal uncle "had a breakdown" in his twenties. She has never seen a mental health professional.

Last month her parents, who are Buddhist, consulted a temple medium, who said a restless spirit was troubling her. Mei half agrees.

She denies wanting to hurt herself. Asked about the lecturer, she says that if he comes near her she "will have to protect herself".