The Ridge Center 's Day Hospital

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.

The major theoretical perspectives provide a framework for understanding and conceptualizing client’s current mental health issues and the potential contributory factors in the development of their problems. The present client, Toni Barone, is seeking treatment for her current unhappiness with her life, social isolation, and bereavement issues stemming from her father’s death.

Heritage Oaks Hospital provides a less restrictive step-down treatment environment at three outpatient centers: Harbor Oaks in West Sacramento serves adults and senior adults; Roseville Oaks serves adolescents, adults, and senior adults; and Winding Oaks next to the main hospital serves adults and senior adults. According to course textbook, the goal of outpatient programs is to improve quality of life and to return clients to daily activities among family, peers, and the community (Varcarolis, 2013). The treatments available include psychiatric, emotional, behavioral, and substance abuse. These outpatient centers have partial hospitalization program (PHP) and intensive outpatient program (IOP). According to the hospital website, outpatient services include physician oversight, medication management, group therapies, educational practices such as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) (heritageoakshospital.com, 2017). I was assigned to Roseville Oaks Outpatient Behavioral Health Center. It was helpful for me to

Terri a 44 year-old African American female present to outpatient counseling for severe anxiety and depression. The client identified current relationship problems with her boyfriend and multiple lapses while in recovery as stressors. Terri began recovery several months prior to seeking additional counseling. She also received services from a substance abuse counselor but wanted a separate counselor for possible couples counseling.

It seems as though, like day evolves into night, people change and evolve as well. Dianne and I have been working together throughout the course of three sessions. We have built a strong helping relationship and it seems as though Dianne has placed trust in our bond. During our previous sessions, Dianne has disclosed that she is 33 years old and was previously a social work student before she had to pause her schooling. She is a single parent, however her child is in care due her crack cocaine relapse. Dianne suffers from cervical cancer and has also been diagnosed with Bipolar and Multiple Personality syndrome. She explained that she experienced personalities that exhibited anger, addiction, depression and a combination of all three of these. Dianne is also homeless with no source of income. Dianne has also explained that she is originally from Ottawa, where she used to reside with her parents, but has come to Windsor to seek out treatment for her substance abuse problem. At this point in our relationship, Dianne and I will be working towards assessing her current situation, creating a contract, as well as intervention and treatment plans. This will further be analyzed throughout this paper.

Mental illness accounts for six to nine percent of emergency room visits in the United State (Zeller, Calma & Stone, 2014). Working in an emergency room this author has seen what boarding in the emergency room and not having a therapeutic environment can do to a pscyharitic patient. Having a therapeutic environment would be having more than just a bed in a room with a television that is behind a screen. Patients state that having a nontherapeutic environment is like being in a jail cell (McKellar, 2015). The environment that the patient his in has to do with his or her experience of recovery and healing process (Donald, Duff, Lee, Kroschel, & Kulkarni, 2015). Patients are sometimes staying as long as seven days in the emergency room waiting for an inpatient bed to become available (Vierheller & Denton, 2014). Having patient that can be boarding up to seven days it is crucial that the environment that the patient is in is therapeutic so the patient could possibly start his or her healing process in the emergency room, and possibly prevent an inpatient hospitalization.

Over the past four months, I have had the privilege of learning and growing in UM’s Ypsilanti Health Center under the supervision of Patricia Rudolph, who showed me what public health and social work looks like in a community clinic. What I learned about trust, communication and most importantly, framing I believe will serve me well, not only in my academic career, but also my professional career. I got to sit-in during patient seeking a variety of care. Some visits were wellness visits for children, others were to confirm a pregnancy and develop a subsequent treatment plan moving forward. I met with an MA who was in charge of chronic disease management reports. She reported various benchmarks as a way for the safety net clinic to get the maximum reimbursements allowed for their majority Medicaid population. I observed the dynamic between different members of staff, from the call center and intake/check-out clerks to the residents and attending physicians. There was a culture of respect amongst the staff, lines of communication were always open, and even when difficult, different parties found ways to keep in contact, and easily accepted having to defer to another party adhering closely to their level of comfort within their prescribed scope of practice. Messages were tailored so that everyone involved in a patient’s care or their care experience was able to understand what was needed of them and how best to move forward.

One major tenant of the program is recovery and recovery oriented treatments. Due to the nature of the mental illness that the veteran is suffering from their needs may be judge on a more in-depth assessment of the veteran. Case Mangers will on average personally visit a veteran two to three times a week. This is done so that the veteran who has issues coming to a VA facility won’t have to miss treatment. Case Mangers depending on the severity of illness will commit to a more intensive case management services. This would be done if a veteran is in a process of detrition if all are in agreement who are motoring the veteran. Case Manager and psychiatrist who hold daily rounds will review the veterans chart a proper course of action. Assessment and treatment data will be reviewed and analyzed by leadership to determine if program would be effective. .

The opportunity of talking to a Professional Mental Health Counselor was very informative on October 19, 2015, I had a chance to meet K.W. she is a License Professional Counselor in Mental Health that holds her (LCPC) for the last ten (10) years. Ms. K.W. also holds her Therapist license in the arena of counseling for the last past six (6) years were her services of care is Mental Health, and Addiction Counseling were her population is men and women that struggles with addiction problems and mental health that is called co-occurring disorder in an outpatient setting.

The client has had a significant mental health history. Based on her history, it is reasonable for a provider to understand her reluctance in seeking mental health treatment. Additionally, her cultural and familial background also cause her to tread cautiously with regard to mental health treatment. As providers, our goal is not to berate the client while in a fragile state, but rather, as Wachtel states (as cited in Wheeler, 2014, p. 15), we want to help them “overcome the fears and inhibitions that have led them to react to his normal and healthy feelings as if they were a threat”.

The client is a 63 year old African American male who is currently homeless. During the assessment the client presented as open and receptive towards the assessor. During 2016 of October, the client was hospitalized at MCV for suicidal as evidence of trying to cut himself with a knife. The client says he was given the diagnosis of Manic Depressed and Bipolar. The client was given Trazadone and Risperdal prescribed by Dr. Burman. The client stated that at the age of 15 he was first diagnosed with Explosive Temper and was prescribed antidepressants.

Susanna Kaysen, an 18-year old high school senior, was sent to a psychiatric hospital because she allegedly tried to commit suicide off of overdosing on aspirin pills and chasing it with a bottle of vodka. She claimed to be trying to get rid of an aching headache. They initially diagnosed her with suffering from depression. Equally important, after residing in the psychiatric hospital for several months she receives her first citation for trying to make a friend feel less distressed through playing music and is sent to the head psychiatrist of hospital. During her session with the psychiatrist, Susanna is ambiguously diagnosed with Borderline Personality Disorder. The psychiatrist diagnostic stemmed from Susanna being sexually promiscuous, emotional dysregulation, and inability to form suitable relationships. I conceive that her symptoms are reasonable to a normally behaving teenager that was wrongfully institutionalized and is now surrounded by women who are mentally ill. Susanna was wrongfully institutionalized and diagnosed because those behaviors are deviant and abnormal for her race, gender, 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.

The People's Hospital applies corporate governance in the management of the company. The management and employees of The People's Hospital are guided by set values that determine the ethics and integrity of each employee.  Moreover, the values of the hospital are used in the determination of the corporate governance in recognizing the responsibilities of patients, employees, shareholders and the community at large. Excellent corporate governance results from the cohesive coordination of resources and responsibilities among all entities of an organization. Commitment of the Chief Executive Officer of the hospital to this objective, in support of all directors/administrators, shareholders of the hospital results in good governance. However, my father's health was compromised at People's Hospital, a factor that questioned the adherence to corporate governance. My father was given wrong medication that worsened his health state and complicated his recovery process.

The Medical Center at Bowling Green, mcbg.org, is a not-for-profit hospital that is under the operation of Commonwealth Health Corporation (CHC). It is one of six sister hospitals under the management of CHC, serving the southern KY areas. It is the largest hospital of that corporation. TriStar Greenview Regional Hospital, tristargreenviewregional.com, is a for-profit hospital that’s a part of the TriStar Health organization, which serves southcentral Kentucky and middle Tennessee areas. Both facilities are located in Bowling Green, KY.