Some Psych Providers are incompetent

[Oldmahubbard]

The 60 y/o male patient was referred with very little history to Assisted Living. By the time I saw him, he had been there for 2 weeks and was described by staff as adjusting well. Asymptomatic.

He was prescribed Risperdal 2 mg po at hs. Which told me nothing at all.

By sheer chance, I overheard his interview with the case manager. He was appropriate, calm and relatively well put together, for a half hour.

However the minute he met me, he immediately began to endorse mental health symptoms, which were not consistent with his objective presentation.

No family to call for information.

We dealt with him, and sent him repeatedly to the ER. Based on his complaints that he heard voices to kill himself. 10 times in 2 months. We had no choice.

I suspected malingering, although I could not figure out the motive. I referred to a psychologist. The dx was malingering.

Finally he left. After which I learned that he had a court order for Clozaril to "keep in him out of the hospital".

Wow.