POST #2 Brittany
Suicide is a major mental health problem faced by many people in the world. In the United States, it is the 10th leading cause of death, surpassing liver disease, diabetes, and HIV (O’Rourke, Jamil, & Saddiqui, 2020). A high percentage of adolescence have admitted to having some level of sucidal ideation at a point in their lives. This data has resulted in suicide screenings and prevention a more common occurrence in the United States. It is important for healthcare workers to be educated on these tools so that they are more alert to warning signs and can help prevent these individuals from taking their own lives.
For this case study, John is a 36-year-old man that has had his life downward spiral rapidly. This has led him to become suicidal. Suicide risk assessment remains a high-stakes component of the psychiatric evaluation and can lead to overly restrictive management in the name of prevention or to inadequate intervention because of a poor appreciation of the severity of risk (Ryan & Oquendo, 2020). Some of the risk factors for suicide that he has is financial difficulties, negative childhood life experiences, loss of his job, martial problems, a history of mental illness, being a male, and feeling a sense of no purpose in life (O’Rourke, Jamil, & Siddiqui, 2020). Although these risk factors are known by healthcare providers, if they are not thoroughly assessing and asking these questions to the patient or missing warnings signs such as frequent hospital visits due to violence, then they will miss their opportunity to aid the patient. If John was properly assessed from homelessness and suicide risk, then the hospital could have helped him by providing a case manager for employment help, addiction programs, and mental health therapy.
All patients should be screened for suicide risk on their first contact with an organization (EDC, 2020). They should especially be screened if red flags are noted such as frequent hospital visits due to violence and illness from poor living conditions. Many events in John’s life from his childhood to adulthood put him at a increased risk for suicide and not being able to cope with any major shifts or changes in his life. As a child both of his parents were alcoholic, and his father was abusive. This began mental health issues in his childhood that he sought out care for, but never followed up.
Mental health is an illness that never goes away for good, and it can be triggered by life experiences, so it is important to continuously get care. Some social causes of this downward spiral include his traumatic childhood experiences, his own issues with addiction to marijuana and alcohol, being laid off from his job, separation from his wife and children, being evicted, and getting into risky behaviors such as theft and violence due to his living conditions. Mental health risks for this downward spiral includes his family history of alcoholism and his own struggle with addiction, not getting mental health care or counseling after his childhood, feeling no purpose in life due to the loss of his job, and eventually developing depression and suicidal ideations. Medical needs that attributed to this downward spiral includes no healthcare insurance, unaffordable prescription medications, frequent infections and injuries, and depression. Healthcare should have screened John as he came in with frequent injuries and infections but was never able to purchase his needed medications. After screening for homelessness and suicide, they could have provided him with resources to help get him back on his feet medically and mentally.
There are many barriers that John has faced in accessing medical care and mental health services. One of the major barriers that he struggled with was a lack of healthcare insurance. With a lack of healthcare insurance, he was unable to get any of his bills covered and he was not able to afford the prescription medications that he needed to treat his infections. For mental health barriers, he was not appropriately screened by his healthcare providers for his depression and suicide. Due to this, he was not given the proper tools or resources to treat these diseases.
References:
EDC. (2020). Screening for and Assessing Suicide Risk. Education Development Center. Retrieved from https://zerosuicide.edc.org/toolkit/identify/screening-and-assessing-suicide-risk
O’Rourke, M.C., Jamil, R.T., & Siddiqui, W. (2020). Suicide Screening and Prevention. NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK531453/#:~:text=Available%20Screening%20Tools&text=Suicide%20risk%20screen%20is%20a,various%20questions%20about%20self%2Dharm.
Ryan, E.P., & Oquendo, M.A. (2020). Suicide Risk Assessment and Prevention: Challenges and Opportunities. Psychiatry Online. https://doi.org/10.1176/appi.focus.20200011
POST # 1 KAYLA
In accordance with National Patient Safety goals, any patient being treated for a behavioral problem must be given a suicide screen (Devylder, 2019). This would be applied to John due to his substance use (past & present) and history of domestic abuse. Although John is not being assessed post suicide attempt, a proper validated screening tool can identify those at high risk for suicide (Devylder, 2019). John had numerous barriers to accessing medical and mental health care. One barrier was the lack of insurance for John after he lost his job. Another barrier is John's substance abuse altering his ability to make the best decisions for himself, specifically for his health. John's lack of support from family and friends is also another barrier. John's behavior has resulted in him being alienated by loved ones. Without support, John is unable to follow through with health care or even transportation to get to these places. Lack of income is also another barrier for John and his potential to get better. When homeless, individuals lack the access to resources they need to maintain proper health (Parsell, Have, Denton, Walter, 2018). Homelessness and mental illness intersect but also influence each other in many ways. Not only does homelessness result because of mental health issues, homelessness itself can be a catalyst in mental health issues exacerbated with the stress of instability. The lack of mental health facilities and support for these individuals cause further mental health disparities for this population. As APRNs, identifying these high-risk populations is the start of better supporting them through resources and adequate support (Bramham et al 2020). References Bramham, H., Deaver, C., Domnick, S., Hand, E., Ledwith, E., O'neill, N., . . . Goodloe, N. (2020). Linkages Between Community Mental Health Services, Homelessness, and Inmates and Probationers with Severe Mental Illness: An Evidence-Based Assessment. 2020 Systems and Information Engineering Design Symposium (SIEDS). Devylder, J. E., Ryan, T. C., Cwik, M., Wilson, M. E., Jay, S., Nestadt, P. S., . . . Wilcox, H. C. (2019). Assessment of Selective and Universal Screening for Suicide Risk in a Pediatric Emergency Department. JAMA Network Open, 2(10). Parsell, C., Have, C. T., Denton, M., & Walter, Z. (2018). Self-management of health care: Multimethod study of using integrated health care and supportive housing to address systematic barriers for people experiencing homelessness. Australian Health Review, 42(3), 303.
