Reflections:
R.H is a 46-year-old African American female who reports feelings of suspicion towards her neighbors. This patient said that her anger and distrust has caused several fights. She also reported noncompliance to her medications and intermittent non commanding auditory hallucinations.
Firstly, obtaining the patient’s consent and right to confidentiality of care is essential. Furthermore, educating the patient and her family on medication compliance; involving her family members (mother and sister) with her consent in her care will help remind her to take her medications and adhere to the treatment plan. Non-adherence to psychotropic medications can result in increased illness, reduced treatment effectiveness, re-hospitalization, poor quality of life, relapse of symptoms, increased co-morbid medical conditions, and suicide attempts (Semahegn etal., 2020).
Due to previous medication allergies, the patient was encouraged to undergo gene testing to dictate which medication would be most effective for her. Starting the patient on Haldol ( first-generation antipsychotic) 5mg p.o to target auditory hallucination as the patient is allergic to abilify, and risperidone (second-generation antipsychotic) will enhance management of this patient. Since I cannot follow up with this patient, I will plan to switch to Haloperidol decanoate IM if the patient tolerates Haldol p.o over time to encourage medication compliance.
Educating the patient on the need for cognitive behavioral therapy is vital to help change dysfunctional thoughts, beliefs, and negative behaviors and aid appropriate thinking patterns, behavior, and mood adjustment. Cognitive-behavioral therapy (CBT) assists individuals in removing avoidant and safety-seeking behaviors that hinder self-correction of faulty beliefs, reduce stress-related disorders and enhance mental health (Nakao etal.,2021).
Based on the patient’s low socioeconomic status and History of marijuana use, the patient was educated against associating with individuals and events that cause drug use. This is because drug use increases impaired judgment and hinders the treatment plan. Substance use has been shown to impact the ongoing stagnation of life expectancy in the United States, which is more evident in lower socioeconomic strata than higher socioeconomic strata (Rehm & Probst, 2018).