m Name: Jasmine Cooper MRN: 210735 Gender: Female D.O.B: 02 November 1990 Allergies: NKA Marital Status: Married Admitting Doctor: Amelia Ong Aboriginal and Torres Strait Islander: No SITUATION: Jasmine (las), 32 years old, was brought into Emergency Department (ED) by ambulance. She called the ambulance after an intentional overdose of her prescribed medications and cutting her left wrist. She smelt heavily of alcohol when she arrived in ED. Jas was drowsy with an unsteady gait but was hemodynamically stable. The ED Psychiatrist reviewed Jas and admitted her involuntarily under the Mental Health Act. She is awaiting medical clearance before transfer to the acute mental health unit. ADMISSION ASSESSMENT: On assessment, Jas was initially guarded and did not want to engage. She said she was tired but cooperated and responded to the clinician's questions. She appears dishevelled, with a strong smell of alcohol and multiple superficial wounds and scars on both lower arms. She reported feeling "hopeless" and "helpless", labile during the conversation, and slurred and pressured speech. She denied any intentions to kill herself but reported taking the tablets to help her sleep. She said she had been stressed lately due to multiple stressors, including losing her job two weeks ago and her wife leaving her with their son. Jas expressed that she did not want to stay in the hospital but could not guarantee her safety at home. Collateral information from Lisa (wife):- Three weeks ago, Jas was fired from her work as a kitchen aid due to misconduct.Lisa reported that she found it out from Jas's manager as she would not tell her what happened. - Before this, Jas was overspending and bought new home appliances. She maxed her credit limit and spent most of her savings. Lisa suspected Jas had stopped taking her medications, but Jas denied it. - After being fired from work, Jas will stay all day in the lounge and drink at least 5L of cask wine. She was up all night and would ruminate about how she was fired unfairly and stated that her previous manager was jealous of her, as everyone liked her as she was the "cool" employee. She also believes she is better than the restaurant chef and stated she has a "god tongue" that all other restaurants were begging her to be their head chef. - Jas's thoughts are derailed even when she is sober. She will respond oddly to a question or jump from one topic to another. - There will be occasions when Jas verbally abuses her. Lisa tried to understand her situation, but she had enough and left the house with Jacob (stepson) 4 days ago. -Lisa said that this is how she presents when her mental state deteriorates, and Jas will benefit from a short hospital admission to restart her medications and stabilise her mental state. At baseline, Jas is funny and friendly. - Lisa reported that Jas would like to walk under the sun and listen to music when distressed. She will also benefit from fidget toys when she is anxious. Jas loves Jacob, and he keeps her grounded. - Lisa requested to be updated on Jas's progress. English (Australial Text Predictions On Accessibility Good to go BACKGROUND: Mental Health -Jas was diagnosed with schizoaffective disorder (SAD) when she was 20. Then she has had multiple mental health admission since then. Most of her admissions are due to aggression and self-harm. - She used to be case managed by the local community mental health under a community treatment order (CTO). Her care was transferred to her general practitioner (GP), including monthly depot administration. However, Lisa has not received her depot for more than three months. Medical - Nil medical or surgical history. - Height: 172 cm Weight: 71kg Abdo Circumference: 28 inches. Social:- Jas identifies as a lesbian and is married to Lisa. They lived in a 2-bedroom apartment with Jacob (4 years old) until Lisa and Jacob moved out four days ago. - Highly functional, previously worked as a sales assistant, factory worker, deli assistant, and recently as a kitchen aid. PROGRESS: After medical clearance, she was transferred to the in-patient mental health unit with a security escort. Jas protested to remain in the hospital and threatened to harm herself, becoming agitated. She said she was physically and sexually assaulted by a male patient when she was last admitted. She does not trust any male staff and demands to be discharged. She does not want Lisa to be involved in her care and excludes her as a contact person during admission. She declined to complete all other admission papers. Jas became verbally abusive towards the staff and assaulted two different consumers. She refuses oral medications. Hence, the multidisciplinary team decided to administer the medication via injection (intramuscular). After two weeks, jas sporadically agrees to take her oral medication. While there are some improvements in her mental state, she still presents with aggression and grandiosity. The treating team requested to extend Jas's inpatient order to prescribe her a depot and discharge her on a CTO. Address the following questions in your Report. (7) • Evaluate and explain three (3) techniques you would use to develop trust and rapport and begin a therapeutic relationship with the consumer when first a st admitted to ed to the hospital. TEOCHE B C [S