Suicidal Case Study Summary

Presenting Problem: Zachary has required x3 inpatient hospitalization within a 6 month time frame. Zachary struggles with communication in the family dynamics that generally evoke anger, irritability, physical aggression, and suicidal statements. Most recently he was admitted at NNBHC due to SI, HI statements and AWOL behaviors. He is not compliant with medication compliance or participating in outpatient treatment. He states overall mood has been on and off with periods of feeling down. He reports decrease interest in activities.

Glazier was asked if she was dealing with any homicidal or suicidal thoughts and she stated no. Although, Ms. Glazier denied suicidal ideation at the time of the assessment a crisis safety plan was put in place for her and she was provided with the number for the crisis hotline. In addition to the above-mentioned symptoms Ms. Glazier also struggles with substance abuse issues and just completed the Wayside Rehabilitation Program in Louisville, Kentucky. Ms. Ms. Glazier expressed she does not have a psychiatrist; however, when she was discharged from the hospital she was discharged with the following medications Gabapentin, Seroquel, and Trazodone. It is recommended that Ms. Glazier participate in mental health support skills building services for at least 5-10 hours per week to assist her with managing symptoms associated with her mental health diagnosis, medication management, increasing pro-social behavior, anger management, coping with traumatic life experiences and assist with connecting with other community

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

Ms. Smith is a 30 year old single, Caucasian female referred for a psychosocial assessment by DOC Parole Officer Ward. She reports she was released from prison 2 months ago after a 3 year sentence for attempted escape due to not notifying her probation officer of her address change. Ms. Smith states due to her past substance use history and trauma experience her referral sources ordered counseling to address complex issues related to her emotional and physical well-being.

Although, Mr. Wilson denied suicidal ideation at the time of the assessment a crisis safety plan was put in place for him and he was provided with the number for the crisis hotline. In addition to the most recent hospitalization Mr. Wilson has history of six to eight psychiatric hospitalizations starting as early as at age of sixteen. In addition to the above-mentioned symptoms that lead to Ms. Wilson’s most recent hospitalization, he disclosed the following psychiatric problems within the last thirty days: depressed mood (daily); auditory hallucinations (3-6x monthly); diminished emotional expression (daily); feelings of feelings of helplessness and hopelessness (3-6x weekly); decreased energy (daily); paranoia (daily); and poor concentration (daily). In addition to having a difficult time with managing his mental health issues, Mr. Wilson presents with substance abuse issues as evidence by him using cocaine (2x weekly) and smoking pot (1-3x weekly). Mr. Wilson expressed he does not have a psychiatrist; however, when he was discharged from the hospital she was discharged with the following medications Hydroxyzine HCL

Please review the case notes for this patient. This is a DCF case and her teenage kids has been removed for the second time. She is recommended for mental and substance abuse treatment from DCF. Deborah works for SalusCare in the prevention department and she has a lot of information about this case that she will put in the SalusCare medical record file. The information that Deborah has access to is from the DCF data base.

The client has high motivation for treatment within MRFH. The client was diagnosed with Alcohol Use Disorder: Severe and Cocaine Use Disorder (crack): Moderate. The client sought treatment at MRFH when he realized he had lost control of using alcohol and crack cocaine. The client stated he attended the MRFH program in the 1980 's but does not remember the exact date of attendance. The client stated he was diagnosed with Mild Depression by a primary care physician when he was 56-years-old. The client reports he has no history of suicidal or homicidal attempts, and currently denies having any suicidal ideations or homicidal ideations. The client stated one to two times per week he experiences muscle tension and worrying about things that he often realizes have no significance. The client stated prior to the age of 18-years-old, "I would knock over my neighbors mailboxes and destroy their gardens, because they would make my parents aware of my wrong doings and that was way of getting them back." The client stated, there was one time that I started a fire and blamed it on my brother. I would break things as well and blame someone else. The client stated if there was an event taking place that he wanted to participate in, he would rush and complete what he was doing so he could become involved in other events taking place around him. The client stated, "I started using drugs and alcohol without thinking about what the consequences. The client appeared to be oriented to the

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.

ICM met with Mr. Perkins at New Start I located at 3653 N. 15th street to follow up with him and see how he has been adjusting to the step down level of care and to assist him with scheduling an intake appointment at John F. Kennedy Behavioral Health Center to address his mental health goal. Mr. Perkins stated that he had a difficult time adjusting to the program due to the required two week observation period. Mr. Perkins informed ICM that during the two week observation period residents are only permitted to leave the facility for a maximum of four hours per day with supervision. Mr. Perkins stated that the observation period limits his freedom and he expressed a desire to have his independence back. ICM explained to Mr. Perkins that

Presenting for treatment is a 39 year old single, Caucasian female born in Montreal, Canada. The client identifies as heterosexual with no children and no current intimate relationship. The client was recently released from a psychiatric residential treatment in the U.S. and referred for ongoing outpatient treatment by her doctor at the hospital. The client has a history of suicidal ideation, with her last attempt leading to her hospitalization. The client reported that both her parents died in a car accident when she was an infant. The client stated that she has a twin brother whom she did not meet until much later in life. The client reported being raised in a hyper-religious school in Quebec and it was there, the client stated,

This case study is on client, Harold, referred to Greenbrier Behavioral Health Center, an intensive outpatient program (IOP), from Greenbrier Behavioral Health Hospital. The client is a 43 year old, retired, white male, living in Slidell, Louisiana. His highest level of education is a GED. He is married with two children ages 8 and 12. He recently retired after more than 20 years from the police force. Harold is overweight, wearing sweatpants and a t-shirt, appears clean and groomed. He is sitting, calm and quiet with arms resting on his legs.

a 32-year old, DAAM, who appears anxious and guarded. Reports that he was brought to the crisis center by police because his father kicked him out of the family home and when he was still sitting on the curb several hours later, the police were contacted. Client reports feeling anxious and depressed. Says that he has been suicidal for "at least the past ten years" and thinks he is at his worst right now. Says he is hopeless, helpless and doesn't think he can change his lifestyle right now.

Dr. Snyder requested an psychiatric evaluation of a Mr. Rodriguez. Mr. Rodriguez is a 21 year old male who presented to the ED with acute psychosis. At the time of assessment, Mr. Rodriguez denies suicidal ideation, homicidal ideation and having any visual or auditory hallucinations. Mr. Rodriguez does not appear to be exhibiting signs of agitation, aggression, or responding to internal stimuli. Mr. Rodriguez reports fear of people trying to kill him and his family members as stressors contributing to his current distress. Mr. Rodriguez reports non-compliance with medications. He states, "I don't take them all the way." When confronted about admitting being current thoughts Mr. Rodriguez stated "My family has told me in my dreams they are trying to kill me, I feel like the shelter is unprotected, they can come in." Per documentation from staff at the shelter, Mr. Rodriguez has been asking for knives and

Client is an 48y/o African American male. He was recently divorced, and has been admitted DTS for psychosis and suicidal ideation. He is oriented x3-4. Displays good insight and sound judgment. Very non-confrontational attitude and behavior. He was admitted after a suicide attempt by his daughter. He has been in this facility for three days after being transferred from the ER after He tried to overdose with pills. When prompted to speak about his family, client became very withdrawn and secretive. When prompted to speak of his experiences, he gladly shares stories. He loves animals especially cats, and to occupy his time he enjoys reading books (the bible) and watching movies. Claims to have no prior history of smoking or substance abuse.

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