Week 1 Discussion NRNP 6665.

Week 1 Main Discussion Post NRNP 6665 Holly Bowling Even though depression is uncommon among children, the prevalence of depression rises sharply during adolescence. A network analysis that was conducted to show suicide ideation as a symptom of adolescent depression, concluded that suicidal thoughts and behaviors, and depressive symptoms can have major negative consequences in the short and long term, as both are related to increased other forms of psychopathology, such as anxiety, substance abuse, or addiction, are a cause of extra distress, and have several behavioral and emotional consequences (Gijzen, Rasing, Creemers, Smit, Engels, & De Beurs, 2021). What Did the Practitioner Do well and How Can the practitioner Improve? In the YMH Boston, Vignette 5 Video, the clinician did a good job of learning about Tony’s achievements in school, even though he stated his grades had been declining, as well as his peer relationships, which ended up being the basis of why he is having the feelings he is having (YMH Boston, 2013). Tony mentioned how his grades have been lacking lately, and one journal article discusses how adolescents with suicidal thoughts and behavior and elevated depressive symptoms show lower academic performance (Gijzen et al., 2021). Also, his girlfriend broke up with him about two months prior, which is when his symptoms of depression first started (YMH Boston, 2013). I do not feel like the clinician did a very good job of building a rapport with Tony, which is the first task of the interviewer (Sadock, Sadock, & Ruiz, 2015). She did not introduce herself or discuss the extent of confidentiality with him, which as an adolescent, is mandated before sharing information with the parents (Sadock et al., 2015). She did ask Tony if he knew why he was there, and when Tony said yes, his doctor referred him, she This study source was downloaded by from CourseH on :48:12 GMT -05:00 NRNP 6665 WEEK 1 HEALTH CARE did not opt to summarize the concerns the doctor was having for him, she just went into the next question. For the evaluation to be successful, the client must understand why the referral was initiated (Thapar, Jacob, Sharma, & Guatam, 2019). Although she did ask him important questions related to symptoms of depression, she did not clarify what any of the questions meant or why she was asking them. And without asking any reasoning for any of his answers, she would move quickly onto the next question. Toward the end, the interviewer did capitalize on Tony’s comment of not wanting to be alive, which opened up a window to discuss his thoughts about suicide (YMH Boston, 2013). Compelling Concerns I believe the main concern at this point in the interview is learning more about Tony’s thoughts of dying and if this is something he is actively planning. Rates of suicide and suiciderelated behaviors increase with age and with gender, with suicide rates higher among the male gender, and 14.5% of high school-age adolescents reporting suicidal ideation in 2007 (Cash & Bridge, 2009). Therefore, the pertinence of the clinician retrieving information about Tony’s thoughts is vital at this point in the interview. Next Question and Why Do you have any plans to end your life? Do you think about harming anyone else or ending someone else life? Suicide is the third leading cause of death among adolescents (Sadock et al., 2015), therefore, Tony should be evaluated as to whether or not hospitalization is necessary or if outpatient follow up will be sufficient (Sadock et al., 2015). Also, if he has intentions to harm someone else, then he would need to be detained and that other person of interest would need to be notified. This study source was downloaded by from CourseH on :48:12 GMT -05:00 Importance of a Thorough Psychiatric Assessment of Child/Adolescents The main goal of a child/adolescent psychiatric assessment is to build a case formulation that helps guide management decisions. Obtaining key signs and symptoms through history and physical can help the clinician focus on areas of concern related to mental health disorders (Srinath, Jacob, Sharma, & Gautam, 2019). The case formulation can help adopt a better view of the client's problems, which will make it easier in developing a treatment plan and assigning roles to other areas of the discipline team. The assessment also allows the family and client to have a better understanding of the disorder the client is presenting with and allows them to reflect on any information they share with the clinician (Thapar et al., 2019; Srinath et al., 2019). Two Appropriate Symptom Rating Scales For Psychiatric Assessment of Child/Adolescent  Reynolds Adolescent Depression Scale- RADS is a 30-item self-report instrument scale that assesses depression symptom severity in adolescents (Stockings, Degenhardt, Lee, Mihalopoulos, Liu, Hobbs, & Patton, 2015). Responses are made on a four-point scale indicating the frequency of symptoms characteristics of depression. The scale assesses cognitive, somatic, psychomotor, and interpersonal symptoms derived from the DSM-III, with an assessment period of the past two weeks. The RADS takes approximately 10 min to complete, with scores ranging from 30 to 120 (Stocking et al., 2015).