Suicidal Ideation Case Summary

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Mr. Farley is a 52 year old veteran who presented to the ED with a BAC of .42 and requesting detox treatment. Mr. Farley denies suicidal ideation, homicidal ideation, and symptoms of psychosis to ED staff. However, after initially denying suicidal ideation, upon discharge and sobering up from several hours in the ED and being given fluids, nursing staff informed patient he was up for discharge, at which point he asked for Ativan to help with his withdrawal symptoms. He was informed he would not be prescribed this medication and reasons why, he then expressed he could not be discharged because he was now a threat to harm himself. It should be noted Mr. Farley was seen 2 weeks ago and upon discharge reported the same. He expressed he was homelessness …show more content…

Farley reported he was staying in the local Comfort Inn where his truck was parked, however did not have any money due to spending majority of it on alcohol. TACT informed him that he could contact the local shelter, which was contacted by staff. Asheboro shelter of hope informed Mr. Farley they would come pick him up at 8am 6/21/17. Mr. Farley continues says, "Well you can't discharge me if I'm suicidal?" This morning TACT assessed patient and confronted this behavior, at which point patient admitted to malingering and stated, "Well I just wanted to get into the Salisbury so I can get some help. I just didn't want to go to the streets." He continue to expressed experiencing fleeting suicidal ideation over the course of the past 10 years. Mr. Farley reports homelessness and chronic alcoholism as the primary stressors contributing to his current distress. He describes depressive symptoms as tearfulness, hopelessness, worthlessness, despondency, guilt, insomnia, and poor appetite. Mr. Farley denies suicidal ideation, homicidal ideation, and symptoms of psychosis. Patient does not appear to be exhibiting signs of agitation, aggression, or responding to internal …show more content…

Patient has a history of abusing other substances and was very med seeking for benzos and opiates in the ED ("I don't want yall to give me nothing if it ain't IV Ativan and Morphine"). He reports drinking a 1 gallon of wine daily. He denies other drug use and this was confirmed by his most recent drug screen which was negative for substances with a BAC of .42. Upon arrival patient was put on detox protocol with Ativan scheduled every 6 hours. Upon assessment this morning patient denies any withdrawal symptoms. After TACT confronted him about malingering and patient admitting this, TACT then began to discuss discharge options. When TACT asked Mr. Farley about withdrawal symptoms he only expressed

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