Reference no: EM133675965

The person in this case study will be discharged in the community. The individual has complex care needs, and you are invited to a case conference to discuss and plan their care to ensure sustainable and safe discharge. Client Details: Name: Alicia Babic URN: 322273 Allergies: Penicillin DOB: 11 February 1961 Gender: Female Marital Status: De Facto Alicia, a 65-year-old lady of Croatian descent is to be discharged after a protracted (>2 years) mental health admission for symptom management and accommodation scoping. Her primary diagnosis is schizoaffective disorder, with personality B vulnerabilities. Background - Alicia had her first mental health presentation when she was 19 and presented with psychotic symptoms. Since then, she had multiple mental health presentations. Her mental health management is complicated by poor insight and medication nonadherence. - She was case-managed on a community treatment order prior to admission. - Alicia's medical history includes congestive heart failure (CHF), type 2 diabetes, and hyperthyroidism. - Alicia is a chronic cigarette smoker and a social drinker. She never used illicit substances. - She has 2 sons from her previous marriage. They live in a different State and have limited contact with her. Her de facto partner lives in a retirement village. - She has an appointed Public Guardian and Trustee who makes decisions and manages her finances. - Alicia is a NDIS participant and is funded for 6 hours of 1:1 daily support. Progress During Admission: Alicia's current admission began in June 2021 when she was transferred to the mental health unit from the medical ward due to a relapse in schizoaffective disorder. This relapse occurred in the context of an eight-week hospitalisation due to difficulty breathing secondary to CHF triggered by medication nonadherence. Due to a combination of poor physical and mental health Alicia has spent more than 2 years in hospital. She is currently in a long-term mental health unit where she is at her baseline mental state and is prescribed a stable psychotropic regimen consisting of paliperidone depot, sodium valproate and melatonin. During this hospital admission, Alicia presented with cognitive symptoms. The treating psychiatrist had a clinical impression of a neurocognitive disorder (dementia). However, this was not quantified as Alicia did not engage in any of the assessments. Alicia is at her baseline mental state, which contains a mixture of symptoms, including intermittent thought disorder and disorganised behaviour, severe mood lability, intermittent persecutory ideation, poor distress tolerance, and poor insight and judgment. Alicia will occasionally refuse to take her medications, leading to negative re-enforcement (including gate leave cancellation). The staff reports that she will present with challenging behaviours if she does not get what she requested. The treating team is under the impression that Alicia is safe to be discharged. They have found a 24/7 supported accommodation for her. They are requesting for the appropriate discharge planning and community follow-up.

Evaluation of Different Mental Health Models of Care:

1. Evaluate three mental health models of care (e.g., Assertive Mental Health, Early Psychosis, Case Management, Crisis Intervention, etc).

2. Considering the case study details, justify the selection of the most suitable model to meet the consumer's specific needs.