Mr Wilson Hospital Case Study Summary

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

During my psychiatric clinical rotation at Carney Hospital I had the opportunity to help run group therapy’s where I was able to understand some of the patients better. During this time I was also able to learn more about my patient F.S. The patient is a fifty-two-year-old divorced Chinese woman with a lengthy history of bipolar disorder and a persistent associative history of schizophrenia and attempts at suicide. The patient has one daughter that is 24 years old who noticed F.S. was throwing her pills down the toilet and hiding them in her pockets so she didn’t have to take them. . During her admission, the patient displayed increased levels of incredible energy and mood activities, an approach that was thought to have been instigated by the worsening of her health condition.

Felicia Allen is a 32 year old woman, who was initially brought into therapy after an attempt to steal a bus. Due to her reported “emotionally disturbed” nature, this consult became a priority. The police report states that Ms. Allen pulled out a knife, and threatened the driver after the driver declined her dollar bills. She then took control of the bus, and crashed it across the street. Upon our meeting, Ms. Allen was fidgety, and swayed back and forth all the while mumbling to herself. If she were questioned, she would look up and say “Sorry, sorry.” As far as patient history goes, Ms. Allen started hearing voices when she was 5 years old. These auditory hallucinations were mostly composed of critical, disparaging voices that made comments on her actions and behaviors. Her severe symptoms led her to be hospitalized fairly consistently since she was 11. Ever since she was young, she has been driven to please, and has a strong desire to be independent. Felicia has been prescribed clozapine for 1 calendar year, which helped her auditory hallucinations a great deal. Given the above symptoms and information, I have diagnosed Felicia Allen with schizophrenia.

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.

Earley highlights this with his son as he leaves the hospital system and is processed through the judicial system. The next responsibility is to understand where we are in a system and where we need to go. The book portrayed Mike, Earley’s son, could not be hospitalized unless he voluntarily committed himself or verbalized harm towards himself or others. It was clear to Earley, who knew his son’s baseline, was deescalating further into psychosis. The situation explains how we can get assistance for clients who may not be able to make adequate decisions in a psychotic episode. Lastly, the clinician should develop a strategic plan of how to achieve the desired results, and the key participants involved. Earley researched the systems involved for over a year before he concluded writing a book would reach the vast of persons involved. He interviewed and studied the systems involved to strategically plan how he could assist his son.

Throughout the many years, there have been many negative public perceptions of Schizophrenia, which is known by majority of the public as an indication of mental illness. This disorder is most of the time perceived by the public as caused by psychological factors. People with this mental illness are considered to be unpredictable and threatening (Angermeyer & Matschinger, 2003, p. 526). Most patients have a behavioural dysfunction. Victims, families and society carry a substantial burden due to this illness (Wood & Freedman, 2003).

Jones Regional Medical Center is a huge academic health center with 900 beds and are known for its research and teaching hospitals. Additionally, the IT staff at Jones supports 300 applications and 12,000 workstations. The center uses Technology Med (TechMed) for their admitting system. The system includes registration, inpatient charge, payment entry, master patient index, admission, hospital billing, and more. The TechMed system has been accessible since 1998; Jones is beginning to plan a replacement of this systems because of the fragility of the software (Wager, 2013).

Mr. Goins is a 52 year old male who presented to the ED via LEO following a 4 day binge on alcohol and requesting help with his dependence. Mr. Goins reports he moved to Asheboro recently and found work, however recently lost his job. He reported a history of alcohol use and depression. Dr. Keith requested an assessment on Mr. Goins.At the time of the assessment Mr. Goins denies suicidal ideation, homicidal ideation, and symptoms of psychosis. He reports 5 days ago he became unemployed. Mr. Goins reports his fiance who is his primary support system left town to go to a doctor appointment in their home state of Georgia. He reports binge drinking for the past 4 days attempting to cope with his recent stressor. Mr. Goins reports calling his fiance last night an expressed to her he need help. He states, "I told her I felt at the time no reason to live." Further Mr. Goins stated, "I just had too much in me last night, I had about 14 of them airplane bottles." Mr. Goins denies a history of self harm. He does report a prior hospitalization for depression in Georgia. He also reports a history of attending substance abuse treatment, which was a positive experience for him.

T.R. is a 69 year old, Caucasian female with a history of schizophrenia who presented to University Hospital Medical Center Emergency Room under Baker Act for recent suicidal attempt. According to the Baker Act report, she ran out of her retirement facility, trying to be hit by vehicles. She suffered a slight injury to her right ankle, as the slightly slightly hit her in an effort to abruptly stop the vehicle. She verbalized to police officers she wanted to die. She reported that peers in her retirement community learned about her history and had been gossiping about her. She reported increased paranoia due to this. She was hospitalized in the same psychiatric unit two months ago, after she was diagnosed with depression. Patient states the reason she was diagnosed with depression is because her two sons are not willing to talk to her. She states that she is separated and living without her family in an Assisted Living Facility. As per patient and chart review, the patient was born and raised in New Jersey and moved to South Florida. The patient currently lives in a retirement home and had to move several times to the different Assisted Living Facility, due to her paranoia and delusional behavior. She is currently retired and reports that she used to work from home as a home health aide. She has two sons and tries to maintain a good relationship with them, but denies any contact with them. She reports the biggest stressor is basically a relationship with her

Strakowski et al. (1996) showed that African-Americans with psychotic disorders are more likely than Caucasian patients to report first-rank symptoms of schizophrenia to their treating clinician. These “first-rank symptoms” refer to auditory

D.D. is a 50-year-old, African American male presenting with a number of anxiety and depressive symptoms. The client reports that he came to counseling for “extra support and someone to talk to.” D.D. has been struggling with mental health issues since he was young. Since the age of 15 he has been hospitalized on and off for “hearing voices.” In the early 1980’s he was diagnosed with schizophrenia and prescribed Risperdal to treat the symptoms. Since then, D.D. has been in a variety of mental health settings, including hospitals, day programs, and outpatient treatment. The client has an extensive alcohol and drug use history that he believes impacted his Schizophrenia. In the early 1980’s the client would use alcohol every day “to avoid the voices,” drinking “anything he could get his hands on.” He was also heavily involved with drugs at that time and regularly used marijuana, PCP, cocaine, and heroine. In 2000, the client was sentenced to eight years in jail for four bank robberies. While in jail, D.D. received mental health treatment and alcohol and drug treatment, which was greatly beneficial. When the client was released from jail in 2008, he was drug and alcohol free and was taken off of Risperdal.

N.G. was a 43-year-old Russian female who was admitted to Palomar’s Downtown Behavioral Unit (BHU) on Monday 10/10/16. The patient’s reason for admission was that she was brought in by the San Diego Police Department on a 5150. She was being held on a 72-hour psychiatric hold for being a danger to others where she was making threats to hurt her mom. She has had a long history of treatment for her Schizophrenia that she was diagnosed with as a child. When she arrived to the BHU she had symptoms of a mood disturbances, including decreased sleep, increased energy, agitation, anxiety, and aggression.

In the event, that no one is calling the hotline, the supervisor, and lead team member utilize the downtime to enhance the quality of service for callers and the crisis hotline members. Regarding recent events, this week a call came in from an individual residing in New Mexico, threatening to complete suicide. During the call, a seasoned employee signals that the caller conveys strong characteristic traits of schizophrenia; however, had no electronically means to confirm. This individual was extremely violent during the call, suffering from severe hallucinations/delusions, breaking objects, and screaming obscenities at the top of his lungs. Events such as this require the undivided attention of the Recovery Specialist, as he or she is actively engaging with the caller, in the attempt to rationalize their delusional thoughts; hence, suicide intervention/prevention. Throughout the call, this individual states that due to the inadequacy of family support, caller feels that by consuming large quantities of pills, family members will then have to pay more attention to the callers physiological needs. The Crisis Hotline members successfully engaged with the caller, providing the caller with the ability to continuing living. The key to assisting the mentally ill populace is empathetic communication, aligning them with reasons to live a meaningful life as humanly possible within society. From a personal perspective, the mentally ill populace deserves adequate and responsive treatment, as the adverse effects inhibit their metacognition. The ideation once possessed is either diminishing or has barriers that enhance the delusions/hallucinations. Proper advocacy and community awareness are needed to bridge the gap eliminating discriminating behaviors to the stigma associated with mental

The patient expressed she has no current suicidal ideation or homicidal ideation. However, she admitted to suicidal ideation in the past, right after her breakup, approximately two months ago. She expressed that she wanted to hurt herself and had a plan on how to do so, but did not think she could go through with it. Her plan was to overdose by taking her mother’s

This paper, broken into two sections, includes a mock case study of a young woman, from the movie Black Swan, who meets criteria for a Schizophrenia spectrum disorder, followed by current research on schizophrenia and recommended treatment. Because specific temporal information is unavailable and the key difference between schizophreniform disorder and schizophrenia is duration, the diagnosis made for the purpose of this paper is schizophrenia. The research portion will cover current research and treatment of schizophrenia. Schizophrenia is a disorder defined by a heterogeneous set of irregularities across multiple modalities, including “cognitive, behavioral, and emotional dysfunctions” (American Psychiatric Association, 2013, p.100). This mock case study is an important reminder for counseling students: Client symptoms may not always be transparent to clinicians. Clients may purposefully withhold information, lack insight to report, or may have sufficient factual insight to avoid the perceived stigma of reporting.