Note: Client is a 40 year old, disabled, single, Mexican-American Male. Client is currently homeless throughout Ventura County. Client is enrolled with Ventura County Behavioral Health 8390 South Oxnard Adults Clinic with a diagnosis of F25.9 Schizoaffective Disorder, Unspecified. Client was previously a long term client of Ventura County Behavioral Health EPICS program with a diagnosis of 295.30 Schizophrenia, Paranoid Type. Symptoms/Focus: Dr. Andrew Bourgeois at Simi Valley Emergency Room requested an evaluation of client by the Crisis Team for Suicidal Ideation and Grave Disability. Client placed a call to EMS on his own behalf on the evening of 05/14/2017. Client requested to be picked up from in front of a restaurant and taken to Simi Valley Emergency Room due to suicidal ideation with a plan to "cut head with a saw". Client stated to Dr. Bourgeois that his depression had increased over the last 3 days. Client denied drug or alcohol use, but was positive for amphetamine in the hospital toxicology screen. Client had been seen at Simi Valley ER and …show more content…
Client stated he "needs to be in a hospital" but does not want to go to a psychiatric hospital. Client advised that he could not live in Simi Valley Hospital and needs further psychiatric …show more content…
Bourgeois notified of the decision to detain client for Grave Disability and was in agreement with client being placed for further psychiatric care. Dr. Bourgeois requested the name and contact information for help in facilitating client being transferred to an LPS designated facility, due to being unable to place him on multiple occasions. This writer contacted Supervisor Robin Boscarelli regarding this issue. It was decided that a member of the Treatment Team will be reaching out to the Hospital Unit Clerk, Gina later this morning. Dr. Bourgeois was in agreement with this plan. Client's Clinic to be notified via email of this Crisis
Harrison, Erica. "Homelessness Among the Seriously Mentally Ill: What We Can Do to Help." Clarityhumanservices.com. N.p., 5 Mar. 2013. Web. 13 Nov. 2013.
Psychiatric hospitals, also known as mental hospitals and mental asylums, are hospitals or wards specializing in the treatment of serious psychiatric diseases, such as clinical depression, schizophrenia, and bipolar disorder. Psychiatric hospitals vary widely in their size and grading. Some hospitals may specialize only in short-term or outpatient therapy for low-risk patients. Others may specialize in the temporary or permanent care of residents who, as a result of a psychological disorder, require routine assistance, treatment, or a specialized and controlled environment. Patients are often admitted on a voluntary basis, but people whom psychiatrists believe may pose a significant danger to themselves or others may be subject to involuntary commitment.
In other words, the patient was sick because of his or her time in the institution. I find this interesting because without a more human telling of the story by Grob, it is hard to gauge if the psychosis of patients deteriorated in general with the length of stay in the institution and if because of this, did that impact the policies or methods of practice? I believe it would be similar to what they are finding now with the orphans of Romania in the 1980’s who were raised in institutions with only basic and minimal human contact and now are mostly homeless and unable to function in society or inmates in prison who have spent years behind bars and then are let go into the general population. History has proven that people struggle with trying to acclimate back into the general population. As a result of this by the 1980’s one-third of the homeless population in the United States were said to be seriously mentally ill. (PBS, "Timeline: Treatments for Mental
Gupta, M. (2001): Treatment refusal in the involuntarily hospitalized psychiatric population: Canadian policy and practice. In: Medicine and Law, Vol. 20, Issue 2, pp. 245-265.
There are a lot of ethical standard that can be apply to this scenario, the most and most important one avoiding harm (Standard 3.04). The psychologist should take a reasonable step to avoid harming the patient especially when it is foreseeable. Before referral, the psychologist has known that the patient was abusing Xanax, she had taken 17 mg in the 30 hours when she should have only taken 2.5 mg, her behavior is very unreliable and she was not overtly suicidal or homicidal but the tendancies were there. Practicing within the boundaries of competent (Standard 2.01), the psychologist was knowledgeable enough to know that the client was in danger of harming herself or others. The psychologist took the necessary precautions to avoid harm by referring her to an inpatient facility. The psychologist cooperated with another professional (Standard 3.09) when it was needed which was in the best interest of the client. The psychologist should be aware of HIPPA rules when cooperating with the other professional. The patients written authorization on release of PHI should be communicated to the other professional. This brings us to the pressing issue for the psychologist right now; the psychologist wants to check on the status of the client, but the facility will neither confirm nor deny her stay there. The psychologist can fax the release form but, with the condition that it should be communicated to the inpatient clinic as confidential on the fax cover. The mistake the psychologist made was not getting a full release from the client, this should have been discussed during informed consent (Standard 3.10). This should also have been done as early as feasible before services and the psychologist had ample time since the client has been coming for several weeks. Even though this patient might be in a heightened emotional state due to her unreliable state before
On 1/6/2016, CM met with the client to complete Bi-Weekly ILP Review. Client was dressed with proper attire for the weather. She was well groomed. In the meeting client appears to be space, disoriented and cognitive impairment which making difficult for the client to express herself or dialogue appropriately.
The counselor met with client for her scheduled assessment. CPS caseworker Margie Jones referred the client because of testing positive for illicit substance. The client is a 25 years old African American woman. She is mother of five children a set of twins and one has recently died. The mother reports the baby was laying on her chest and got tangle in the cover and died. She became tearful when talking about this. The mother reports she has been distraught and began using illicit substances to cope with her grief. The client reports being recently prescribed an anti-depressive to address her depression. She reports one prior suicide attempt in 2013 by overdoing on pills. The client reports being sexually assault at the age on 12. She reports
Until the middle of the last century, public mental health in the United States had been the responsibility, for the most part, of individual states, who chose to deal with their most profoundly mentally-ill by housing them safely and with almost total asylum in large state mental hospitals. Free of the stresses we all face in our lives, the mentally-ill faced much better prospects for peaceful lives and even recovery than they would in their conditions in ordinary society. In the hospitals, doctors were always accessible for help, patients were assured food and care, and they could be monitored to insure they never became a danger to themselves or others. Our nation’s state hospital system was a stable, efficient way to help improve the lives of our mentally disabled.
Discharge planning for these patients into the community does not consider living in shelters and assisted living facilities. The revolving door situation creates negative outcomes for patients and organizations. These organizational alternative housing services do not provide medication supervision, therefore adherence to medication regimen and treatment is not provided to them. Consequently, they return to hospitals seeking follow-up treatment. Unfortunately exacerbation of mental illness symptoms is inevitable reflected from premature discharge and inadequate follow-up care. It is imperative that all patients receive proper treatment and discharge plan. Providing discharge instructions to patients for transitioning to independent living and self-care is not sufficient. Proactive health interventions and planning organizational strategies are needed to improve health outcomes for patients who are living in health care institutions (National Health Care for the Homeless council,
The physician will question the patient about any stressors she may be contending with at home or work prior to her entering the hospital. The physician will order lab tests and speak with the patient to understand the psychological factors; a referral will be made for making a final diagnosis. After the physician reviews both lab tests and the psychological factors, a referral will be made for the patient to see a clinician. The referral will focus on obtaining support and stabilization. The clinical assessment will gather information using written forms as a first step, including releases to speak with family members. The second step would be to invite the family along with the client in an effort to obtain a better understanding of existing medical conditions along with any past mental disorders. Abuse as a child or abuse as an adult will be determined. The clinician will evaluate if the client is portraying any signs due to alcoholism or a drug addictions. An example of one question her clin...
The Center for Disease Control and Prevention [CDC] used the U.S. Department of Health and Human Services’ definition of mental illness as “health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning” (2011). Our community is exposed to a large number of individuals with mental illness. Among those individuals are the widespread homeless populations. The United States Department of Housing and Urban Development reported “twenty-five percent of the sheltered homeless report a severe mental illness (as cited in Allender, Rector and Warner 2014 p. 907).” This author found the target population to be predominantly Caucasian, Non-Hispanic, single males of thirty-one years of age and older. In reviewing the research, this author found that multiple health disparities happen in conjunction with mental health and homelessness. This includes cardiac and respiratory issues and HIV/AIDs. Without the proper healthcare services, the homeless mental health population remains vulnerable.
Gulcur, Leyla, Padgett, Deborah K., and Tsemberis, Sam. (2006). “Housing First Services for People Who Are Homeless with Co-Occurring Serious Mental Illness and Substance Abuse.” Research on Social Work Practice, Vol 16 No. 1.
It is the doctor’s responsibility to realize this and refer the patient for psychiatric evaluation. In the above case, the doctor did not do so, and the results are overwhelming. The patient may have had other options that had not yet been discussed, but her judgment was clouded and she felt that there was no alternative. Had she been properly evaluated there may have been a different result. In this case it is clear that the physician is at fault. The events of this particular case are unfortunate, and a prime example of what can happen without proper
States obtain many services that fall under mental health care, and that treat the mentally ill population. These range from acute and long-term hospital treatment, to supportive housing. Other effective services utilized include crisis intervention teams, case management, Assertive Community Treatment programs, clinic services, and access to psychiatric medications (Honberg at al. 6). These services support the growing population of people living in the...
Throughout county jails, there is a large population with serious healthcare needs, such as mental illnesses and medical conditions; The majority of these individuals are not violent criminals, most of the inmates have not gone to trial and the rest are serving short sentences for minor crimes. However, few jails are equipped to provide the extensive mental health services that are needed for these individuals. According to the Bureau of Justice Statistics (2015), only one-third of individuals who enter jail with mental conditions are receiving proper treatment. Since the mentally ill inmates do not receive the proper treatment, they suffer and the