PSY645 Fictional Mental Health Consultation Scenario
You have received the following email from a colleague working at a local crisis house.
Here is the case we talked about briefly over the phone. Please let me know your thoughts. This one really has me stumped.
John Smith, PsyD Clinical Psychologist (PSY042)
Please note the following privacy information: This message and any files transmitted with it may contain privileged and confidential information intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient or the person responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination or copying of this message or any of its attachment(s) is strictly prohibited. If you have received this message in error, please immediately notify Dr. Smith by email and permanently delete the original message and attachment(s) from your computer system. Thank you for your time and consideration in this matter.
Bob is a 38-year-old male. He presented to the crisis house late last night, appearing disheveled and poorly groomed. He repeatedly stated, “The police are after me,” but did not articulate any reason why the police would be looking for him. His speech was pressured and circumstantial; he had significant psychomotor agitation and elevated body temperature. Bob reported having been in psychiatric treatment “for years,” but refused to share previous diagnoses and would not complete a release of information to allow examination of his medical history. When I shared with Bob that his medical history is important information for me to know in order to help him, he screamed, “You work for the police, don’t you? I bet you’re a cop!” Bob was admitted to the crisis house due to risk of further decompensation without this level of care.
Normally, I would wait a few days to observe Bob and make a diagnosis, but I need to make a diagnosis within 24 hours of admittance according to our crisis house policy. Additionally, I do not currently have access to a tox screen or a toxicology report for Bob. Help me understand what’s happening with him so I can make a provisional diagnosis.
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