Overpass Case Study

Present Psychiatric Illness/Symptoms: Client reports episodes of feeling completely depressed to the point of having suicidal thoughts, difficulty focusing on set tasks at work, having emotional breakdowns during lunch breaks at work, and stabilizing moods. Has not attempted suicide in a year, but still thinks about it.

During the time of the assessment the patient was sitting of her bed with her mother on her bedside. The patient appears guarded. The patient mother reports that the patient has been experiencing bullying at her current school. The patient was not very open about her situation. The patient has more

Psychiatric and general hospitals are required to, “Conduct a risk assessment that identifies specific characteriscts of the individual served and environmental features that may increase or decrease the risk for suicide” (Joint Commission, 2010). Many psychiatric hospitals have extended their services in the last few decades to drug and alcohol rehabilitation and these admissions and their environments will now require a complete suicide risk assessment, if it has not been done so before.

Mr. Saunders is a 60 year old male who presented to the ED via LEO under petition by his niece, Rachelle, for allegedly putting a gun into his mouth, him putting a gun in another individuals mouth called "legs", and increasing alcohol consumption. At the time of the assessment Mr. Saunders is calm and cooperative. He denies suicidal ideation, homicidal ideation, and symptoms of psychosis. Mr. Saunders reports he has been depressed for several months and has been binge drinking alcohol. He reports relational issues with his wife has been the primary stressor contributing to his distress. He express feelings of hopelessness, worthlessness, irritability, and isolation. He does admit to informing a friend, William, he see no reason to leave if he can not be with his wife. Patient does not appear to be exhibiting signs of agitation,

After working in the mental health field for several years, part of my job as an intensive case manager is facilitating crisis assessments on individuals who present in the emergency room (ER) and endorse suicidal ideation. Virtually all people who I have assessed and are genuinely suicidal with high risk mainly report major depressive disorder as their primary mental health disorder. Many of these individuals also have a previous history oftrauma as well, whether physical, sexual, or emotional abuse.

2. Client is demonstrating phase of life problems and which is presenting as restlessness, anxiety, and loss of identity (un-fulfillment) due to his child pulling away from him as she enters school full time.

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

Dr. Gentry requested an assessment for Kaitlin Bradley, an 19 year old female who presented to Randolph Hospital ER reporting suicidal ideation, with a plan, and symptoms of psychosis, and homicidal ideation. She stated " I plan to do some stupid shit". Ms. Bradley reports she has had suicidal ideation daily since the age of 10, She reports that in the past two weeks her suicidal ideation has gotten worse. She reports yesterday she was suicidal and reports if she was going to kill herself she would overdose no whatever pills she can get her hands on. Ms. Bradley reported cocaine and marijuana use, which was confirmed in her drug screening. She reports she came to the hospital so she would not harm herself. Ms. Bradley has a history of suicide

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

The assessment was conducted on a patient who was forty nine (49) years old bisexual, a white female and single, a Roman Catholic and who didn't have any child. Most importantly, this patient has worked with me for a period of one year from January 2010; therefore I have been seeing her every week for about fifteen minutes. The patient was given to me by one psychiatrist who came across her at event where the housing project was being commissioned to support Veterans. By that time ,the patient was suffering from Anxiety Disorder NOS and Depression NOS.

E.S. had a complex case because he was not only grieving the loss of his son but he soon thereafter was grieving the loss of his grandson. The grieving process appeared to be quite tough for E.S. since his family unit had been torn apart (some lived in Los Angeles, while others lived in Chicago). Since his children come from different wives it was hard for E.S. to navigate the family unit upon the loss of one of his sons. He mentioned that it was difficult to talk with the boy’s mother in this time of grief “ because she would start crying and I just couldn’t handle that.” It appears that he felt inadequate for not being the support that his ex-wife needed. This veteran did present signs of depression and grief. E.S. attended a Bereavement Group in Building 500 at the West Los Angeles VA. Before I was forced to terminate with E.S., I found out that he was on three different types of medications. He was prescribed an antidepressant (Zoloft), medication for his blood pressure, and medication for his cholesterol. While he was on this combination of medications, this veteran reported thoughts of suicide. Veteran confirmed that the suicidal thoughts stemmed from his anti-depressant (Zoloft), and once he stopped taking the Zoloft and

Mr. Blevins is a 22 year old male who presented to the ED with suicidal ideation with a plan to shoot himself. At the time of the assessment Mr. Blevins was calm and cooperative. He reports substance abuse and symptoms of depression as stressor contributing to his distress. Mr. Blevins expressed depressive symptoms as feelings of hopelessness, worthlessness, tearfulness, isolation, and insomnia, and guilt. Mr. Blevins stated, "I was at the coastal and was going to off myself with my friends 38." Mr. Blevins reports stealing his friends gun to end his life. He expressed drug use has become overwhelming for him and his thoughts were to end his life. Per documentation Mr. Blevins reports a history of suicidal ideation, however never before yesterday

At the time of the assessment Mrs. Hyatt denies suicidal ideation, homicidal ideation, and symptoms of psychosis. She reports a history of depression and anxiety. Mrs. Hyatt reports a history of cutting behaviors for stress relief and to harm herself. She reports 2x suicidal attempts in the 2004 when she tried to overdose on pills and cut her wrist. Mrs. Hyatt reports recent stressors as relational issues and possibly

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

The patient is a 29 year old male who presented to the ED with suicidal thoughts of jumping off a bridge. The patient denies homicidal ideation and symptoms of psychosis. The patient reports that he has been taking Suboxone to prevent from relapsing on pain pills.