Introduction
Bipolar type 1 disorder is a mental disease that has a long life course and leads to high mortality and morbidity rates. It is also known as a manic depressive disease that affects people in society. The paper prepares an assignment on bipolar type 1 disorder focusing on the patient’s chief complaint, history of illness, medications, treatment plan, and the state and federal regulations for bipolar 1 disorder.
Chief Complainant
I had to go to a long-term psychiatric facility for diagnosis and treatment. I was admitted to the psychiatric healthcare center and am not prepared to return there.
History of Present Illness (HPI)
JD is a 21-year-old black American boy who came to the clinic accompanied by his uncle with a history of bipolar 1 disorder. He reported that he had been in foster care for the past years; however, he began living with his uncle three months ago. The uncle reported that he is worried about his behaviors. He reported wanting to have the freedom to stay in his friend’s house, although his uncle disapproved of his desire.
Furthermore, he reported having been involved in unsafe conduct, including having sex with multiple partners and strangers and smoking marijuana. He noted that, at times, he has the feeling of wanting to injure himself by cutting his wrist. He has a history of involvement in self-injury behaviors in which he used to cut his writs using a razor blade. He has been experiencing sleeping difficulties and fair hunger and denies hearing things, voices, or suicidal ideation/homicide.
Further, he has reported having been admitted many times to different local children’s healthcare facilities because of suicidal attempts and depression. He has earlier been prescribed Vistaril and Topamax, even though he is not compliant. His uncle reported that he wanted him to be examined and have some sessions with the therapist.
Social History
JD was born in Belto County, Texas, and was raised by his parents. He is the only child and currently lives with his uncle. He is not married and is a college student. His hobbies include playing basketball, swimming, and dancing. He has no legal problems or history of trauma or violence.
Family Medical History
His father experienced anxiety disorder, and his paternal grandfather had a delusional disorder. Nonetheless, he reported that there is no family history of alcohol abuse, substance use, illness, or suicide.
Past Medical History
He does not recall the age at which he was admitted for treatment. His uncle is the caregiver and has had a history of many hospitalizations in various children’s hospitals. However, he cannot remember when he was hospitalized. He has a history of suicidal attempts and self-injury, even though he has no homicide history. He has a history of utilizing Vistaril and Topamax, which he reported were practical. Further, he has had a history of alcohol consumption and smokes marijuana, although he has denied using other illegal substances and has never encountered withdrawal symptoms.
Medications
He is currently on oral Vistaril 25 mg QHS and Topamax 25 mg each once daily. He has an allergic reaction to penicillin medicines, although he has no food or known environmental allergies. He has no STIs, even though he reports that he is sexually active with strangers and multiple partners.
Treatment Plan
Patient Education
He will be educated on his situation, the significance of being compliant with prescribed medicines, and the importance of being physically active. He will be educated on the need to abstain from alcohol consumption and smoking marijuana, avoid stressors, and eat a healthier diet (Woolf et al., 2019). He will be supported to ensure that he joins local support groups and attends all the prescribed therapy sessions (Fang, 2019). In addition, I would educate his uncle concerning his condition and how he may help and support him.
Treatment
Bipolar management is enduring and entails a blend of psychopharmacotherapy and psychotherapy agents, especially mood stabilizers and antipsychotics. JD will need to continue with his current medication regimen of Vistaril and Topamax and will be enrolled in psychotherapy.
State and Federal Regulations
The state in which I live, Texas, has laws that prescribe behavioral health drugs. In Texas, the legend drug authority is comprised of licensure, although to prescribe controlled substances, the NP should apply for Controlled Substance Registration. All NPs in the state have to operate under a doctor’s supervision.
In terms of the Affordable Care Act, one JD cannot be charged more or denied insurance coverage because he lives with a mental disorder. The ACA cannot cancel coverage if one gets sick or utilizes more services. Therefore, since JD is in Texas, he should have the medications prescribed by a physician or an NP who works under a physician for compliance with the state law on prescribing behavioral drugs (Beckmann, 2018). In the case of ACA, he will have to use insurance coverage for his medications for mental health disorders.
Available Community Resources
In the JD community, there are various community resources that one may refer patients needing help before establishing care with a primary mental health provider. These include family-to-family education programs, peer-to-peer education, supportive programs, and on-campus student clubs. Belton, Texas, has several facilities, such as Metroplex Pavilion, Darnall Community Hospital Emergency Behavioral Health Department, and Cedar Crest Behavioral Unit. The areas offer mental health services to patients needing urgent assessment and intervention.
The resources in the Belto area available to patients who may not be able to afford behavioral health care are the Community Counseling Center, Belton Counseling, Community Life Center at UMHB, and Burker Center (Mental Health Centers, 2023). However, in the area, the patient could access the ZIP Code, online mental health services search form, and the service area map that helps find the LMHA closest to a patient.
Legal and Ethical Considerations
The legal issue is many licensures require mental disorder people to provide a history. Further, it is necessary in Texas that an NP to provide a prescription for the drugs should be working under a registered substance control. The ethical issue in treating psychological disorders is a social stigma in which the disorder is linked to demonic passion, weakness, or sin; thus, treatment is needed to avoid this subjection to JD. Social stigma may discourage JD from seeking medication for his mental disorder.
The follow-up includes a list of medicines to take and visits to a mental health provider a week after discharge. As a primary care provider, in mitigating potential behavioral risks, there is a need to communicate well with the patient and offer patient-centered care (Beckmann, 2018). In addition, NPs should work under medical supervision and maintain a good relationship with patients.
Conclusion
Bipolar 1 disorder is a typical psychiatric disorder featuring cognitive deficits and affective instability, specifically, high mood episodes. The changes may make it challenging to perform daily activities, as in the case of JD in the study. The treatment plan for this disorder comprises patient education and the use of antipsychotics or mood stabilizers. In Texas, an NP has to work under a physician when prescribing behavioral health drugs, as in the case of the primary healthcare provider for JD.
References
Beckmann, A. (2018). CNAP steps into history. Web.
Fang, Y. (2019). Depressive disorders: Mechanisms, measurement and management. Springer Nature.
Mental Health Centers. (2023). Mental health facilities in Belton, TX. Web.
Woolf, C., Mowszowski, L., & Naismith, S. (2019). Psychological interventions for cognitive dysfunction in major depressive disorder. Cognitive Dimensions of Major Depressive Disorder,3(4) 241-256. Web.