Identifying Information: : 18 years old/ Male/ Native American
Payor: Bill Nozdack
Present Psychiatric illness/symptoms
Kingsley Walker is an 18-year-old male having a history of depression due to being diagnosed with post-traumatic stress disorder (PTSD) when he was only 13 years old. His condition did not get any better because he started abusing marijuana during that tough period that he was experiencing. When interviewed on Tuesday about his past experiences, she stated that his parents have not always been supportive in terms of helping him come off his drug addiction. He was admitted at DC Hospital due to his abuse of hard drugs such as marijuana and cocaine coupled with his diagnosis of schizophrenia at the age of 14 years old.
His psychosocial stressors at the age of 13 years included a non-supportive family environment who could not understand the psychiatric illness that he had at the time. He would experience moments of hallucinations, delusions and his thought order was disorganized (Olver, Pinney, Maruff " Norman, 2014). Her current stressors include her non-involvement in school activities which have made him go on detention several times. Her teachers have not completely understood his condition and they constantly give him a hard time for his absent mindedness. Moreover, his parents do not provide a much needed support system for him and that makes him a little bit cranky and even more delusional. The fact that his father is a drunk and even though he is aware of his medical condition, he fails to understand him once he consumes large amounts of alcohol.
The basic concerns and needs of the patient
The patient has a challenge of taking medication, he almost always fails to take his medication. Failure to remind him of the need to always take his medicine, he never sees any need to do it. Furthermore, the patient has a serious need for housing as his father is not very considerate of his situation and tends to look at him as a liability. He also refers to him as a “possessed” child because of the hallucinations he experiences due to his psychiatric illness. He thus needs to find a suitable home where he can be taken care of, having in mind his medical condition.
The past diagnosis of the patient
When Kingsley was 13 years old, he was diagnosed with depression due to the post-traumatic stress disorder after being involved in a horrible accident where he was the only survivor of the horrid event. Later on that year, he was diagnosed with schizophrenia where he would be suicidal from time to time, especially when he was abusing hard drugs such as cocaine and marijuana. During these times, he would have delusions that he was being pursued by evil spirits and he would try and take his life in a bid to stop the evil spirits from “killing” him.
Forms of Medical health medications: Seroquel and Abilify (both administered orally to treat bipolar disorder and schizophrenia)
Past Medical Concerns: Depression, Delusions, Hallucinations, Thought disorder, Poor expression of emotions, Cognitive difficulties.
Past Family History of Addiction/ Illness
The father of the patient is a drunkard and is totally not considerate of the medical condition of the patient. He suffered from depression because of excessive drinking of alcohol.
Spirituality
The patient does not have any specific denomination.
Forms of Cultural Consideration
Kingsley has a problem socializing with the members of his class. He is completely ostracized from the members of his class. He has a huge challenge forming any meaningful relationships with members of the opposite sex. The members of the class look at him as the “weirdo” that does not comprehend what happens in class. He does not have a plan for the upcoming Prom.
Personal History
The patient has been subjected to severe physical abuse due to the slippery relationship he had with his father. The father would come home drunk when the patient was 13 years old, and start calling him a lunatic, while hitting him for not being able to understand the basic concepts in class. The mother rarely intervened as she feared that the father would descend on her too. He has on several occasions sought custody with the Director of Children Services because of such abuses but the mother has always made an assurance that he is free from danger, and the fact that he is 18 years old makes it a little bit problematic.
Education: The patient is in his final year in High School. He is responding well to treatment but still has problems with Math, especially Geometry and History because of its recall nature. However, he has a lot of interest in English and loves reading Science fiction novels.
Developmental History: The patient denies having schizophrenia and almost always insists that he is fine. He has always had a problem understanding issues and slowly interprets most issues
Legal History: No involvement in any form of legal action.
Marital/Relationships: Heterosexual. He, however, is not in any sexual relationship. His relationship with his father is a wreck. However, his mother is understanding and because of that, they are pretty much close.
Work History: The patient is currently in his final year in high school and would like to be a journalist in future.
Strengths, Needs, Ability, Preference (SNAP)
The patient is currently responding well to treatment, appreciates the love and support he receives from his siblings. The patient, however having an unstable mind, is a good artist who is able to sketch and draw objects in three-dimensions. The patient is in serious need of a psychiatric home where he can receive specialized treatment and recover
Interpretive Summary
Kingsley Walker is an 18 year old living with both her parents and his 4 siblings. His biological father is a drunkard who occasionally hits him for his “lunacy”. He is concerned that his father does not understand his condition and that he should have been admitted to a psychiatric home. He is fighting drug addiction which has been a huge impediment for the taking of his medication. He was diagnosed with depression which was caused by a horrific accident that he was involved in where he was the only survivor. He identifies his sexuality as heterosexual even though he is not in any sexual relationship. No religious affiliation.
Short and Long term goals
Member will continue to receive medical treatment at DC hospital. He will however find ways in which he is able to take his medication by having an accountability partner. There will also be a family sensitization program that will be aimed at educating the members of his family on how best he can be taken care of.
Transition/discharge plan
SWI will provide care and support for the patient, ensure that he takes his medication, make follow ups on the visits to the hospital. Furthermore, it will provide helpful information to the family of the patient. The patient can also be placed in a psychiatric home when home care is not forthcoming.
Invitation to Treatment Team: Consumer Response [X ] Accepted [ ] Declined
The member, having received invitation from the treatment team last week, was delighted to be part of the start of a long journey. He reported that he was willing to be well and to recover so that he was able to function normally like any other person of his age. He stated that he wanted to be accepted by his father as normal child and that reaffirmed his commitment to the treatment cause.
Therapeutic Interventions Provided
Therapist will see member two times in every week where there will be individual and group sessions for the times that he visits. Further, there will be sessions where the members of the family will be invited to be part of his support system.
Services Recommendations and Plan
It is recommended that Kingsley and his family see a psychiatric illness specialist who will be able to walk with them through the process of having a grown man with schizophrenia. The support will be granted on two specified days by the member of the family. Furthermore, Kingsley will be taken to a psychiatric home after a comprehensive analysis has been done on the care he is receiving at home. Provision of these services will help in the monitoring of the member’s behavior and progress. The service provision will also be aimed at equipping the parents and siblings with skills that will help them to better deal with their child/sibling.
Reference
Olver, J., Pinney, M., Maruff, P., " Norman, T. (2014). Impairments of Spatial Working Memory and Attention Following Acute Psychosocial Stress. Stress And Health, 31(2), 115-123. http://dx.doi.org/10.1002/smi.2533
Appendixes
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Physical/mental illness
Alcohol or drug abuse
In recovery from alcohol or drug abuse
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Kingsley Family Eco-map
