Case Management

Persistence pays off with difficult psychiatric patient

Case Management Monthly, November 1, 2010

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Sarah arrives at a large medical center after a failed suicide attempt in which she ingested multiple drugs, drank alcohol, and left a suicide note. Sarah has a history of mental illness. She has seen a psychiatrist who diagnosed her as bipolar. Sarah had attempted suicide several times before her most recent admission. 

After several days of acute care, Sarah is medically stable for discharge. Sarah’s family is fearful that she will try committing suicide again if she returns home. Her physician agrees. Sarah’s physician and psychiatrist decide to transfer her to a facility that has a dedicated psychiatric unit. 

The case managers work with Sarah, her family, and the psychiatrist to find a facility that fits Sarah’s needs. Sarah tells the case managers that she does not have healthcare insurance. She applied for Medicaid and disability benefits on three separate occasions and was denied each time, despite her history of mental illness. 

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