Planned interventions for a newly admitted severely depressed patient should include:

Question

a. allowing the patient to be alone if he or she prefers.
b. encouraging the patient to sleep to regain energy.
c. careful, unobtrusive observation around the clock.
d. chances to enact a leadership role in the therapeutic milieu.

Answer 1

C
Approximately two-thirds of depressed people contemplate suicide. A suicide attempt requires only a short period of unobserved activity. Traditional "every-fifteen-minute checks" allow sufficient time to enact a suicide and are inadequate. Therefore, ongoing direct (but unobtrusive) observation of the depressed patient, at least until such time as his risk for self-harm has been fully assessed, minimizes the chance of self-harm while on the unit. Allowing excessive "alone time" facilitates withdrawal. Rest is important, and while it is not unusual for depressed patients to have a sleep deficit, excessive sleeping is a form of withdrawal, and sleeping at atypical times can further disrupt the patient's circadian rhythm, interfering with sleep in the long run. Impaired cognition, concentration, and self-esteem would make assuming a leadership role unrealistic and frustrating for the patient.