Cnl 605 Topic 5 Case Study Teda Single Man Of 40 Years Of Age Named T ✓ Solved

CNL-605 Topic 5 Case Study: Ted A single man of 40 years of age named Ted cut his carotid artery at home. He had suffered from chronic schizophrenia, dominated by paranoid symptoms, for 20 years. During his illness, Ted had spent a total of 12 years in mental hospitals; individual hospitalizations had varied in duration. While he was hospitalized, his bizarre delusions of altered body states and his experiences of being controlled by external, often invisible, agents rapidly disappeared. He had death wishes and suicidal thoughts since the onset of his schizophrenia.

Death wishes also stopped soon after hospitalization. Over the years, opinion about Ted changed and his condition began to be regarded as hopeless. He was difficult to treat; he accused personnel, was unreliable, acted pretentiously, and reacted by acting out. Four years before committing suicide, he had to be transferred to another mental hospital. Two years before his death, he was transferred to a halfway house belonging to the hospital, because the staff feared that his dependence on the hospital might become excessive.

After his transfer to outpatient care, his suicidal tendencies increased. Six months before committing suicide, he lost his long-term nurse. Subsequent treatment consisted of occasional office visits with a psychologist or psychiatrist. Just before committing suicide, Ted tried to enter the hospital where he had been during the initial phases of his illness. He had suffered increasingly for a few months from paranoid fears of being murdered.

He threatened to commit suicide unless he was admitted to the hospital, but the threat was considered demonstrative and hospitalization was brief. The day before he committed suicide, he visited his childhood home and became afraid that a group of men had surrounded the house. He repeated his wish to enter a mental hospital. During his final night, his state changed. According to his father, Ted was exceptionally calm on the day of his death.

The father said, "He no longer seemed afraid of anything." Adapted from: Saarinen, P. I., Lehtonen, J., & Là¶nnqvist, J. (1999). Suicide risk in schizophrenia: An analysis of 17 consecutive suicides. Schizophrenia Bulletin, 25 , . © 2021. Grand Canyon University. All Rights Reserved.

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Case Study Analysis: Ted's Journey through Chronic Schizophrenia and Suicide

Introduction

Ted, a 40-year-old single man, presents a difficult and poignant case study highlighting the complexities of chronic schizophrenia, specifically dominated by paranoid symptoms, and the associated risk factors for suicide. This report will analyze Ted's history, his behavioral patterns, and the overall context of schizophrenia as it pertains to his tragic outcome. Additionally, it will explore clinical interventions, treatment methodologies, possible preventive measures, and relevant literature.

Background on Schizophrenia

Schizophrenia is a severe mental disorder characterized by disruptions in thought processes, perceptions, emotional responsiveness, and social interactions (American Psychiatric Association, 2013). Chronic schizophrenia, as experienced by Ted, is often marked by persistent symptoms, leading to increased difficulties in social functioning and a heightened risk of suicidal ideation (Brent et al., 2016). The prevalence of suicidal behavior among individuals with schizophrenia ranges from 4% to 13%, reflecting a critical need for effective interventions (Fitzgerald et al., 2016).

Ted's Mental Health History

Ted's chronic schizophrenia began over 20 years ago, with a history of long hospitalizations totaling 12 years. His early hospitalizations saw a reduction in symptoms, such as bizarre delusions and experiences of external control (Saarinen, Lehtonen, & Lönnqvist, 1999). This symptom reduction during inpatient treatment is not uncommon; however, the return to the community often presents its own set of challenges (Fowler et al., 2018).
During his outpatient phase, Ted's condition began to deteriorate, marked by increasing suicidal ideation following the loss of his long-term nurse. This relationship likely provided a significant support system, which was abruptly taken away, demonstrating the importance of stable therapeutic relationships in managing chronic mental illnesses (Gonzalez et al., 2019). The re-hospitalization attempts noted in Ted's case indicate a critical turning point in his mental state, defined by acute paranoid fears and desperation.

Risk Factors Contributing to Suicide

Understanding the risk factors associated with Ted's suicide is vital. The presence of chronic schizophrenia, suicidal ideation, a history of multiple hospitalizations, and social isolation are significant contributors to suicide risk (Dumont et al., 2018). Ted's expression of death wishes and his feelings of being overwhelmed by paranoid fears demonstrates how these symptoms interact dangerously in the context of his mental health. A meta-analysis has shown that individuals with schizophrenia who experience paranoid delusions have an increased risk of suicidal behavior compared to those without such symptoms (Cerdá et al., 2019).
Moreover, Ted's behavior towards mental health professionals can be construed as a coping mechanism for his perceived helplessness. The pattern of acting out is characteristic of defense mechanisms employed by individuals with mental illnesses experiencing danger or distress (Williams et al., 2020).

Clinical Interventions and Treatment Methodologies

Ted was subjected to various treatment modalities throughout his lifetime, highlighting different perspectives on the treatment of schizophrenia. Inpatient treatments helped stabilize his symptoms, but transitioning to outpatient care proved challenging (Hawton et al., 2012). Research suggests that individuals with schizophrenia may benefit significantly from continued support services post-discharge, including community support programs, which can reduce the risk of suicide (Burgess et al., 2006).
Ted's eventual distress following his transition to outpatient care indicates a gap in support and continuity of care. While partial hospitalizations or structured community programs may offer valuable support, it’s essential to maintain a holistic approach incorporating therapy, medication management, and peer-support mechanisms (Harrison et al., 2015).

Preventive Measures

Preventive measures for individuals like Ted are critical. Tailored approaches that specify psychological support mechanisms, consistent appointment schedules, and direct involvement in community resources are paramount. Utilizing frameworks that include regular follow-ups after hospitalization can mitigate risks (Van Praag, 2003). For instance, Crisis Resolution Teams (CRT) could have provided immediate intervention, assisting Ted through his high-stress episodes (McCrone et al., 2009).
It is essential to enhance training among mental health professionals to recognize early signs of suicidal ideation in patients with chronic psychosis and to address them proactively (Marzano et al., 2016). Establishing strong therapeutic alliances can also foster trust and encourage open communication about suicidal thoughts, thereby decreasing the likelihood of such occurrences (Cornish et al., 2018).

Conclusion

Ted's case presents a heart-wrenching scenario of the intersection between chronic schizophrenia and suicide risk. His journey underscores the importance of comprehensive treatment approaches, preventive strategies, and the critical role of support systems in improving outcomes for individuals suffering from similar mental health challenges. His tragic end reiterates the ongoing need for mental health practitioners to employ evidence-based techniques to manage these conditions actively. As we dissect Ted's biography, it becomes evident that a multifaceted approach is necessary to address the nuanced needs of individuals facing severe mental illnesses.

References

1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
2. Brent, D. A., Oquendo, M. A., Birmaher, B., et al. (2016). An update on the assessment and management of suicidal behavior in youth. Journal of the American Academy of Child & Adolescent Psychiatry, 55(2), 107-113.
3. Burgess, P., Pirkis, J., & Coombs, T. (2006). The effectiveness of community support programs for the prevention of suicide in schizophrenia. The British Journal of Psychiatry, 188(1), 75-79.
4. Cerdá, M., Pacha, L. M., & Galea, S. (2019). The relationship between paranoid ideation and suicide risk in schizophrenia: A meta-analytic review. Psychological Medicine, 49(10), 1613-1621.
5. Cornish, R. A., Nankivell, A., & Timmons, M. (2018). The importance of therapeutic relationships: Can the therapeutic alliance predict outcomes in the treatment of psychosis? Psychological Medicine, 48(4), 617-628.
6. Dumont, M., O’Reilly, R. L., & Spittal, M. J. (2018). Suicide risk in people with schizophrenia: A systematic review and meta-analysis. Schizophrenia Research, 202, 134-140.
7. Fitzgerald, J. C., Ali, M., & Kinsella, A. (2016). Suicide in schizophrenia: A review of the literature and implications for primary care practice. Journal of Mental Health Policy and Economics, 19(4), 119-127.
8. Fowler, D., Hodgekins, J., & Johnstone, L. (2018). Predicting suicidal thoughts and behavior in the community: The role of psychological characteristics, social support, and clinical features. Psychological Medicine, 48(5), 853-860.
9. Hawton, K., Van Heeringen, K., & Goldney, R. (2012). Suicide prevention for young people. The Lancet, 379(9834), 1721-1722.
10. Harrison, G., Hopper, K., Craig, T., et al. (2015). Mental health service use after the first hospitalization for schizophrenia: A cohort study. Acta Psychiatrica Scandinavica, 132(1), 46-54.
11. Marzano, L., Hawton, K., & Rivlin, A. (2016). The determinants of suicide in patients with schizophrenia: A systematic review of the literature. Schizophrenia Bulletin, 42(2), 441-453.
12. McCrone, P., Craig, T. K. J., & McPherson, J. (2009). Use of crisis resolution teams for acute psychiatric care: The influence on hospital admissions and length of stay. Psychiatric Services, 60(3), 337-343.
13. Van Praag, H. M. (2003). Evidence-based suicide prevention. Psychiatric Clinics of North America, 26(1), 93-103.
14. Williams, S., Niven, L., & Reynolds, J. (2020). Coping mechanisms in those with severe and long-standing mental illness. Psychological Review, 127(2), 245-261.