Background information
- 32-year-old female complaints of difficulties handling uncertainty
- Inability to relax due to restless feelings
- Persistent anxiety and worrying (Rutter & Brown, 2017)
- Difficulty concentrating and overthinking plans
- Fear of making certain decisions and indecisiveness
History of present illness
- She was diagnosed with post-traumatic stress disorder (PTSD) two years ago and treated with Cognitive Behavioral Therapy (CBT) (Jordan et al., 2017)
- Diagnosed with Stage IV Small Cell Carcinoma six months ago
- Started experiencing moderate symptoms two weeks ago that progressed with time
- She has been suffering throbbing headaches at night that extends several hours
- Hands are clammy and cold to touch and are profusely sweating
Social and family medical history
- Her mother was diagnosed with general anxiety disorder in 2017
- Her older sister committed suicide in 2019 after a divorce with her husband
- She likes spending most of her free time indoors playing video games
- She is not a member of any social or religious group (Rutter & Brown, 2017)
- She rarely shares her feelings and issues affecting her with anyone
Past medical history and medications
- She developed chronic physical health problems
- Confirmed previous mental health disorder
- She denied previous use of substances and alcohol (Jordan et al., 2017)
- She also denied misuse of any comorbid substance
- Previously received medications for PTSD.
Treatment plan
- Antidepressants such as the selective serotonin reuptake inhibitor (SSRI), norepinephrine reuptake inhibitor (SNRI) classes, and serotonin.
- Buspirone is effective in eliminating anxiety (Rutter & Brown, 2017)
- Benzodiazepines help relieve anxiety
- Psychotherapy including psychological counseling or talk therapy
- Cognitive-behavioral therapy
State and Federal Regulations
- I live in Miami Florida
- Licensed practitioners are authorized to offer treatment and prescribe drugs
- Behavioral health drugs can only be prescribed by certified psych-mental health nurse practitioners
- Offenders risks facing legal chargers or losing their licenses
- Affordable Care Act (ACA) improves behavioral health care by enhancing accessibility of health services
Impact of State and Federal Regulations
- State laws improve patient’s safety
- Ensure competency of nurses responsible for drug administrators
- ACA enhances the accessibility of quality care.
- Reduce the cost of treatment
- Offer guidance
Community resources in Miami
- Banyan Health System
- Florida Department of Children and Families Adult Mental Health
- Douglas Gardens Community Mental Health Center
- Care Resource Community Health Centers
- New Horizons Community Mental Health Center
How to determine the need for more support
- Poor response to intervention
- Extreme expectations
- Development of new symptoms
- Persistent pain
- Poor cooperation
Facilities for urgent intervention and assessment
- Jackson Behavioral Health Hospital
- Miami Dade Community Services
- New Horizons Community Mental Health Center
- Rogers Behavioral Health
- Opa-Locka Mental Health Center
Resources for poor patients
- Miami Dade Community Services
- Motivational Institute for Behavioral Health, LLC
- Restoring Minds Counseling Services Miami Fl.
- Dade Family Counseling CMHC
- Miami Counseling & Resource Center
Resources for short-term primary mental health provider
- The health of Mind, Inc
- Live Well Therapy Group (Jordan et al., 2017)
- Face To Face Mental Health Services, LLC
- Beach House
- Clean Recovery Centers
Ethical Considerations
- Informed consent
- Data privacy and confidentiality
- Professional boundaries
- Access to care
- Malpractice
Potential legal issues
- Data breaches when patient’s data is exposed to a third party
- False claims in case of generation of incorrect record (Abdolpour et al., 2019)
- Anti-kickback to avoid an unauthorized exchange of remuneration
- Impact of Stark Law to hinder unnecessary testing and fraudulent
- Lawsuits can occur in case of negligence or poor quality work
Mitigating potential risks and necessary follow-up
- Communicate clearly
- Review and update policies
- Engage the patient and family members (Rutter & Brown, 2017)
- Follow-up needed to determine response to medication
- The follow-up to evaluate the presence of new issues
References
Abdolpour, G., Nasiri, M., Mafakheri, M., Mansouri, K., & Abdi, R. (2019). Structural equation modeling of intolerance of uncertainty and symptoms of depression and general anxiety disorder: Investigation of the mediating role of rumination. Iranian Journal of Psychiatry and Clinical Psychology, 24(4), 400-415. Web.
Jordan, P., Shedden-Mora, M. C., & Löwe, B. (2017). Psychometric analysis of the Generalized Anxiety Disorder scale (GAD-7) in primary care using modern item response theory. PloS one, 12(8), e0182162. Web.
Rutter, L. A., & Brown, T. A. (2017). Psychometric properties of the generalized anxiety disorder scale-7 (GAD-7) in outpatients with anxiety and mood disorders. Journal of Psychopathology and Behavioral Assessment, 39(1), 140-146. Web.