Suicidal Ideation 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

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 current suicide rate among 15- to 24-year olds is quite disturbing. Growing in numbers since 2007, the latest toll taken in 2013 on suicide within college settings is 11.1 deaths per 100,000 people (Scelfo, 2015). According to the article Suicide on Campus and the Pressure of Perfection, Pennsylvania State University had six students commit suicide in a 13-month stretch (Scelfo, 2015). Suicide within college settings are usually linked with severe depression. As mentioned by Kevin Breel in the Confessions of a Depressed Comic Ted Talk, depression is not sadness, real depression is being sad when everything in your life is going right and this, this I can personally relate to.

Mrs. Patterson is a 72 year old female who presented to the ED with complaints of ringing in ear and some sores in her nose. Per documentation Her son, however reported Mrs. Patterson has expressed repeated threats of suicidality and has said she is going to overdose on medication and has overdosed in the past. He reports she also threaten to walk into traffic. At the time of the assessment Mrs. Patterson denies suicidal ideation, homicidal ideation, and symptoms of psychosis. She appeared 3X oriented. Mrs. Patterson memory appears recently impaired. She reports a history of 1 attempted suicide years ago. Mrs. Patterson states when asked suicidal attempt she responded, "Yeah,but I forgot what I done." Her son Jim was contacted for collateral information. Jim reports 6 months ago his mother overdosed and has done so multiple time, however he is unaware if it's intentional with the intent to harm or her memory effecting her actions. He states, "She makes jokes about it (referring to suicidal ideation)." Jim expressed his primary concern with his mother is her not managing medications effectively. Jim reports he has a plan to move his mother into his home and take care of her daily needs and also manage her medications. Additionally, Jim reports her going to Daymark recovery Services. He reports DSS came out to the home today to offer any additional aid to Mrs. Patterson. She reports a history

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,

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

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.

Mr. Moore is a 24 year old male who presented to the ED with reports of experiencing depressive symptoms, vague suicidal ideation without a plan, and recent episodes of anxiety. At the time of the assessment Mr. Moore denies current suicidal ideation, homicidal ideation, and symptoms of psychosis. He reported to suicidal ideation would come and go, however never had a plan . Mr. Moore appears calm, cooperative and in good spirits during assessment. He reports a history of anxiety, depression, and emotional trauma by father at the age of 8 years old. Mr. Moore expressed he started noticing increase anxiety when he had to speak in large groups, present in school, driving, and engaging in social actives. He states, "Over the past 16 years my father has been out my live, when I was younger he would hit me if he felt I said anything out of line." Mr. Moore reports recent relationship issues and separation with his fiance. He reports due to him not engaging in many social actives his fiance has left him. He reports for many year going to Randolph Counseling Center for his anxiety. He reports positive results from services. Mr. Moore mention coming to the hospital last Thursday for his anxiety and bring prescribed a 30day supply of Ativan, which he reports has helped him become more stable when engaging in actives,like driving his mother's car. He reports depressive comes and goes depending on the mood he is in. He describes symptoms on occasion as feelings of

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

Please list outcomes of any/all drug screens. Please include the date, type, results, and substance (if applicable)

Mrs. Passmore is a 31 year old female who presented to the ED via LEO attempting to harm herself. Per documentation Mrs. Passmore reports someone taking her Klonopin several days ago and has not been able to take it. Today she allegedly tried to cut her wrist. She denies suicidal ideation, homicidal ideation, and symptoms of psychosis to nursing staff. At the time of the assessment Mrs. Passmore reports a mental health history of bipolar, anxiety, and depression. Mrs. Passmore noted she has only been hospitalized when she was 15 year old for behavior issues. She denies having a history of self harm or suicidal attempts. Mrs. Passmore reports recently she has been going through a lot. She reports her father died 3 weeks ago, financial issues,

Mr. Enochs is a 50 year old male that presented to the ED by IVC paper work from Daymark Recovery Services. Patient reported depressive symptoms and SI with a plan. Mr. Enochs stated : "I'm worried about my family and not being able to support them." He reports he has been unemployed and unable to find a Job. Mr. Enochs reports in the past 3 days consistent worrying about his sick wife, kid, and having continuous panic attacks. Mr. Enochs reports racing thoughts. He stated: "my mind never shuts down."Mr. Enochs reports he has been thinking about walking into traffic or falling into a hole at a construction site to take his life. Mr. Enochs stated: "I think if I was dead I could help my family financially." He reported only having 3 hours of

During the time of assessment the patient was sitting upright in her bed, her father at her bedside. The patient denies HI, SI, and symptoms of psychosis. The patient reports a history of depression. She expresses that a few days ago her and her boyfriend ended their one year relationship and he left the home due to the multiple domestic violence situations that have occurred in the home. The father of the patient provided a copy of the message sent of Facebook sent to the boyfriend, which expresses that the patient is hurt by the relationship ending and has suicidal thoughts with a plan to take a prescribe bottle of Valium to cope with the situation. Per documentation, patient's boyfriend throws knives at her, beat her and is verbally abusive. This was confirmed by the patient and her father. Per documentation the patient's parents picked her up a few days ago and she feels safe to go home. The patient reports joking about taking pills on Facebook. Per documentation the patient states, " If I wanted to kill myself,I'd just stay with him." Further the patient states, "If I go back to my boyfriend, he's going to beat me and I won't be able to take in much long." Per documentation the patient express crying episodes and feeling sadness, panic attacks for the past few day, and trouble

Depression affects everyone's life at sometime or another. Depression comes in a wide variety of forms, from mild unhappiness to a chemical imbalance in the mind. There are many different symptoms that reveal a person's problem with depression. If left untreated, depression may continue to develop into a serious illness or even death.