You will be using the following escenario: To complete your clinic assignments. Please note the area the
patient lives in when you are recommending resources for this patient. Since you are not going to clinical, I
expect you to research the resource that you are recommending and provide a convincing argument on how
this resource will benefit your patient.
Scenario A- Serious mental illness.
History:
Christopher, age 45, lives in Houston Texas in the medical center area. He has a history of
severe mental illness (SMI) and is causing a disturbance in the public library. He is arrested
when he refuses a police officer’s order to leave. Charged with disorderly conduct, he is
subsequently found to be “guilty but insane” and conditionally released to mandatory
psychiatric treatment. At a local clinic he receives a long-acting intramuscular antipsychotic
medication due to his history of nonadherence. He also joins a day program and is assigned
to a case manager who helps him apply for Supplemental Security Income. When his aging
parents state that he can no longer live with them, he moves to a group home. Because
Christopher wants to work, he is referred to Houston Food Bank where he receives job
training and coaching, leading to a job unloading trucks. The stable housing and the
requirements of his conditional release lead to consistent treatment and prevent
nonadherence. He remains stable and employed for the next 5 years.
Christopher has done well in a group home and decides to move to his own apartment.
Over the next 2 months, his mental status remains stable. However, his nurse, who weighs
him monthly, notices that he has lost 12 pounds. Christopher denies any change in his
eating habits, and he doesn’t follow up with the primary care provider at The Harris
Psychiatric Clinic where he’s been referred. During the next 6 weeks he loses another 10
pounds. Christopher’s work supervisor noticed that Christopher is talking out loud to
himself, is more isolated, and today, smelled of alcohol. The supervisor dismisses him for
the day and requires him to get treatment before returning to work.
At his appointment, the psychiatrist, nurse, and nurse-therapist discuss these changes and
recommend that Christopher go into the partial hospitalization program for support and
medication reevaluation. Although he denies that he has a problem, Christopher reluctantly agrees.
Clinic Scenario assignment:

1. What are important assessment data you should obtain or document on this patient. Is there any information
   you should gather from family members or significant others in this situation?
2. Community health nursing addresses components of primary, secondary and tertiary prevention. (refer to
   chapter 27). Define one of the following concepts from your textbook (primary, secondary or tertiary
   prevention). Compare how the care you would have provided or recommended in this scenario met the type of
   prevention you identified.
3. Define case management and the duties involved. Identify case management changes that may have a
   positive impact for this patient and give rationales to support your suggested changes.
4. Community resources play a major role for patients with mental health problems. Identify resources in this
   case scenarios demographic location that would best benefit that patient. Be specific and provide a convincing
   argument on how this resource will benefit the patient or family in the scenario.
5. What specialized assessment tools/screening would be most beneficial for you to gather assessment data
   on your patient and why you think this tool would be valuable for you. (example the Beck depression inventory/
   Hamilton depression scale or the geriatric depression scale for someone that is depressed).
   The book to use for this course is:Varcolis’ foundations of psychchiatric-mental health nursing 8 edition