MH is a 17 year old female who presents to the emergency dep…

MH is a 17 year old female who presents to the emergency department with suicidal ideation. She has a history of MDD, beginning approximately one year ago around the time that she experienced significant bullying in school. She reports “things would be better for my family and everyone at school if I wasn’t around anymore”. She attempted suicide once in the past by overdose and was treated in the ED for this (treatment unknown). She currently takes escitalopram (Lexapro) 20 mg.   What other parts of a lethality assessment should you ask about to determine the appropriate plan of care (select all that apply)?

Your patient in the partial hospitalization program (PHP) ha…

Your patient in the partial hospitalization program (PHP) has come in for his appointment today.  You are running behind and front desk staff notifies the patient that there will be about a 10-minute delay.  The patient begins shouting at the front desk staff that this isn’t fair and kicks over the trash can in the lobby.  Then he picks up an object from the trash and proceeds to throw it toward the administrative staff and is threatening harm to the staff.   The chart indicates no allergies.  What is the most important intervention at this point?

A.R. tells you he doesn’t want to go to the hospital because…

A.R. tells you he doesn’t want to go to the hospital because “they never do anything for me.” He is still speaking loudly and the blood pressure cuff is having a hard time obtaining a measurement because he won’t stop gesticulating. What is your most appropriate action at this time?