Martine is a social worker at a local psychiatric hospital. Her primary duties are to evaluate patients that enter the Emergency Department with psychiatric complaints. One evening, an 18 year old Caucasian woman named Kara is brought into the Emergency Department by paramedics. Kara lives with her parents, and is a senior in high school. She had sent a friend a text that she was planning on killing herself by overdosing on her anti-anxiety medication in the high school bathroom the next day. Her friend had called 911, and had sent them the text.
Kara initially does not want to talk to Martine, and she states “You are going to tell my parents, and so I can’t talk to you.” Martine notifies her of HIPAA and confidentiality, and lets her know that, because she is over 18, Martine cannot share any information with her parents without her consent. Kara tells Martine that she is pregnant, and that her parents will “flip out” if they find out, and so she decided to kill herself by overdosing on her medications. Her parents currently maintain this medication, but she has been not taking it and storing it away so that she could overdose. Martine lets Kara know that she would review her situation with the psychiatrist, and the she anticipates that the psychiatrist will recommend that Kara is admitted to the inpatient unit for her own safety. Kara agrees to sign admission paperwork voluntarily.
Kara’s parents arrive, and they are very concerned and want to know what is going on. Kara refuses to talk and sits silently in the room.
After reviewing the above situation, please discuss:
- Martine needs to complete the voluntary admission paperwork to the hospital with Kara. What should she say to the parents as they sit in the room? Why would Martine give that answer?
- Kara is voluntarily admitted to the hospital. She continues to refuse to talk to her parents about her treatment or situation. Discuss at least two principles of the NASW Code of Ethics that the unit social worker should consider while working with Kara in order to avoid unethical actions. Discuss your reasoning for choosing these principles.
- If you were the social worker in this situation, how might you engage Kara as you work with her to design an appropriate discharge plan that would keep her safe? Make sure that you follow the NASW Code of Ethics in your plan!
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