01 Feb You are a PMHNP-BC in an outpatient clinic

You are a PMHNP-BC in an outpatient clinic. You have an appointment with Michael, a 52-year-old man, whom you have been treating for major depressive disorder for the past 6 months. He has been stable and is currently taking bupropion XL 300 mg daily and sertraline 100 mg daily.

He has a history of major depressive disorder (diagnosed in his late teens), hypertension, and suicidal ideation. His most recent hospitalization was approximately 18 months ago for suicidal ideation. He was kept for 72 hours and then released to a partial-day outpatient program before returning to your care.

He is single, and both of his parents are deceased. He was an only child and had few friends. He has difficulty holding employment, but since his depressive episode 18 months ago, he has been working steadily at a gas station near his home. He does not drive because he cannot afford a car.

You receive a phone call from Michael approximately 20 minutes before your scheduled appointment. He tells you that he cannot get out of bed and will be missing his appointment with you. You quickly ask him if he is able to have a virtual appointment instead, and he agrees.

Upon initiation of your appointment, you see that Michael is unkempt and appears sad and withdrawn. He reports that he is tired of living like this and feels very alone. He states, “I have no friends, no family, and things are not going to get better.” You see a half-empty bottle of alcohol on the bedside table. Michael has no prior history of alcohol abuse. He reports that he has plans to kill himself by shooting himself in the head. His prior suicide attempts have been via overdose.

Based on the scenario, prepare a PowerPoint® presentation with the following slides:

· Introduction

· Risk factors for suicide

· What questions do you need to ask Michael?

· What assessment tool can you use on Michael? Why did you choose this tool?

· What are the laws for involuntary commitment in the state you intend to practice in or live in?

· What are this patient’s rights?

· Can Michael be forced to take medications if he does not want to? Is there a legal process in your state?

· What is one strategy for treating treatment-resistant depression? (This can include an alternative therapy.) Use one journal article to support the use of this treatment.

· Conclusion