Mental Status Examination Interview Essay

Within this essay, I will reflect and critically analyse an OSCE which has increased my awareness, or challenged my understanding, in assessing the holistic needs of a service user (John), referred by his GP, whilst incorporating a care plan using the Care Programme Approach (CPA). By utilising this programme and other sources of current literature, I hope to demonstrate my knowledge and understanding in relation to this skill as well as identifying areas with scope for learning.

Goal : To assess for suicidal, homicidal intent, to gather psychological history, family, educational and developmental history, to assess client and family needs and strengths, to formulate a clinical diagnosis and complete all necessary assessments tools in order to assist the family in developing and reaching the goals that have been identified.

There are so many different type of population that I can and would like to work with, but the group of clients I decided to work with are clients suffering from dual diagnosed. Clients that are suffering from both mental health issues and also have a substance dependency rather alcohol or drugs. I am still not sure on what age I want to work with yet. One thing I differently sure of is working with our veterans suffering from PTSD, anxiety, adjustment behavior and depression along with their dependency on alcohol or drugs abuse.

The patient is a 12 year old female who presented to the ED with thoughts of self harm and cutting behaviors. The patient denies suicidal ideation, homicidal ideation, and symptoms of psychosis. The patient reports that she has been sad lately. Per- documentation the patient reports to peers at her school that she was trying to kill herself, which the school sent her to DayMark. Further, Daymak IVC the patient and requested further evaluation.

Suicidal ideation is a medical term for thoughts about or an unusual preoccupation with suicide. The range of suicidal ideation varies greatly from fleeting to detailed planning, role playing, and unsuccessful attempts, which may be deliberately constructed to fail or be discovered, or may be fully intended to result in death. Although most people who undergo suicidal ideation do not go on to make suicide attempts, a significant proportion do.[1] Suicidal ideation is generally associated with depression; however, it seems to have associations with many other psychiatric disorders, life events, and family events, all of which may increase the risk of suicidal ideation. Recurrent suicidal behavior and suicidal ideation is a hallmark of

The client is a well-dressed, well-groomed Palestinian female who present to the clinic dressed appropriately in denim jeans, printed top, head scarf and sandals. The client is alert and oriented to person, place, time and situation. The client appears to be younger than her stated age. She appears visibly anxious, flushing noted to bilateral cheeks and clammy hands. The client appears tired with red and sunken eyes. The client is cooperative during the interview, sitting with her legs crossed but her foot was in constant motion. The client also made very large hand gestures when discussing her reason for evaluation. The client reports being very anxious and states “I considered checking myself in the hospital…I know I need help.” The client’s speech is rapid and pressured with a foreign accent. The client’s tone of voice is appropriate with trembling, but fluctuates at times. The client frequently looks for the correct English translation of words

Mr. Wooten is a 33 year old male who presented to the ED following a visit to his primary care provider. Prior to Mr. Wooten coming to the ED his provider contacted TACT with concerns of Mr. Wooten mentioning suicidal ideation with a plan to use a gun to shoot himself and experiencing depression. At the time of the assessment Mr. Wooten denies suicidal ideation, homicidal ideation, and symptoms of psychosis. He states having no suicidal ideation today, however mentioned to his provider a previous thought of harming himself. It should be noted Mr. Wooten was seen on 4/22/17 here at Randolph Hospital for reporting similar statement, however retracted his statement after reports a hidden agenda of only seeking anti-depressant medication to alleviate

J.F. is a 42-year-old, Hispanic male who was transferred to the behavioral center for suicidal ideation, in which he planned to hang himself with cable wires. He has a history of mental illness in the family. The patient’s mother has a history of bipolar disorder, and passed away when the patient was 37 years old. The patient was emotionally and abused by a family member when he was around 8-10 years old. He had attempted suicide as a teenager by trying to overdose on pills. His medical history includes diabetes, pancreatitis, and methamphetamine use.

In addition, for patients who are being treated for mental health problems or for those patients who I may suspect as being suicidal, I can work on gradually leading the patient to talk about their suicidality in order to get them to open up and gain their trust (Bryan & Rudd, 2006). For patients who have show suicidal thoughts or ideation in the past, I will work on treating the suicide as the behavior to change instead of focusing just on any comorbid mental health disorders (M. Class 4/10). I will focus on getting to know my patients better and the factors that have lead them to where they are in life. In order to help them the most, I will need to know their drivers and in order to do that, I will need to build rapport with them, so that they share with me. We will also work to build their coping skills, because I know how hard it can be to figure out coping mechanisms on your own especially when you are dealing with a crisis (M. Class

Ms. Elliott is a 63 year old female who presented to the ED with acute psychosis and suicidal ideation with a plan. Per documentation Ms. Elliott has been making several gestures with an ink pen to stab herself in the heart. At the time of assessment, Ms. Elliott reports endorses feelings of wanting to harm herself. Ms. Elliott reports she is currently talking to more than 20 people in the room. She reports having a demon in her and being a doctor of every profession on the planet. Ms. Elliott non compliance of medication because she thinks people are trying to harm her. . Patient denies having a history of suicidal ideation. She has a history of schizophrenia. Per Stephanie from Brooke Stone Heaven, Ms. Elliott living facility, since July

I chose to review Beck Scale for Suicide Ideation (BSS; Beck & Steer, 1993). The BSS was developed from Beck and Steer’s (1993) clinical rating version The SSI which is a 19-item measurement that is used to assess an individual’s traits as it relates to suicidal thoughts. The BSS is the self-report version is based on 21-items but only 19 of the items are used in scoring the test results. The test kit consists of an Administration and Scoring Manual and a Record form. The Beck Scale for Suicide Ideation is a widely used instrument to assess suicidality. Suicidal behaviors consist of but not limited to the planning for suicide, suicidal ideation (thoughts of harming or killing oneself) and/or gestures.

Overall mood is calm and content. Affect is full range and appropriate. Ss was cooperative throughout the interview. Ss does not appear dangerous to others or to self. When Ss wrote a couple of the points, her eye brows shifted from their default to a strained position that could suggest anger, memory recall/thinking

The patient is a 59 year old male who presented to the ED via EMS with suicidal and homicidal ideations.Patient reports conflict a roommate and his nurse as the contributing factors to his distress. The patient reports depressive symptoms as: feelings of isolation, hopelessness, worthlessness, anhedonia, fatigue, irritability, and tearfulness. Patient reports history of bipolar. Patient reports one hospitalization and no attempted harm to self. The patient denies current symptoms of psychosis, however reports experiencing auditory hallucination a month ago.

Mrs. Owens is a 61 years old female who presented to the ED from Randolph Cancer Center with suicidal ideation with a possible plan to overdose. Mrs. Owens denies suicidal ideation, homicidal ideation, and symptoms of psychosis to ED staff. At the time of the assessment Mrs. Owens reports recently finding out her throat cancer is in "remission". She reports medical issues and conflict with her daughter Nancy substance abuse issues as stressors contributing to her distress. Mrs. Owens currently denies suicidal ideation, homicidal ideation, and symptoms of psychosis. She is able to contract for safety. Mrs. Owens states she is too afraid to actually harm herself and has no history of harm herself. She has been seen hospitalized at Novant Health

There is an ethical duty to report a client of any age when there are reports of suicidal attempts or ideation. Confidentiality is a consideration, but the safety of Angela is the first priority. There is a legal and ethical duty to report if there is a foreseeable harm (Remley, T. P., & Herlihy, B., 2010). A counselor must be knowledgeable of the proper assessments and tools, and should consult other