Jack is a 25-year-old man. He has been referred to an outpatient mental health clinic after a
recent release from the hospital.
Jack graduated from high school at the age of 18-years and got a job working in a video store as
he decided if he would go to college or not. After working for about 6-months Jack began to hear
voices that told him he was no good and that he would fail at anything he did. He also began to
believe that his boss was planting small video cameras in the returned tapes to catch him making
mistakes. Jack became increasingly agitated at work, particularly during busy times, and began
“talking strangely” to customers. For example, one customer asked for a tape to be reserved and
Jack indicated that that tape may not be available because it had “surveillance photos of him that
were being reviewed by the CIA”.
After about a year of working in the store, Jack quit his job one night, yelling at his boss that he
couldn’t take the constant abuse of being watched by all the TV screens in the store and even in
his own home.
Jack lived with his parents at that time. He became increasingly confused and agitated. His
parent took him to the hospital where he was admitted and kept for 6-weeks. He was discharged
back to his parents home with medication and a referral to an outpatient psychiatrist and
therapist. He saw the psychiatrist but failed to maintain therapy appointments. His parents were
minimally supportive and felt that he would get better with less stress. Jack never returned to
work and stayed home watching TV and smoking; rarely leaving the house. From time-to-time
Jack stopped taking his medication, and the voices and concerns over being watched became
stronger, he would become more agitated, and his parents would take him back to the hospital.
After his 3rd hospitalization (at the age of 22-years), Jack was referred for SSI and, with the
assistance of a case manager, eventually moved into a treatment apartment program and joined a
psychosocial “clubhouse” for people with mental illness. Until his most recent hospitalization, he
would attend the clubhouse 3 times a week, answer the phone, and help write the clubhouse
newsletter. He had made a few on-the-job but was unhappy that he never had a girlfriend. He
attended group counseling through his program and saw a psychiatrist every month. His case
manager at the time reported he was medication compliant. He would visit his parents 2-3 times
per week, though they continued to be less than supportive of his mental health issues.
Six-months ago, Jack was noted to be frequently bruised and, when asked about it, become easily
agitated. He was also seen talking to himself and make statement that suggested a concern that
his case manager and supervisor at the Clubhouse were spying on him. He refused to visit his
parents and stopped all clubhouse activities. It became apparent that Jack was medication non-
compliant, and his symptoms escalated to the point of needing another hospitalization.
While in the hospital, it was learned that, for the past 5-months, another apartment program
resident had been bullying Jack and taking his money and personal items. Apparently this
included physical attacks. This resident was removed from the program prior to Jacks hospital
release
- You will be given a selection of case studies of individuals with mental health and life issues
- You will be asked to submit a written:
- Diagnostic Statement
- Diagnostic justification