Scenаriо (5/6) L.A. wаs fоund in his dоrm unresponsive with а bottle of Vicodin on the floor. He was taken to an emergency room, stabilized and admitted to the medical floor for 24-hour observation. When questioned, he denied suicidal thoughts and continually requested discharge stating: “Everything is fine. I need to go to school in the morning. I have a test.” Concerned for his safety, the RN requests a consultation with the Psychiatric Emergency Response Team (PERT) clinician. The PERT RN assesses L.A. and determines that he is in imminent danger of harming himself. Collateral data shows a recent break-up with his girlfriend and failing grades in school. His appetite is poor and he finds it difficult to fall asleep and stay asleep. His relationship with his parents is “strained” at best, as they require “perfect behavior and excellent grades.” The PERT RN places him on a 5150 with a plan to transfer to an inpatient behavioral health facility in the morning. L.A.’s 5150 expires in 2 hours. L.A.’s nurse and physician discuss his status and progress on the unit. The nurse notes that his affect remains blunted and his mood depressed. He has lost three pounds in the last two days and states he has no appetite. He admits to wanting “to just sleep forever so the pain will go away” and continues to have difficulty falling and staying asleep. He has refused medication stating: “that stuff is only for people who are sick.” L.A. wants to go back to school and try to reconcile with his girlfriend, as that would “make him feel better.” He has not participated in any of the group therapy sessions and does not disclose information with the nursing staff. The team determines that the patient:
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