Is the patient motivated to receive mental health care, with an appointment scheduled for tomorrow, following a recent episode of panic accompanied by hallucinations?

From the Guidelines

The patient is motivated to engage in mental health care and has an appointment scheduled for tomorrow, which is a crucial step in addressing the recent episode of panic with hallucinations. The patient's presentation suggests a possible anxiety disorder with psychotic features, which requires prompt professional evaluation 1. The combination of panic symptoms and hallucinations warrants comprehensive assessment to determine appropriate treatment, which may include anti-anxiety medications (such as SSRIs like sertraline or escitalopram) and potentially antipsychotics if hallucinations persist. Documentation should include the nature of hallucinations (visual, auditory, tactile), duration of symptoms, any precipitating factors, and whether this is a first-time occurrence or recurrent episode. It's essential to assess for safety concerns, including suicidal or homicidal ideation, as suggested by the American Psychiatric Association practice guidelines for the psychiatric evaluation of adults 1. The patient's motivation for treatment is a positive prognostic indicator, suggesting potential for good treatment adherence. Regular follow-up appointments should be scheduled to monitor symptom progression and medication effectiveness if prescribed. Additionally, the assessment and management of patients at risk for suicide, as outlined in the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guidelines, should be considered, including collaborative identification of social support and review of crisis resources 1. The patient's scheduled appointment tomorrow is a critical step in addressing their mental health concerns, and it is essential to prioritize their safety and well-being in the meantime. Key aspects to focus on during the appointment include:

• Comprehensive assessment of the patient's symptoms and mental status
• Evaluation of safety concerns, including suicidal or homicidal ideation
• Development of a treatment plan, which may include medication and therapy
• Collaboration with the patient to identify social support and crisis resources
• Regular follow-up appointments to monitor symptom progression and treatment effectiveness.

From the Research

Assessment Note

The patient is motivated to receive mental health care and has an appointment scheduled for tomorrow. Recently, the patient experienced an episode of panic accompanied by hallucinations, as described by the patient.

Key Points

• The patient's motivation to attend the appointment is a positive indicator, as studies have shown that prompts to encourage attendance can be effective in increasing clinic attendance 2.
• The patient's recent episode of panic with hallucinations is a significant concern, as hallucinations have been linked to an increased risk of suicidal ideation, particularly when combined with depression 3, 4.
• Scheduling an outpatient mental health appointment as part of discharge planning has been shown to increase the likelihood of attending outpatient care following discharge 5.
• Framing health messages in a positive way, such as highlighting the benefits of attending an appointment, can also increase engagement rates in specialty mental health care 6.

Patient Status

• The patient is currently motivated to attend the scheduled appointment tomorrow.
• The patient's recent episode of panic with hallucinations requires close monitoring and follow-up care.
• The patient's attendance at the scheduled appointment is crucial in addressing their mental health concerns and reducing the risk of suicidal ideation.