08-16-2014, 04:22 PM
A 20-year-old college student with no known psychiatric or medical history is admitted to the orthopedic surgical service after sustaining a right patellar fracture after falling off a low bridge. After drinking at a friend's apartment the evening prior to admission, he decided to go for a walk to clear his head at around 3 in the morning. Over the past month, he has had numerous family members and friends die unexpectedly, and he reports that he was pondering how he would handle things if one of his parents died unexpectedly. He states that he was crossing over a bridge when a car startled him and he fell off the bridge, hitting his knee. When asked if his fall was a suicide attempt, he replies, "No. doc. I understand that it sounds like a weird story, but I wasn't trying to kill myself, I would never do anything like that." After evaluating him, the on-call psychiatrist asks the patient for permission to call his parents for more information. The patient says "Oh, please don't call them. They'll just worry about me and I don't want them to stress about something silly like this."
What is the best course of action?
A.Call the parents to ask if they have any concerns about the possibility of a suicide attempt
B.Discharge the patient home with outpatient psychiatric follow up
C.File an emergent detention to a psychiatric facility
D.Have the patient sign a suicide contract prior to discharge
E.Respect the patient's wishes and do not contact his family
What is the best course of action?
A.Call the parents to ask if they have any concerns about the possibility of a suicide attempt
B.Discharge the patient home with outpatient psychiatric follow up
C.File an emergent detention to a psychiatric facility
D.Have the patient sign a suicide contract prior to discharge
E.Respect the patient's wishes and do not contact his family