Daymark Presentation Case Study

Presenting Problem: She has a hx of multiple failed placements and relates being placed in the programs for her substance abuse, anger and aggression. She has 2 past suicide attempmts one from an attempted hanging and the other from attempting to jump off a building. She reported feeling homicidal 7-8 times against her stepfather. Rhonda reported physical and emotional abuse from maternal uncle and incidents of sexual assault btwn the ages of 6 and 12.

Mr. Davis is a 33 year old male who presented to the ED with homicidal ideation with a plan. Mr. Davis states he has a plan to go out in his yard with a machete and kill someone. Per documentation he states, "I'm going out into the yard with my machete and I am afraid I am going to kill someone. I feel really crazy." He states he has these thoughts towards anyone that does him wrong. At the time of the assessment Mr. Davis is asleep, however becomes awaken and 4x oriented by hearing his name called. He has a history of Bipolar. He denies current suicidal ideation, homicidal ideation, and visual hallucinations. He does endorse auditory hallucination. Mr. Davis reports hearing several people telling him things. He reports his outpatient provider is DayMark and he usually go there twice a month for his Depakote injections, however has not been there since

Fast forward two years: Bader 5 is a psychiatry inpatient service at the Boston Children’s Hospital and it was where I was checked into late August 2014. Originally, I was going to the hospital for a checkup on my headaches, but when my mother pointed out to the doctor what I had been struggling with mentally, I was taken to the emergency room for suicide watch. I sat in the emergency room for over two hours with Marcos, a tall man who spoke broken English, whose only job was to make sure I would not strangle myself with the bed sheets. My mother was signing paper work, getting food and calling my father for a majority of those two hours. By the time she came back, it looked like she had aged ten years.

Brandy is a 17 year old Caucasian female. Her family and school counselor has sent her for a clinical intervention after she recently tried to attempt suicide by taking her mother's Xanax. The client admits she is suicidal and wants to kill herself after recent accounts of being bullied at school by classmates. me today at her family and school request for counseling. Her presenting complaint is that since the start of nine grade she has been excessively teased, ridiculed and bullied by a small group of girls. The client reports that the girls have repeatedly told her to go “kill herself”. The client reports that a “friend told her to pop some pills and she'd overdose quickly”. The client states that she is tired of being bullied at school and online at home. The client states that she is no longer interested in activities at school (eg., band, art, and tennis) as well as going out with friends. Her parents sought for a counselor to intervene and provide counseling after finding the client “passed out

Pt is a 14 y/o African American male presented to NNBHC with his mother with a dx of ADHD, ODD, PTSD and Depressive D/O. Pt states that he had an episode of enuresis last night when he had a nightmare about killing his family. Pt states that when he woke up he began to have intrusive thoughts of wanting to kill his family and himself so he wouldn’t have to go jail. Pt states that recently he have been blamed for everything in the home that is missing, or goes wrong. Pt states that he has taken ownership over all the negative things in the home, so none of the his sibilings wont get in trouble. Pt states “I am pretending to be happy, this is not my family”. Pt states when he cam home from residential that his biological

Mrs. Patterson is a 72 year old female who presented to the ED with complaints of ringing in ear and some sores in her nose. Per documentation Her son, however reported Mrs. Patterson has expressed repeated threats of suicidality and has said she is going to overdose on medication and has overdosed in the past. He reports she also threaten to walk into traffic. At the time of the assessment Mrs. Patterson denies suicidal ideation, homicidal ideation, and symptoms of psychosis. She appeared 3X oriented. Mrs. Patterson memory appears recently impaired. She reports a history of 1 attempted suicide years ago. Mrs. Patterson states when asked suicidal attempt she responded, "Yeah,but I forgot what I done." Her son Jim was contacted for collateral information. Jim reports 6 months ago his mother overdosed and has done so multiple time, however he is unaware if it's intentional with the intent to harm or her memory effecting her actions. He states, "She makes jokes about it (referring to suicidal ideation)." Jim expressed his primary concern with his mother is her not managing medications effectively. Jim reports he has a plan to move his mother into his home and take care of her daily needs and also manage her medications. Additionally, Jim reports her going to Daymark recovery Services. He reports DSS came out to the home today to offer any additional aid to Mrs. Patterson. She reports a history

My aunt grabbed my mother’s hands preventing her from getting to the steering wheel. When we made it to the entrance she tried to choke my dad from behind, I saw my father’s face turn red. We begged her to release to him, my mother eventually let go, with us pulling her back. My father was scared to death , he got off the car quickly so my mother wouldn’t be able to choke him. We protested her to get out of the car she started pulling my aunts hair, my aunts face turned even more red than my father. All hear is my crying and everyone else’s, while my brother ran inside the hospital telling them to help us outside with my mother. As my mother got out of the car, she took off her shoe and started hitting my dad, a innocent person who never gave up on her. I quickly grabbed her from behind so she could stop hitting my dad, I don’t know where my strength came from. A few moments nurse came outside saw what was happening, my mother hitting my father with a shoe and yelling. Then you see her talking in the walkie-talkie, as she talked in the walkie-talkie she said the dreadful words I despised the most “code gray”. Soon later you see all these security guards coming outside with a wheelchair, they tried to

Pt is a 15 y/o African American male presented at NNBHC with a dx of PTSD, ODD, ADHD, Bipolar Disorder, and Depression, who have been demonstate emotional instability and aggressive episodes in the home. Pt discussed that he have been having difficulty controlling his anger when triggered for getting trouble. Pt stated that he god in troubled for hiding soiled clothes in his drawer, where his mother found them. Pt stated he became upset and demonstrated verbal aggression which includes threats and foul language. Pt states that he black outs and have mind/body experiences where he lose control over his actions. Pt states that during his anger outburst typically one of his parents have to tell him what he has done. Pt states he is easily trigger by being called “fat” or discussion of his bed wetting. Pt discussed he frequently have phobias in new places due to believing he may be sexually assaulted again which intensify his nighmares and nocturnal enuereis.

PER REPORTER: Keshia said she received the following information from a Nurse Practitioner by the name of (Tammie) that works with her. She said according to Tammie, Malia was brought into the clinic today by her babysitter (Linda) to be seen by a physician due to her suspecting that the child has been sexually abused. Tammie said Linda told her that she keeps the child for her uncle due to him being her caretaker at this time due to her mother being in jail. However, Tammie said Linda is suspicious that the child’s uncle may be sexually abuses her. Tammie mentioned that the Linda also told her that Malia has been displaying inappropriate behavior problems. Tammie said Malia is currently being taken to UMMC by the AMR due to her having scar

Mr. Watterly is a 15 year old male who presented to the ED via LEO under IVC by Daymark Recovery Services for homicidal ideation and auditory hallucinations. At the time of the assessment Mr. Watterly reports he sent his father messages expressing thoughts of "mass homicide and hurting people". Mr. Watterly reports feeling this way for an extent period of time. He states, "I can't even tell you when I actually started thinking like this." Mr. Watterly expressed experiencing feelings of anger and irritability without any specific trigger. Per documentation Mr. Watterly reports thoughts of slitting peoples throats, stabbing them multiple times, and snapping their necks. He admits to these thoughts in his dreams and throughout the day. Mr. Watterly

Kimmy is presenting for “anger outbursts”, homicidal threats, and behavioral problems. The client reports these behaviors began eight months ago after the death of her mother. Her mother died in an auto accident, for which the children were not present. Kimmy has been hospitalized three times in the past 8 months for anger outburst towards her Uncle, older brother, and peers. She has made homicidal threats towards her older brother. Prior to her most

Mr. Watson is a 8 year old male who presented to the ED via LEO under IVC through Daymark Recovery Services for resisting instructions and commands from parents and other adults. Per documentation Mr. Watson denies suicidal ideation, homicidal ideation, and symptoms of psychosis. At the time of the assessment Mr. Xavier is calm and vaguely cooperative. His mother reports their family moved from tribal lands of South Dakota 5 months ago where she was a single mother taking care of her children. She reports her son's behavior began to worsen when she moved to North Carolina to be closer to her son's father. Mr. Xavier expresses relational issues with his father. He reports his father calls names like, "buster child." Mr. Xavier reports his relational

Emily is a 6-year-old girl referred by her pediatric psychologist because of behavioral issues. Emily’s parents have informed the analyst that her problems first arose when she

Jim is a 30 yr. old white male, he arrived via transport form Metro State Hospital. Where he was originally a patient since 2009. Jim main complaint was drug use and hearing voices, but he claims it’s for his drug use is the reason why he is here to see me. I asked to describe what is happening he stated I hear voices that are very derogatory and always put me down. They are mostly from people that I know who are either currently alive or dead. I know that my drug use is what caused me to start hearing these voices and I know that they are not real so I try to ignore them as much as possible.” I advised Jim that we will do the best to get him better. I excused myself and went to to see his admitting records. Patient admitted into Aurora Charter Oak Hospital on 04/27/2016. Admitting interview showed that Jim is a risk for injury related to schizophrenia as evidenced by history of suicidal ideations, self-harm, and occasional command hallucinations to induce self-harm. A memo in his transfer file from discharge nurse reads as follows, Altered thought related to schizophrenia as evidenced by the client staying in his room, timid behavior, few friends, derogatory auditory hallucinations, visual hallucinations, self-harm, and paranoid symptoms. After review of his brief history I am leaning to agree that Jim has been diagnosed correctly. Jim’s previous doctors and counselors all have come to a diagnosis of schizoaffective disorder and with Criteria A, B, and C being met as well.

The patient is a 38-year-old Caucasian male, with a history of Schizophrenia for the past 24 years. While the patient has a history with recreational drugs i.e., marijuana and methamphetamines, he has had the diagnosis of schizophrenia when he was 16 years old. He has been in and out of outpatient substance abuse treatment programs. The patient has had run-ins with the law after being found in a hotel trying harm himself by slamming his head against the window to the indoor pool. The police were trying to get the patient to stop while the patient persistently yelled the devil was