Mark De Antonio, Mission Psychiatrist, and I were asked to see a 20 year old female
patient who initially came to the mission for medical care regarding a broken nose. The mission surgical team decided that the patient did not need surgical intervention at this time, but referred them to us to address her immediate mental health needs.
We initially met with the patient and her father. After talking with them both together and getting some family history and learning how she broke her nose, we asked to meet with the patient alone. This was a challenging case to deal with due to the family dynamics and family violence which led to the patient having a broken nose. We were finally able to work only with the patient without her father in the room to provide crisis intervention to her regarding her current home situation.
We were also able to refer her to the mission mental health clinic, COSMA for ongoing mental health services including continued medication management and counseling. The father of the patient was adamant that she needed surgery regarding her broken nose due to the potential negative psychological effects of not doing surgery. However, he then reported if the mission does not perform surgery on his daughter, she will hound him for the money to have the surgery, $2,000. In talking directly with the patient, she told us she was fine with not having surgery, but was extremely distraught about the home situation and not feeling safe in her own home. We provided her with a information for a domestic violence shelter in the community as an additional safety resource. She was open to the resources we provided and willing to follow up. It became very important to speak to her alone as her father was not ultimately a support to her in achieving safety and psychological support.
This was a rewarding experience for us to be able to help this
patient. We also realized in working with this
patient that surgery is not always the answer. In cases like this, the mental health interventions we can provide are of primary importance.
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