Mr Wooten Case Study

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

Robin Henderson is a 30-year-old married Caucasian woman with no children who lives in a middle-class urban area with her husband. Robin was referred to a clinical psychologist by her psychiatrist. The psychiatrist has been treating Robin for more than 18 months with primarily anti-depressant medication. During this time, Robin has been hospitalized at least 10 times (one hospitalization lasted 6 months) for treatment of suicidal ideation (and one near lethal attempt) and numerous instances of suicidal gestures, including at least 10 instances of drinking Clorox bleach and self-inflicting multiple cuts and burns. Robin was accompanied by her husband to the first meeting with the clinical psychologist. Her husband stated that

The patient was admitted to the hospital by her daughter after discovering that she had abandoned her medication and was significantly experiencing adverse effects from the withdrawal. The patients’ medical history included renal dysfunction, anemia, malnourishment, back pain, and a family history of mental health. The patient has a psychiatric history of being previously placed in the same clinical structure eight months ago due to related issues including the failure to take her medication and increased levels of mental health conditions that led

Mr. Gillespie is a 21 year old male who presented to the ED after an intentional overdose on 20 600mg of Gabapentin. Per documentation from ED staff Mr. Gillespie reported he became angry at his grandmother tonight and tried to "prove a point." Mr. Gillespe reported to staff threatened to overdose on his on pills, however dumped them in the toilet. He expressed after making threats to overdose on his prescribed Celexa did not phase his grandmother, he proceeded to take her Gabapentin. Per documentation Mr. Gillespe has been living with grandmother for 2 weeks and before that was living with his mother in Cary. At the time of the assessment Mr. Gillespie was calm and cooperative. He denies current suicidal ideation, homicidal ideation, and symptoms of psychosis. He appears guarded during the assessment. He reports tonight his grandmother and he got into an argument over him getting a job. He reports his grandmother informed him he has to be out by Friday. Mr. Gillespe denies history of self harm. He

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.

The judicial precedence set by Tasaroff v Regents of the University of Caliornia.17 Cal.3d 425,551 P.2D 334,131 Cal. Rptn 14 (1976) demonstrates vividly that unlike their counterparts in other medical disciplines, Psychiatrists may need a lower disclosure threshold given that they may see patients who are mentally volatile and potentially dangerous!( Farlex,2012).In this scenario, Prosenjit Poddar, a mental health patient student at the University of California, informed his Psychologist of his intent to murder Tatiana Tasaroff two months in advance. The Psychologist went ahead and disclosed this information to the campus police who held the patient for a brief period and released him upon deeming him rational only to end up killing Tasaroff !The

The patient is a 10 year old male who presented to the ED with multiple lacerations on his left hand. The patient denies suicidal ideations, homicidal ideations, and symptoms of psychosis. The patient states, " I don't know why I cut myself." Later on, the patient denies threats towards other students and admits he cut himself because it felt good.

Client reported feeling down within the last month and using heroin to cope. Client also reported feeling better and motivated towards the end of the month. Client completed a Beck Depression Inventory in which he scored a 6 indicating normal ups and downs. Client VA records confirm a diagnosis for PTSD and the medication list includes, Sertraline and Setraline HCL, as well as methadone to which the client appears compliant. Client reported he is medication compliant. Client denied any S/I or H/I.

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

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

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.

Sara is in need of residential treatment due to her history of self-injurious behaviors, and multiple attempts of suicidal gestures. Sara requires a higher level of care which outpatient care is currently failing to provide her at this time. Sara continues to have depressive symptoms and anxious feelings for the last few months. The patient has had two acute inpatient admissions within the last 3 months and requires long term stabilization. At this time Sara requires 24 hour supervision and ongoing intervention and treatment.

a 44 year old Divorced African Male came into Henry Ford Hospital ED as a walk-in and told the HFHS staff that he was having mental health issues he does still struggle with depression and anxiety. The consumer stated that he initially went into the hospital after his brother was shot twice in the head. At that time the client reports that he was placed on Risperdal, while at Kingswood in January, and he became a zombie at that time. He stated that he has been in and of the hospital multiple times since then, and each time, he has been placed on Risperdal and he doesn't feel that his meds were ever adjusted correctly.

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

Intervention/goals Risk for self-injury related to depression/psychosis as evidenced by previous suicide attempt and suicidal behavior. Patient will verbalize feelings; express decreased anxiety and anger