Test Group D.pdf - Therapist Name: on call psychiatrist...

SOUTH HADLEY PSYCHIATRIC HOSPITAL
153 Newton Street
South Hadley, MA
413-538-5063
Therapist Name: on call psychiatrist
Date Referred: 3/25/2|
TREATMENT PLAN
Patient Information
NAME Baker Gregory H
(last) (first) (Ml)
DOB 10/03/2001 GENDER M SNN 572-18-4584
(MM/DD/YYY) (M/F) (HEHE EHH)
ADDRESS 17 Main Street Apt. B
(street) (apt)
Chicopee MA 01013
(city) (state) (zip)
PHONE n/a EMAIL [email protected]
(XXX-XXX-XXXX)
Chief Complaint:
Mr. Baker was brought in by campus police from his university. He was picked up after refusing to leave the lecture hall of
a class in which he is not enrolled, where he was shouting and singing loudly and would not stop.
Patient Background
Current Medications
none
Drug Allergies Hospitalizations or Surgeries
Reason: tonsillitis
none
Date: 10/5/2009
Reason:
Date:
Reason:
Date:
Women Only
Pregnant? YES NO Planning Pregnancy? YES NO

Height: 6’0”
Weight: 170 lbs.
Ethnicity: white
FAMILY HISTORY and INFORMATION
Mother: Spoke to on call psychiatrist, comments noted below. White, age 50.
Father: Deceased two years ago. Cause of death: old age.
Siblings: Sister Emma, 18 years old, spoke to on call psychiatrist, comments noted below.
Children: None
MEDICAL HISTORY
O Headache 0 Pneumonia O Anemia O Rheumatic Fever
0) Shortness of Breath O Ulcers O Arthritis O Glaucoma
OQ Heart Murmur 0 Gl Disorder O Osteoporosis O Epilepsy
OQ Chest Pain QO Lactose Intolerance 0 Hypertension () Other (please specify)
Ol Dizziness/Fainting O Gallbladder Disease 0 Depression
0 Allergies O Bowel Irregularity O Gout
O Asthma QO Diabetes 0 Stroke
QO Bronchitis 0 Hepatitis O Cancer
HABITS
& Smoke ___1___ packs daily 0 Alcohol: Type/Amount
How long? bY Sleep
When stopped? be Difficulty falling asleep
O Coffee cups daily Continuity disturbances
1 Other Caffeine 0 Snoring
0 Exercise Routine O Early morning awakening
Patient Description and Commentary:
Mr. Baker’s sister said that he has quit seeing his friends and spends most of his time lying in bed staring at the ceiling.
She also explained that she repeatedly saw him mumbling quietly to himself and noted that he would sometimes, at
night, stand on the roof of their apartment building and wave his arms as if he were conducting an orchestra. Mr. Baker
explains his actions by saying that he feels liberated and in tune with the music when he is on the roof and that the roof
is the only place he is safe from the people who are always trying to kill him.
During the past several months, Mr. Baker has become increasingly preoccupied with a female, Anne, who lives down the
street from his family home. While he insists that they are engaged, Anne told Mr. Baker’s sister and mother that she has
only spoken to Mr. Baker a couple of times in passing.
Ultimately, Mr. Baker agreed to sign himself into the psychiatric unit, stating, “I don’t mind staying here. Anne will
probably come and visit me.”

SOUTH HADLEY PSYCHIATRIC HOSPITAL
153 Newton Street
South Hadley, MA
413-538-5063
Therapist Name: on call psychiatrist
Date Referred: 3 /2s/2i
/
OFFICE USE ONLY — FORM 582A
TREATMENT PLAN
Patient Information
NAME Santana Juan J
(last) (first) (Ml)
DOB 9/12/1967 GENDER M SNN XXX-XX-3329
(MM/DD/YYY) (M/F) (HERE HEHE -HHHH)
ADDRESS 11 Newton