Mental Health Crisis
Marcie is a new client, a 22-year-old female who works as a receptionist in a doctor’s office. She has just revealed to you during the intake session that she has recently lost interest in most activities, has been sleeping a great deal yet feels tired all the time, and sometimes wishes she could cease to exist. She mentioned feeling as though she were “on an emotional roller coaster” during the past year, throughout her on-again, off-again relationship with a 35-year-old married man. The last breakup with him seemed really final, and Marcie has felt herself sinking deeper and deeper ever since.
When probed further about suicidal ideations, Marcie admitted that she has considered killing herself although she is uncertain whether or not she would actually do it. She said that she is currently in possession of a gun her friend allowed her to keep in her home following a rash of burglaries in the neighborhood, but she doesn’t know whether she would actually use it.
You have consulted with your supervisor, who has agreed that Marcie should be referred immediately for a psychiatric evaluation and has instructed you to arrange for Marcie to go directly from your office to a nearby hospital. Marcie told you that her mother accompanied her to this appointment and is in the waiting room, but she has emphatically stated that she does not want her mother to know what is going on with her. How should this delicate situation be handled? Describe how the principles you have learned thus far apply here. Be specific in your answer and thoroughly explain why.
Sample Solution
Mental Health Crisis
The counselor has treated the situation properly up to this point, she understood the pain that Marcie was experiencing, and the concern for harming herself. She underwent a patient assessment and received recommendations from her boss, who also felt that a psychological examination could help Marcie. The counselor needs to be empathetic in such a situation and consider the state of Marcie. If, in front of her mother, she is not comfortable talking, then that should be allowed.
Moreover, the confidentiality of clients is very critical and also an ethical issue. But because this is a sensitive situation, her family wants to know about her condition since she needs her family help in this situation. In special situations, licensed counselors will violate this ethical code. The most common is when a client is a danger to himself or others, where a therapist must alert the person at risk or notify anyone who can keep the client safe.
Therefore, since hospitalization is necessary, the counselor needs to share information about the treatment as well as limited to diagnosis only and any prescriptions needed. As it also includes firearms, there are also legal issues and the family needs to be told about it. If it helps to discuss the whole situation with Marcie, then it will be easier to deal with the case, but if not, the mother would have to be told to protect her without her permission.
Read more: Addressing A Mental Health Crisis
