The writer works as a social work intern with the severe mentally ill in the adult Asian inpatient psychiatric unit at Bellevue Hospital Center, the flagship facility of New York City’s Health and Hospitals Corporation (Bellevue Hospital Center’s wikipedia, 2013). Bellevue is exceptionally renowned for its inpatient psychiatric facilities and is open to patients of all backgrounds regardless of the ability to pay (HHC, 2013). The inpatient psychiatry specializes in the acute care of patients with a wide variety of mental illnesses, including chronic severe mental illnesses, geriatric psychiatry, and co-occurring disorders (HHC, 2013).
The Asian inpatient psychiatric unit is located on the 18th floor south wing (most often referred to as “18S”) and receives referrals from the hospital’s comprehensive psychiatric emergency program (CPEP). A multidisciplinary treatment team provides comprehensive treatment, care, and person-centered health plans to the mentally ill in the unit. The interdisciplinary team consists of psychiatrists, psychologists, social workers, nurse, nutritionists, and environmental service professionals. Since the deinstitutionalization movement in 1950s, the mentally ill are found less in hospitals and more in communities. Because of this, it becomes essential to form a working alliance with the mentally ill individuals and their families and to prioritize their concerns. Evidence-based research suggests that multidisciplinary team is an effective mean of delivering a comprehensive mental health service to people with severe mental illnesses, especially those with chronic mental health problems (Tyrer, et. al., 1998).
The patient is a 32-year-old, Vietnamese and English speaking, single, female, with California insurance, residing with older brother in Santa Cruz, California. She has two prior psychiatric hospitalizations with a diagnosis of Schizoaffective Disorder, bipolar type. She was prescribed with Abilify 2mg with outpatient treatment at Santa Cruz Mental Health Department. Patient was brought into the hospital via an emergency medical services (EMS) shuttle after the report of patient jumping onto the Amtrak train tracks.
Patient’s Need Evaluation
Patient was brought into Bellevue’s comprehensive psychiatric emergency program (CPEP) due to a severe manic episode: jumping onto the Amtrak train track for unknown reasons. CPEP conducted an initial psychosocial assessment and a comprehensive physical evaluation. Then patient was transferred into the adult Asian psychiatric unit for the culture milieu.
The psychosocial assessment, firstly, is extremely difficult to be completed due to patient’s psychosis. During the initial assessment, patient was guarded and thought blocked. She lacks any insight and denies any history of mental health hospitalizations. She reported a history of depression due to "stress" and sees a therapist by the name of "Barbara" for the...