Feature Image
Collage Mikel Roby with Daniel Craig
Capturing Pseudobulbar Affect
(Pathological Laughter)
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-
Mikel (Left) & Daniel (Right)
Inappropriate Laughter V Laughter as a response to PAIN
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[INSERT TITLE]
Title of Report “Scrambled Eggs”
Blogger Title – Mikel Roby – A #Casestudy
by MSG and Torkelson Pathology – #Housing Advisory Board #Investigation
(201908) – Produced by Keith Torkelson MS
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Social Media Management – Google Blogger
Table - Blogs – Report Distribution
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Social Media Management – Google Blogger
Table - Blogs – Report Distribution
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|
||||
Note
|
Address
|
Mikel Study I
|
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AnimaCules
|
|
Not Used
|
||
Brand New Day HMO
|
Link via UCD Fit Photo
|
Complementary
Portions
|
||
RX for Ecstasy
|
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Comparing Clozapine
To Invega
|
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Torkel Saga
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20190510-F:
Shared address on Pinterest
|
|||
Housing Advisory Board
|
|
Full Paper
|
||
P4D
|
20190510-F:
Shared address on Pinterest
Serious Mouse Experimentation
|
Sections about Behavioral Health lessons learned
|
||
Table last addressed: 20190821-W:
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Before Leaving on Respite – Buster’s Last words
20190813-TU-AM: Buster to Mikel
“You put up a good fight this
time around yet it may be time to go back to the hospital before you hurt
yourself and/or others”
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Dedicated to & In Memory of:
Road Kill Mark (RKM) & Kelly Thomas
[INSERT Images]
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Kelly Thomas Dying After "The Fullerton Affair"
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Our Peer Mark - Before he Died Too Young
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Insight into Managed Passing
Even sensational stories of those
that Died To Young (DTY) in Orange County just fade away. With all the stigma surrounding suicide the
community really doesn’t care about the lost individuals after the story has
faded. Take for example Kelly Thomas
pictured dying in the photograph above.
It has been less than ten (10) years after he died and few seem to care
anymore. Mark on the left was too much
for us to help as friend. He only
committed suicide within the last two (2) years and few if any who knew him talk
about him anymore. In our opinion his
program Brand New Day (BND) failed to appropriately honor him. For them his death appears to be no more than
lost revenue. We dedicate this paper to
both Mark and Kelly in that they did not die in vain.
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-
[INSERT PINTEREST LINKER]
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-
Mikel when there is really nothing to laugh about
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Abstract – Executive Summary
This report pertains to the association
of three roommates renting in a Share Room Environment. For the most part it concentrates on two the
roommates: Mikel Roby and Keith “Buster” Torkelson. Mikel was accepted to move in for a trial
period about three *(3) months ago.
Buster in the room is the incumbent.
Said room is owned and operated in what we fondly call Shank’s Truck Stop
(STS). Mikel has lived in the operation
that we can Shank’s Truck Stops before.
Earlier Mikel walked out on his lease.
The owner of STS “G” took a risk by inviting him back to live again in
her operation. Returning people only
have about a fifty-fifty chance of being accepted back. Unfortunately we cannot champion all peers in
need that come our way. Yet we know when
people need help. About a year ago
another individual in the STS operation needed help. Try as we may we could not help him. We saw him once before he managed his own
passing. He jumped off a freeway bridge
in Orange County into traffic. He died
and now we call him Road Kill Mark (RKM).
None of his paid helpers such as his Behavioral Health Doctor or Primary
Care Physician pay respect to Mark. In
addition none of his professional helpers take credit for their parts in Mark’s
demise at such a relatively young age in his fifties. We hope to do better helping Mikel.
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Professional Failure Cases (PFCs)
Again, we can’t champion all those
that are or have been failed by their professional care helpers. We call this ever growing group those that
Died To Young (DTY). For both Road Kill
Mark (RKM) and Kelly Thomas before him we have participated in the mop up
efforts. We share this report about
Mikel such that RKM, Kelly Thomas and others in our DTY cohort did not
sacrifice their lives in Vane.
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Problems and Concerns
The first assessment we share
measures Concern Intensity. Higher scores
indicate more concerns. On May 21 (TU),
2019 Mikel was paired with Buster and another roommate that sleeps in the bed above
Buster. On June 21, 2019 Mikel earned
himself an 88.2% with respect to his concern density. In other words Mikel has many concerns.
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Maladaptive Behaviors
Just for Mikel we created a
Maladaptive Behavior Impact Scale. On
July 25th, 2019 we ran it with both Buster and Mikel. We also included the third roommate and the
time Mike O. What follows is what each
able body earned for a Concern Load (CL): Mike O 73.3%, Buster 17.9%, and Mikel
25.0%. As you can see it could be worse
for Mikel. Mike O is so messed up at
present that Brand New Day his service provider has left him to die. They will only step up to avoid a
hospitalization.
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Activation
Activation
Next we assessed for behaviors
problems. On August 8, 2019 Mikel earned
himself 100% for Behavior Management Score (BMS). High scores indicate more severe behavior
issues. In many of these assessments we
compare Mikel with Buster. In general
based on Buster’s scores Buster earns better outcomes. Make note that Mikel is restless day and
night. We applied our Over-activation
tool on August 8, 2019 with Mikel. Mikel
earned himself 93.2% for his over-activation & restlessness. At this point we investigated for the chance
that Mikel suffers a variation of Tourette’s syndrome. This is good place to discuss medication yet
we are holding any major medication issues back for a follow up report
regarding Mikel.
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GAF Build
The next assessment theme we
applied is a pair of Global Assessment of Functioning adaptations. The first assessment yields a Dys-Functioning
and Mal-Behavior score. This assessment
was administered to Mikel on August 14, 2019.
The mark he earned for Dys-Functioning and Mal-Behavior Score was
94%. On this date we also addressed
Mikel’s Social Behavior status. On
August 14, 2019 he earned a score of 92% with higher scores indicating Social
Poverty.
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Controlling for Buster – Sleep
Value Score (SVS)
Buster evaluates his as well as
others’ sleep as one of the most important indicators for appropriate service
and supports. When a patient is in the
psych-ward they try their best to address sleep needs. For example last time around in 2012 Buster
was prescribed by Bum Soo Lee MD Restoril to sleep. Once Mikel does not pose a risk to Buster’s
sleep we will curtail the level of intensity with our time spent about
Mikel. We would like it that Mikel’s
professional service team stumbles on this publication and renewing their
efforts by initiating more effective care on Mikel’s case. At this point we know not the name of his
doctor or care coordinator. We know his
services are associated with his relationship with the Mental Health
Association of Orange County (MHAOC). Shame
on Mikel's trusted professionals to neglect and potentially abuse him from our
perspective. We are with Mikel up to
twenty-four hours per day while his professional team sees him about five (5)
minutes per month.
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20190816-F
On August 16th, 2019 we
applied our Progressive Health & Human Services instrument to both Mikel
and his Rent A Shared Room (RASR) roommate Buster. For this assessment high scores are
superior. Working through this tool Buster
earned an 83.3% whereas Mikel earned 0.0%.
This tool is not fair until Mikel’s service providers agree and apply progressive
Mental Health Service Act principles across the board. Buster’s higher score is primarily due to his
meaningful contributions with the Orange County Health Care Agency – Behavioral
Health Service division. Buster is
Mental Health Services Act (MHSA) literate.
He also applies Steinberg Programming Language (SPL) in his program of
recovery.
-
We ran to assessment tools on
both Buster and Mikel that measure suicidality.
Low scores on both assessment tools are superior. The first yielded a Signs of Suicide Score
(SSS). For Mikel we were unable to get
any value considering he is in general mute.
In other words for us about Mikel it is hard to get any meaningful response. Buster earned himself a 28% (20190813) about
Signs of Suicide. The second tool to
measure suicidality is our Self-Harm Critical Sign instrument. Once again by August 13, 2019 over a three
month period we were unable to determine (UTD) any reliable status about
Mikel. Applying the same assessment for
Buster, Buster earned a Self-Harm Critical Sign Score (SHCSS) of 13.6%.
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Close and Next Steps
We have exhausted enormous
resources to get this study of Mikel Roby up and running. If he and his paid support team were to
correct about a half dozen behaviors we probably would stop with only one
report. Not! We ask where to go next? We will address some nuances of Mikel’s case
and his associations that include Renting A Share Room (RASR) with Buster.
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Controlling for Buster – Sleep
Value Score (SVS)
In this paper we address one of
Buster’s respites taken since Mikel moved into his shared room. One of the most important elements for
Buster’s continuing welfare is the quality of his sleep. To gauge sleep quality we record a nightly
Sleep Value Score (SVS) for buster. In
general when Buster is away from the house, room, and Mikel his SVS comes in at
5.0 of 5.0 meaning the best it really could be.
Buster has an absolute sleep requirement. If his sleep gets interfered with then he
faces crisis. After two days with compromised
sleep Buster is at risk of hospitalization just to get the necessary sleep for
avoiding complications. It’s August 19,
2019: We just asked Mikel: What would you like to say on your behalf? He responded: I guess I’m doing OK. He’s not but for now that is a start. How is it that the behavioral health patient
is lying so much to themselves and their doctors?
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Relationship to Housing Advisory
Efforts
This section is created by MSG as
if ready to share with Jeff A Nagel (PhD) the current Orange County Health Care
Agency (OCHCA) Deputy Director Behavioral Health Services Director. We are trying to include him in our work with
housing the disadvantaged including the homeless in Orange County. We need to massage the findings in this
report for relating to our Housing Advisory Efforts (HAEs). Our primary project at this time is to help
the agencies with which we associate begin fixing the issues in Orange County
about housing the disadvantaged including the homeless. There is no good count of those disadvantaged
people that will benefit from new and improved help with housing. Also we have yet to find and itemized
inventory of where the beds are including day to day openings. We know that renting a shared room is also called
a Room & Board. In Orange County we
project 200 beds in the RASR bed base.
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PEACE
Many agencies feel that the work
is done by just placing a person in need in a bed and possibly providing some
sort of program, support, and services.
The case of Mikel Roby here offers a peek into the complexity of
achieving thrive and PEACE in a shared room.
Based on our fact finding and profiling efforts her with Mikel: We
believe doctors such as the one treating Mikel are falling short. They do not seek to discern the impact of
housing on health. We find more often
than not doctors really do not provide tangible case-by-case fixes as required
with their charges. For too many
providers servicing those in the Rent A Shared Room (RASR) environments
medication management is far from enough.
We are just trying to provide for Mikel a nice and PEACEful environment
in which healing may be possible. In the
information that follows see if you may discern Mikel's level of PEACE. For this study we held back running our PEACE
assessment.
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A Word to the Treating Doctor In
Charge (DIC)
Here in this report MSG shares pathology
that deserves to not be forgotten. Keith
our principle here at Mentalation Solutions Group (MSG) holds a degree in Pathology. I am Avey Asus the MSG Construct. We here at MSG say shame on the Doctor that
is in charge of Mikel. One of our
efforts we call Closing The Loop (CTL).
The loop is closed when vital information from the community level is
made available and received by the current and future doctors in charge (DICs). Mikel is far too young. He deserves the highest quality and effective
care. We see him as rather hopeless
right now. He shows signs of both being
underserved as well as inappropriately serviced. Confidentiality has been abused in that it
masks the truth of Behavioral Health Doctor (BHD) ineffectiveness. Only a few BHD’s with which we are familiar
have proven the concept of their practices with statistical relevance. At this point Mikel’s DIC has earned himself
about this case the Mentalation Solution Group Wakko Award (MSG-WA).
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[INSERT WAKKO Warner]
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Psychiatry 4 Dummies – Preface
Elimination
We just searched online for
Pharmacology For Dummies. There are no
Google hits for that title. Yet
Neurobiology for Dummies came up. Our
principle here at MSG has always wished to write one or more books. The first book he wrote was “My Literacy
Autobiography” for Janet Randall PhD.
The second book was Aaron George Torkelson’s (AGK’s) Operation Manual
for his great nephew AGK. We are going
to release our Psychiatry 4 Dummies book one Chapter at a time. The Chapters will basically cover the summary
sections of our in scope papers after each has been released in full via our
Blogs. We support about five (5) Blogs
at the present time. In reality we have
enough papers in scope of Psychiatry already published that as Buster become old
and feebler we can retrieve material from our existing publications.
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Nature of Acronyms
For this report we chose to embed
the acronyms.
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Key Words
Profiling – Discovery – Coping –
Sharing – Steinberg Programming Language
#Suicide#911#Psychiatry4Dummies#MentalationSolutionsGroup#PEACE
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Index of Tables – Matrices –
Figures
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20190816-F: Table - General Information Pertaining to Mikel
Roby
Record: 20190430 to Present – Table - Room Dynamic Log
Introduction
2019 Cast of Characters – Rent A
Shared Room (RASR)
Introduction – Table - Controls
Introduction – Table - Split out from – Goals Up Front (GUP)
Material & Method – Leveraging Media
Material & Method – Table -
Foundations - Assessment Eliminations
Table - Strengths First Approach
(SFA) - Basics Correct (Things He Gets Right)
Results
20190621-F: Matrix - Presenting
Problems (Highest Priority)
20190605-W: Update - Table - Buster’s Concessions (Sampling)
20190610-M: Table – Mikel Roby Features as reported by “G”
20190616-SUN-ON – Table – Triad Notes
20190725-TH: Table - Mike O Centered Notes
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20190808-TH: Matrix – Behavior
Management Assessment (16 Item)
20190808-TH: Matrix –
Over-activation Capture
20190814-W: Table - Behavior Inventory – GAF Driven –
Functionality
20190814-W: Table - Behavior Inventory – GAF Driven – Social
Behavior Inventory
20190816-F: Matrix - Steinberg
Programming Language (SPL) – Applied
20190817-SAT: Table – Phase I Checklist – Assimilation &
Accommodation
20190817-SAT: Table – Phase II Checklist - Assimilation
& Accommodation
20190812-M to 20190817-SAT - Matrix – Respite – M6ON August
Respite
20190813-TU: Table - Signs Of Suicide (SOS) Capture
20190813-TU: Table = Critical Signs of Suicide – CSOS –
Capture
20190816-F: Table - Communication Issues Capture
Appendix – Table - OCHCA & Other Community Resources
Capture
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Introduction
Introduction
Purposes for This Report (Brief)
This report pertains to the
recent, as of May 2019, association of Keith “Buster” Torkelson and his Rent A
Share Room (RASR) roommate Mikel Roby.
Buster has been on and off severely disabled since he gave up his role
at Chief Financial Officer about his family’s small business back around
2006. Beginning 2009 Buster engaged
meaningfully in a volunteer role working on implementation of the Mental Health
Services Act (MHSA) in Orange County California. Again, Mikel came into the picture back in
May of 2019. For us here at Mentalation
Solutions Group (MSG) we find Mikel’s case rather complicated. We feel it is novel enough to share with
others in the name of progressive transparency.
We hope to share some of our findings here with the Deputy Director of
the Orange County Health Care Agency.
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Prevention & Early
Intervention – Catastrophic Loss
We will cross-apply the lessons
we learn here in this study with MSG’s work on housing the disadvantaged
including homeless in Orange County. A
summary of this report we will share in our Blog: Psychiatry 4 Dummies. Mostly we hope to find and sustain our
purpose: Help Mikel and in doing so help Buster. Thank you our readers for you time and
consideration. We believe that
technology such as Blogging can help with recovery. With technology comes more ways to increase
one “Digital Presence (DP)”. We have
already improved Mikel’s DP by posting a short video on You Tube. We will include the link later. If interested in DP search the follow
statement “keith torkelson mikel r”.
This report is associated with our Housing & Catastrophic loss
study.
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Metadata > 08_PEI_Catastrophic_Loss_16091002_Contents
V2019
-
Introduction
20190816-F: Table - General Information Pertaining to Mikel
Roby
-
|
|||||
Category
|
Discovery
|
Note
|
|||
-
|
|||||
Name
|
Mikel Roby
|
||||
Age
|
Approx 30
|
||||
Date Case Discovered
|
May 21, 2019
|
||||
Orientation
|
African American
|
||||
Parents
|
None present
|
||||
Family
|
None present
|
||||
Natural Supports
|
Few if any
|
||||
Doctor
|
Unknown
|
Associated with Mental Health
Association (MHA)
|
|||
Insurance
|
Unknown
|
||||
Program
|
MHA
|
||||
OCHCA Involvement
|
Unknown
|
||||
-
|
|||||
Education
|
Grad HS minimum
|
||||
Work History
|
Unknown
|
||||
Learned Helpless
|
Severe
|
||||
Service History
|
Predicted inappropriate
|
Poor Outcomes
|
|||
Nature of Housing
|
Rent A Shared Room
(RASR)
|
With two others:
Buster and William
|
|||
Medication
|
Ineffective
|
As measured by (AMB) symptom
intensity
|
|||
-
|
|||||
GAF
|
At or near 30
|
||||
GAF and/or SOFAS History
|
Records
None available
|
||||
Suicidality
|
DBO
|
||||
Homicidality
|
DBO
|
||||
Confidentiality
|
RBO
|
||||
-
|
Last Date Addressed: 20190816-F: DBO
= Denies By Omission: RBO = Release By Omission
-
Introduction
-
Record: 20190430 to Present –
Table - Room Dynamic Log
2019 Road to Now - Triad: Buster – Mikel – Mike O
Positioning Summary Timeline – Major Changes in Equilibria
-
|
|||||
Time Stamp
|
Key Event
Notation
|
Notation
|
Triad
|
||
-
|
|||||
20190430-TU-ON
|
Rochester relocated
|
Buster – William – Vacant
|
|||
20190521-TU
|
Clayton fails
|
Missing In Action (MIA)
|
|||
20190521-TU
|
Mikel Roby moved in
|
Buster – William – Mikel
|
|||
20190621-F
|
Our adjustment to Mikel finished
|
||||
20190715-M-ON
|
William Relocated
|
||||
20190715-M-ON
|
Mike O moved in
|
Buster – Mikel - Mike
|
|||
20190813-TU
|
Begin closure respite
|
Control for Buster
|
|||
20190815-TH
|
Mike O out
William Swapped back in
|
Buster – Mikel - William
|
|||
20190821-W
|
Paper ready to publish
|
Multiple Blogs
|
|||
Last Update: 20190816-F:
-
Introduction – 2019 Cast of
Characters – Rent A Shared Room (RASR)
-
|
|||||
Character
|
Position
|
Note
|
Sharing
|
||
-
|
|||||
“G”
|
Landlord – Manager – Owner
|
The mother
|
Shares with “M”
|
||
“M”
|
Landlord – Manager – Owner
|
The muscle
|
Shares with “G”
|
||
Buster
|
Client – RASR
|
AKA Keith
|
At one time or another with
each below
|
||
Clayton
|
Client – RASR
|
Missing In Action
|
|||
Mike O
|
Client – RASR
|
With Buster & Mikel
|
|||
Mikel Roby
|
Client – RASR
|
With Buster & Mike then
Buster & William
|
|||
Rochester
|
Client – RASR
|
With Buster & William
|
|||
William
|
Client – RASR
|
With & Rochester and Ted
Then with Buster & Mikel
|
|||
Ted
|
Client - RASR
|
Another room & never with
Buster
|
|||
-
|
Last Reviewed: 20190818-SUN:
-
Introduction – Table – Controls
All relative to Mikel Roby &
his association with “Buster”
-
|
|||||
Element
|
Note
|
||||
-
|
|||||
Agent
|
Infective & Transmissible
elements transfer with behaviors not in scope
|
||||
Control for Buster
|
Did this by going on more than
ten days of respite over the course of three months
|
||||
Control for Fight-or-flight
|
Focus on sadness and hurt
rather than fear
|
||||
Landlords
|
Assume that the landlords’
parts are good enough
|
||||
Medication
|
Assume that in general it is
problematic as measured by (AMB) the plethora of symptoms
|
||||
Nutrition
|
High carbohydrate diet
Not addressed at this time
|
||||
-
|
Last Reviewed: 20190818-SUN:
-
Introduction – Table - Split out from – Goals Up Front (GUP)
On Crisis Prevention Management (PEI) – Relative to the
Mikel & Buster Association
-
|
|||||
Control Point
|
Stopgap
The Mikel & “Buster” Association
|
||||
-
|
|||||
911 Call
|
2019 history – House is on a run – No 911 Calls
|
||||
Age Related
|
“Mikel is too young to stay this sick”
|
||||
Centralized Assessment Team (CAT) Call (Public Health
Service)
|
Landlord would have to do it
Buster would introduce too much drama if he made the call
|
||||
Catastrophic loss
|
Mikel has little to lose
Buster has much to lose
|
||||
Consequences of disruptive sleep
|
Drama in the middle of the night
|
||||
Deterioration in condition
|
Mikel doesn’t get enough sleep to rejuvenate and heal
|
||||
Disrupted nighttime sleep
|
Mikel may not sleep much more that an hour at a time
|
||||
Deteriorating GAF / SOFAS
|
Mikel can’t really deteriorate about his GAF unless he
coverts to being suicidal
|
||||
Landlord burnout
|
If they burnout they will replace him
|
||||
Loss of bed
|
Moderate-high risk
|
||||
Prevent hospitalization of either party
|
For Buster this may take having Mikel replaced
|
||||
Younger people experiencing the same
|
One of the reasons for this report is that the younger
generations get better serviced
|
||||
Updating Landlord
|
This helps Buster cope
|
||||
-
|
Last Reviewed: 20190820-TU:-
-
Sleep
Our primary interest when it
comes to Renting A Share Room (RASR) is the quality of sleep for a given
cohort. As of August 20, 2019 the cohort
in “Our Room” is: In order of tenancy:
Buster the longest, Mikel, and then William the shortest. Buster and William share a bunk-bed with
William on top. Mikel has a standalone
bed across Our Room. What follows is MSG’s
Beta version Sleep Crisis Flowchart (SCF).
For Buster Sleep is a proven Currency For Health (CFH).
-
[INSERT SLEEP MECHANISM]
-
-
Next Steps
After we get this report behind
us we will return to our efforts to share findings from our sleep studies. Overall we call our investigation of sleep
SleepAbility. One of the key quantities
regarding sleep we call a Sleep Value Score (SVS). So far Mikel has helped us earn satisfactory
SVSs. William on the other hand influences
our SVS by shaking the whole bed during Nightly Quiet Time (NQT) which is
roughly 830pm to 830am.
-
Metadata in Scope > Assess_CIM_Sleep_Related_19050101_Results
-
Material & Method –
Leveraging Media for Recovery
For this report we performed some
research online. We knew that Mikel’s
laughing was bothersome yet we didn’t know much about the nature of
inappropriate laughter. We suggested to
Mikel that he get a Smart Phone and videotape himself so he could better
understand his condition. Then we
realized that for Mikel and us a video baseline was prudent. Now we have a record to show our helpers:
Doctors Nagel, Chau, Bera, and Mojica. If
we were to share the video during a meeting or appointment Buster would earn
credit for a “Digital Appointment”. We
call telling video and imagery our Media Transparency Approach (MTA). Mikel’s inappropriate laughter bout rate is
about 1 bout per 2 minutes more or less.
-
Metadata > 13_Media_Case_Mikel_Profiling_19081202_Working
-
Pseudobulbar Affect (Pathological
Laughter)
Then we found online that Mikel
may suffer an ailment called Pseudobulbar Affect. He has just enough control over it that he
most likely doesn’t demonstrate it while he is in an appointment with his
Behavioral Health Doctor (BHD). Before
his association with Mike Roby: Buster really didn’t know much about
inappropriate laugher or Pseudobulbar Affect.
In the last three months Mikel has suffered bouts of Pathological
Laughter every day that Buster was home to observe. In one hour he cycles from staring blankly to
laughing in excess of more than twelve times.
You can see on his face that he is very likely suffering something. Then we saw the video below and we remembered
when Buster laughed inappropriately when he was a transitional aged youth
(TAY). For Buster this laughter was
associated with intense pleasure. Just
like people that drink too much you can’t get them to stop because of alcohol’s
pleasure factor. Yesterday, August 18,
2019, we played the video for Mikel to try to help discover that this
phenomenon is not centered about him alone.
We think we may be increasing his awareness about his conditions.
.
Link to Objective Online Video
Back on April 22, 2011 “sackman11”
published on You Tube his short video addressing Bothersome Laughing. We shared it with Mikel yet he could not get
out of his head enough to focus on the video component. He did hear the audio component. We would like to play it for him once every
day.
-
Video Metadata
20190817-SAT: 155,988 views:
Runtime = 2:53:
Here is the text information that
accompanies the video by “sachman11”
“My buddy, Scott, as he gets
overcome by a fit of unprovoked and uncontrollable laughter. Fortunately this
episode occurred in the relatively private confines of my vehicle, but other
times can be less appropriate (out for lunch, during meetings, sex, etc.). This
rare, often painful symptom of multiple sclerosis is also known commonly as
pathological laughter, or in medical terminology, as Pseudobulbar Affect.”
-
-
A Baseline Recording
Mikel rocking, rolling and laughing in his safe spot his bed
Another person perspective as shared on Facebook
-
-
Material & Method – Table -
Foundations - Assessment Eliminations
Quick Score Method (QSM)
-
|
|||||
AMB
|
Buster Clozapine
|
Invega
Mikel
|
|||
-
|
|||||
Sleep as an Indicator
|
Contributes
|
Weak effect
|
|||
Rest as an Indicator
|
SoSo
|
Weak effect
|
|||
Activities of Daily Living
(ADLs) as an Indicator
|
Contributes
|
Weak effect
|
|||
Global Assessment of Function
(GAF)
|
Helps with Buster’s functioning
|
Little help
|
|||
Health Related Engagements
(MSG-HREs)
|
More than twelve HREs per year
centered about Clozapine management
|
Evidence absent for HREs
|
|||
Minded Medication Evaluation
(MME)
|
Empowering & High priority
|
Counters empowerment
|
|||
Quality Of Life (QOL)
|
Contributes
|
May Impair
|
|||
Satisfaction With Life (SWL)
|
Contributes
|
May Impair
|
|||
Last Reviewed: 20190818-SUN:
-
Material & Method – Table - Foundations – Media -
Assessment Eliminations
Media
|
Buster
|
Mikel
|
|||
Video – Objective
|
Readership interpretation
Baseline before Buster
intervenes about Mikel
|
Awareness outside of the
association
|
|||
Video - Subjective
|
Coping method
|
Situational Awareness
High information density
|
|||
Photographs - Objective
|
Audience interpretation
|
Lower information density
|
|||
Images
Impression about images
|
Proving the concept
|
Will not look and process
images of himself
|
|||
Digital Presence
|
Rather huge
|
Improving thanks to Buster
“That they did not suffer in
vane”
|
|||
-
|
Last Reviewed: 20190818-SUN:
-
Image Awareness Method (IAM)
Years ago we came across some
methodologies for psychiatrists treating in-patients in a few of the State
Mental Hospital institutions. One of
these treatments was developed in response to developments with
photography. The Photo Driven Therapy
(PDT) preceded psychotropic treatment by some forty years. We do not consider early treatments with
cocaine because it appears to not help in the long run. Recall at the turn of the twentieth century
the primary therapeutic interventions were good nutrition and plenty of bed
rest. We decided to give our Image
Awareness Method that works for Buster a trial on Mikel. We offered him a photo taken of him while he
was in a bout of laugher. He did not
want to see himself. Remember we are
helping him peer-to-peer and probono.
This offers us a freedom more typical to those amateurs using Blogger or
Facebook.
-
Boundaries for Doctor Ravinder P
Singh MD
Quite a while ago Ravinder P
Singh offered up an assignment to Keith “Buster” Torkelson. She indirectly said he might investigate his
shortfalls with Boundaries. As the dust
settles in Buster’s volunteer role of patients-rights advocate: Writing and
sharing this document would be within the boundaries of a progressive transparency
study. Now if we turn table focusing on
Mikel: Mikel is violating Buster boundaries.
The level of risk this study propagates for Mikel is meniscal with the
benefits to him and others that suffer in similar fashion.
-
Method
Strengths First Method (SFM)
-
20190812-M: Last Lecture Before
Respite – Table of Peer-to-peer Notes
Has little vision both mindful
and ocular
-
Table - Strengths First Approach
(SFA) - Basics Correct (Things He Gets Right)
Date Mikel Moved in Club Shank –
May 21 (TU), 2019
After and during three (3) months
– Adjustment Phase Over as of August 15 (F), 2019
-
|
|||||
Strength
|
Mikel
20190816
(F-RT) - Note
|
WTRC Standard
Retro 2006-2007
|
|||
-
|
|||||
Proper airflow
|
Adjusted
Window open when best choice
|
Air-conditioned about 68
degrees Fahrenheit
|
|||
Communication
|
Demonstrating slight
improvement
|
Expected & Graded
|
|||
Privileges
House Key
|
He was fast tracked
|
Earned outing privilege
|
|||
Ambient
Natural lighting
|
Seems not to notice lighting
changes
|
Artificial light reigned
|
|||
Chores
Cleaning house
|
Improving
|
Keep all areas tidy
|
|||
Destroying property
|
Compatible
Not demonstrated
|
Not well tolerated
EBLOP
|
|||
Theft / stealing
|
Compatible
Not demonstrated
|
Not well tolerated
EBLOP
|
|||
SleepAbility (MSG)
|
SoSo
Has permitted both roommate to
sleep
|
Yes
|
|||
Quiet-time
|
SoSo
Daily at night
|
Yes
|
|||
Medicine
|
Took until he ran out
|
Required
|
|||
Airflow
Window
|
Compatible
Seems not to have preference
Open when appropriate
|
Windows locked shut
Not an option
|
|||
-
|
Listed: 20190816-F: EBLOP =
Enforced By Loss Of Privilege: WTRC = Westminster Therapeutic Residential
Center
-
Results
20190621-F: Matrix - Presenting
Problems (Highest Priority)
Mikel Roby Scored by RASR
Roommate Buster
RASR = Rent A Shared Room: ADLs =
Activities of Daily Living
Concern Intensity Tool (CIT)
-
|
|||||||
##
|
Problem or Concern
|
Mikel
20190621
A1M
|
Mikel
QUANT
|
Buster
20190621
A1M
|
Buster
QUANT
|
||
-
|
|||||||
01
|
At risk of losing bed and/or
housing
|
Probation period not promising
|
1.00
|
SoSo
|
0.50
|
||
02
|
Cannot hold conversation
|
SoSo
|
0.50
|
No
|
0.00
|
||
03
|
Defiance (Primary with
landlords)
|
Immediate
|
1.00
|
No
|
0.00
|
||
04
|
Impaired about ADLs
|
Immediate
|
1.00
|
No
|
0.00
|
||
05
|
Impairing health of roommates
|
Yes
|
1.00
|
SoSo
|
0.50
|
||
06
|
Inability to plan
|
SoSo
|
0.50
|
No
|
0.00
|
||
07
|
Inability to sleep through
night
|
Yes
|
1.00
|
SoSo
|
0.50
|
||
08
|
Inappropriate laughter
|
Yes
|
1.00
|
No
|
0.00
|
||
09
|
Inappropriate medication
|
Yes
|
1.00
|
No
|
0.00
|
||
10
|
Intense restlessness
|
Yes
|
1.00
|
SoSo
|
0.50
|
||
11
|
May need hospitalization
|
SoSo
|
0.50
|
No
|
0.00
|
||
12
|
Program Value
|
SoSo
|
0.50
|
Good
|
0.00
|
||
13
|
Pseudobulbar affect (PBA)
|
Yes
|
1.00
|
No
|
0.00
|
||
14
|
Selective Mutism
|
Yes
|
1.00
|
No
|
0.00
|
||
15
|
Tics - Kinesthetic / Motor
|
Repetitive
NP
|
1.00
|
SoSo
|
0.50
|
||
16
|
Tics - Vocal
|
Audible NP talking
|
1.00
|
No
|
0.00
|
||
17
|
Up and down all day and night
|
Yes
|
1.00
|
No
|
0.00
|
||
-
|
|||||||
CALC
|
15.00/17
|
2.50/17
|
|||||
Concern Intensity
Score (CIS) =
|
88.2%
|
14.7%
|
|||||
-
|
Information Generated:
20190814-W: Last Scoring: 20190816-F: Low scores are favorable: NP =
Non-Productive: A1M = After One Month
-
FYI - Three Months of
Miscellaneous Commentary – Buster to Mikel
-
“They say you laugh because you
need to cry”
“I cried when I first got here”
“It’s OK to cry”
“You may have to be bedridden
before you get up”
“In the hospital they may have to
heavily sedate you”
“Let’s work on sleeping all night
first”
“I a movie I saw an individual
that laughed as you do: He was being tortured”
-
20190605-W: Update - Table - Buster’s Concessions (Sampling)
By Buster 4 Mikel
-
|
|||||
Notation
|
Buster (We) Preferences
|
Concession Note
|
|||
-
|
|||||
1-Sleep Time
|
8pm-6am
|
Prepared to address nightly PRN
Huge challenge
|
|||
Bathing
|
Shower PRN else every other day
|
Mikel is improving yet landlord says he take too long of
showers
|
|||
COPD Related
|
Cough outside room or muffle coughs
|
Mikel’s coughing is tolerable
|
|||
Destructive Sounds
|
Prefer none
|
More tolerant because he is much better than Rochester was
|
|||
Eating
|
Outside room
|
Eat crunchy food outside bedroom
|
|||
Housework
|
Shared work in room
|
Finally got him to sweep floor – We gave him a reward
|
|||
Inappropriate Laughter (PBA)
|
Prefer little or none
|
Addressing his problem take time from our other
engagements
|
|||
Medication
|
We announce to him whenever we take our Meds
|
Tailored commentary
“We take this Med because it helps us stay better”
|
|||
Nature of Wakeup
|
Natural unless alarm
|
History of waking us up by laughing in the morning
|
|||
Privacy Time
|
We go away up to 24 hours per day
|
Unfortunately Mikel is going away less
|
|||
Productive Sound
|
Office standard: Printer running – Binders clicking –
Keyboard noises - Etc
|
We batch office related noises
|
|||
Quiet Time
|
8pm-830pm: Means he has to stop laughing
|
Reminding him daily
|
|||
Sound Reduction
|
Headphone use
|
Whenever he is in earshot
|
|||
-
|
Last Reviewed: 20190816-F:
-
20190610-M: Table – Mikel Roby Features as reported by “G”
RASR_MR_Assessment
Commentary – Owner/Manager/Landlord Observations
-
|
||||||
Comment
|
A2M – Landlord Impression
|
|||||
-
|
||||||
Can move out on whim
|
Continues
The downside of having few personal belongings and not
much to lose
|
|||||
“Smelly” Body Odor
|
Now issue with too long of showers
|
|||||
Good out all day
|
Landlord prefers he goes out during day because he is not
a team player
|
|||||
Medication Issue
|
We are confused about this
|
|||||
Behavior at other house
|
Mentions how he walked out last time around
His option to move to the other house may be lost
|
|||||
Thank You for telling me (20190610-M)
|
August 17, 2019 (SAT)
Last update by Buster to Landlord
She is becoming less appreciative for the Intel
|
|||||
-
|
Last Update: 20190818-SUN: A2M =
After Two (2) Months
-
20190616-SUN-ON – Table – Triad Notes
Centered about Mikel
Comparative Coping and Annoyances
Triad: Buster – William – Mikel - Snapshot
-
|
|||||
Notation
|
Buster
|
Mikel
|
William
|
||
-
|
|||||
Bothering RASR William
|
Yes
|
Yes
|
NA
|
||
Up and down all night long
|
No
|
Yes
|
Daily risk
|
||
MR Asks Buster
“Why I am sleeping on the floor?”
|
William from above violently shakes bunk-bed
|
Sits & Lays on floor PRN
Landlady does not like
|
Never
|
||
SleepAbility
Relocate to Floor fix
|
Fails because Mikel gets up and down all night long
|
We don’t think he sleeps much
|
Impact of top bunk restless individual
|
||
Overnight PEACE
|
Contributes
|
Detracts
|
Daily risk
|
||
Selflessness Status
|
Passes
|
Fails
|
Fails
|
||
Intervention
|
Needed when sleep is challenged by a RASR roommate
|
“G” without asking helps with William
|
|||
Self control
|
Hurdle of Buster to face
|
Asked him to pick one: Up or Down
|
Probably unlikely
|
||
Defiance Status
|
Low
|
Defying “G” & “M” about Laughing
|
Often yet as not as problematic
Tourette syndrome
|
||
-
|
Last Updated: 20190816-F: RASR = Rent A Shared Room
-
20190725-TH: Table - Mike O Centered Notes
Triad – Buster T – Mike O – Mikel R
Maladaptive Behavior Summary
20190815-TH: Mike O exchanged with William
-
|
||||||
##
|
Feature
|
20190725
(TH-RT)
Mike O
Impact
|
20190725
(TH-RT)
Buster
Impact
|
20190725
(TH-RT)
Mikel
Impact
|
||
-
|
||||||
01
|
Behaviors interfering with common sleep
|
High
|
SoSo
|
SoSo
|
||
02
|
Does not attend program anymore
|
BND
SoSo
|
BND
He goes
|
MHA
SoSo
|
||
03
|
Goes through others drawers
|
SoSo
|
Not
|
Not
|
||
04
|
Interfering with our freedoms
|
High
|
SoSo
|
SoSo
|
||
05
|
Irritating house owner Mel
|
High
|
Not
|
High
|
||
06
|
Minor stealing
|
High
|
Not
|
Not
|
||
07
|
Naked too much
|
High
|
Not
|
Not
|
||
08
|
Nighttime
|
High
|
SoSo
Slightly better
|
SoSo
|
||
09
|
Parkinson’s like signs
|
SoSo
|
SoSo
|
Not
|
||
10
|
Problematic self sex at night
|
High
|
Not
|
Not
|
||
11
|
Squeezes wrists
|
SoSo
|
NA
|
NA
|
||
12
|
Stares into space
|
Low
|
Not
|
Not
|
||
13
|
Steals others food
|
High
|
Not
|
Not
|
||
14
|
Stepping in a certain pattern
|
Low
|
Not
|
Not
|
||
15
|
Walks and paces too much
|
High
|
SoSo
|
SoSo
|
||
-
|
||||||
CALC
|
11.0/15
|
2.5/14
|
3.5/14
|
|||
Maladaptive Behavior
Impact Score (MBIS) =
|
73.3%
|
17.9%
|
25.0%
|
|||
-
|
Date started scoring:
20190725-TH: Last Reviewed: 20190816-F:
-
20190808-TH: Matrix – Behavior
Management Assessment (16 Item)
RASR – Profiling Mikel Roby -
Feature Summary
Low Scores are Favorable
Compare Mikel with Buster
-
|
|||||||
##
|
Feature
|
Mikel
20190808
(TH-RT)
|
Mikel
20190808
(TH-RT)
|
Buster
20190808
(TH-RT)
|
Buster
20190808
(TH-RT)
|
||
-
|
|||||||
01
|
ADL issues
|
Yes
|
1.00
|
No
|
0.00
|
||
02
|
Argues for laughing
|
Yes
|
1.00
|
DNA
|
|||
03
|
Audibly laughs to self
Pseudobulbar affect (PBA)
|
Excessive
|
1.00
|
No
|
0.00
|
||
04
|
Audibly talks to self
|
Yes
|
1.00
|
No
|
0.00
|
||
05
|
Backpack important
|
Yes
|
1.00
|
Yes
|
1.00
|
||
06
|
Bothers William
|
Did
|
1.00
|
Yes
|
1.00
|
||
07
|
Denies Behaviors
|
Yes
|
1.00
|
No
|
0.00
|
||
08
|
Eat very little
|
Yes
|
1.00
|
No
|
0.00
|
||
09
|
False promises
Stated hope to improve at the start of June
|
Yes
|
1.00
|
No
|
0.00
|
||
10
|
Mirror time
|
UNK
|
No
|
0.00
|
|||
11
|
Mutism (75% or greater)
|
Yes
|
1.00
|
No
|
0.00
|
||
12
|
No planning AMB
|
Yes
|
1.00
|
No
|
0.00
|
||
13
|
No sign of effective medication
|
Yes
|
1.00
|
No
|
0.00
|
||
14
|
Pressure talking (Mute)
|
Yes
|
1.00
|
SoSo
|
0.50
|
||
15
|
Skips meals
|
Yes
|
1.00
|
No
|
0.00
|
||
16
|
Virtues issues AMB BSA
|
SoSo
|
1.00
|
No
|
0.00
|
||
CALC
|
15.00/15
|
2.5/15
|
|||||
Behavior Management
Score (BMS) =
|
100%
|
16.7%
|
|||||
Last Update: 20190816-F: DNA = Does Not Apply: Low Scores
are Favorable: RT = Real Time
-
20190808-TH: Matrix –
Over-activation Capture
RASR – Profiling Mikel Roby -
Feature Summary
Over-activation Screener (OAS 11
Item)
Compare Mikel with Buster
-
|
|||||||
##
|
Feature
|
Mikel
20190808
(TH-RT)
|
Mikel
20190808
(TH-RT)
|
Buster
20190808
(TH-RT)
|
Buster
20190808
(TH-RT)
|
||
-
|
|||||||
01
|
About 30 years old
|
Issue
|
1.00
|
Older
Wiser
|
0.00
|
||
02
|
Intense restlessness
Up and down during day
|
Yes
|
1.00
|
SoSo
|
0.50
|
||
03
|
Intense restlessness
Up and down during night
|
Yes
|
1.00
|
No
|
0.00
|
||
04
|
Little personal belongings
Nothing to lose
|
1.00
|
SoSo
|
0.50
|
|||
05
|
No chores
|
Yes
|
1.00
|
No
|
0.00
|
||
06
|
Problem leaving the house
|
Yes
|
1.00
|
SoSo
|
0.25
|
||
07
|
Property security issues
Wallet
|
Yes
|
0.50
|
Yes
|
0.75
|
||
08
|
Not effectively served by
|
MHA
Poorly
|
0.75
|
BND
Above AVG
|
0.75
|
||
09
|
Sleep Issues
|
Yes
|
1.00
|
SoSo
|
0.50
|
||
10
|
Time in Bed Issues
|
Yes
|
1.00
|
No
|
0.25
|
||
11
|
Very restless in general
|
Yes
|
1.00
|
SoSo
|
0.50
|
||
-
|
|||||||
CALC
|
10.25/11
|
5.00/11
|
|||||
Over-activation and
Related Score =
|
93.2%
|
45.5%
|
|||||
-
|
Last Update: 20190816-F: Low Scores Are Favorable
-
Feature Topic Global Assessment
of Functioning (GAF)
We know that the Diagnostic &
Statistical Manual (DSM-Version 5.00) has dropped the GAF quick score
assessment. The last appearance of GAF
we do believe to be in the DSM-IV-TR, p. 34.
We do belief SOFAS is still acceptable.
Because we have more records including GAF scores than we do the SOFAS
we choose to still work around GAF scoring.
We derived a couple of assessments from the basic GAF. With our derivations we address consumer
functionality for behaviors and social skills.
Consider that both Buster and Mikel are gravely disabled we do not
address occupation as a strength or deficit.
As of August 12 (M), 2019 Mikel earned by our Quick Score Method (QSM) a
GAF of 30 at best. On April 20, 2012
doctor Ravinder P Singh MD the Doctor In Charge (DIC) at the time felt Buster
earned a 30 for his GAF. Since a
substantial low in 2012 we all here at MSG believed Buster was improving just
to find his debilitating anxiety and bi-polar disorders have given way to
serious Attention Deficit Disorder. His
doctor cannot treat him because he does not respond well to stimulants. At the end of 2011 while attending two
courses at a local college Buster could stay focused for 2 hours. Now Buster is lucky to stay on task for one
half of an hour. This moment is a good time for a break for Buster to walk
around a bit. Buster also suffers pain
while sitting.
-
FYI - [PDF] - Global Assessment
of Functioning (GAF) Scale
Global Assessment of Functioning
(GAF) Scale. (From DSM-IV-TR, p. 34.)
-
20190814-W: Table - Behavior
Inventory – GAF Driven – Functionality
GAF (MSG) Adaptation - Impairment
Summary (GAF-MSG-Beta 9 Item Screener)
Evaluating Mikel Roby
-
|
||||||
##
|
Element (Behavior)
|
Mikel
20190814
(W-RT)
|
Mikel
QUANT
|
|||
-
|
||||||
01
|
Behavior is considerably
influenced by delusions
|
Yes
|
1.00
|
|||
02
|
Behavior is considerably influenced
by hallucinations
|
SoSo
|
0.50
|
|||
03
|
Serious impairment in
communication
|
Yes
|
1.00
|
|||
04
|
Serious impairment in judgment
|
Yes
|
1.00
|
|||
05
|
Sometimes incoherent
|
Yes
|
1.00
|
|||
-
|
||||||
06
|
Acts grossly inappropriately
|
Yes
|
1.00
|
|||
07
|
Suicidal preoccupation
|
UTD
|
X
|
|||
08
|
Inability to function in almost
all areas
|
Yes
|
1.00
|
|||
09
|
Stays in bed all day
|
Yes
|
1.00
|
|||
-
|
||||||
CALC
|
7.5/8
|
|||||
Dys-Functioning and
Mal-Behavior Score =
|
94%
|
|||||
-
|
20190814-W: Low Scores are
Favorable
-
20190814-W: Table - Behavior
Inventory – GAF Driven – Social Behavior Inventory
Functionality - GAF Adaptation -
Impairment Summary (GAF-MSG-Beta 6 Item Screener)
-
|
||||||
##
|
Element (Social)
|
Mikel
20190814
(W-RT)
|
Mikel
QUANT
|
Note
|
||
-
|
||||||
01
|
No job
|
Yes
|
1.00
|
|||
02
|
No home
|
SoSo
|
0.50
|
|||
03
|
No friends
|
Yes
|
1.00
|
|||
04
|
No family
|
Yes
|
1.00
|
|||
05
|
No natural supports
|
Yes
|
1.00
|
|||
06
|
No program
|
Yes
|
1.00
|
|||
-
|
||||||
CALC
|
5.5/6
|
|||||
Social Behavior
Status Score =
|
92%
|
|||||
-
|
Date of Scoring: 20190814-W: Low
scores are favorable - UTD = Unable To Determine
-
Engagement Photograph
Observations
-
Buster's program at the Wellness Center West
A Buster Engagement - OCHCA MHSA Steering Committee Meeting
Buster's Program - Brand New Day
-
-
Table - Programs – Social:
Service: Support Engagements
-
|
|||||
Program
|
Consumer
|
Association
|
|||
-
|
|||||
Brand New Day
|
Buster
|
Primary Service Provider
|
|||
Orange County Mental Health
Association (MHA) Homeless
|
Mikel
|
Little or no attendance & little
service and support
|
|||
MHA Housing
|
Buster
|
External Quality Review efforts
|
|||
Wellness Center West
(WCW)
|
Buster
|
Optional
Primary grief work
Alternative to BND related
therapist
|
|||
Wellness Center Central
(WCC)
|
Buster
|
Assigned by OCHCA
Member since 2009
|
|||
Fountain Valley Alano Club
|
Buster
|
SUD issues
|
|||
MHSA Steering Committee Meeting
(SCM)
|
Buster
|
Regular attendance since 2009
|
|||
-
|
Last Reviewed: 20190818-SUN:
-
-
20190816-F: Matrix - Steinberg
Programming Language (SPL) – Applied
Sample Selections
Related Document:
MHSA_INN_HAB_18121302_VMV 2019
Comparative & Balanced
Scorecard for Accountability Purposes (14 Item Screener)
-
|
|||||||
##
|
SPL Promises
|
Mikel
MHA
|
QUANT
|
Buster
BND
|
QUANT
|
||
-
|
|||||||
01
|
Access effective services
|
No
|
0.00
|
Yes
|
1.00
|
||
02
|
Accountability
|
NEA
|
X
|
Yes
|
1.00
|
||
03
|
Apply Recovery &
Empowerment Notebook
|
NEA
|
X
|
Yes
|
1.00
|
||
04
|
Appropriate Service
|
No
|
0.00
|
SoSo
|
0.50
|
||
05
|
Appropriate Supports
|
SoSo
|
0.00
|
SoSo
|
0.50
|
||
06
|
Better Outcomes
|
No
|
0.00
|
Yes
|
1.00
|
||
07
|
Consumer-driven
|
NEA
|
0.00
|
Yes
|
1.00
|
||
08
|
Early Intervention
|
SoSo
|
0.00
|
SoSo
|
0.50
|
||
09
|
Outcome driven
|
No
|
0.00
|
Yes
|
1.00
|
||
10
|
Proof of Concept
|
No
|
0.00
|
Yes
|
1.00
|
||
11
|
Strengths-based
|
SoSo
|
0.00
|
Yes
|
1.00
|
||
12
|
Support with Technology
|
No
|
0.00
|
Yes
|
1.00
|
||
13
|
Transparency
|
No
|
0.00
|
Yes
|
1.00
|
||
14
|
Viable Individualized Treatment
Plan
|
No
|
0.00
|
Yes
(Passive)
|
1.00
|
||
-
|
|||||||
CALC
|
0.00/14
|
12.5/14
|
|||||
Progressive Health
& Human Services Value =
|
0.0%
|
83.3%
|
|||||
-
|
Date Addressed: 20190816-F: NEA =
No Evidence Available
-
-
Metadata > Steinberg
Programming Language (SPL)
[INSERT]
-
20190817-SAT: Table – Phase I
Checklist – Assimilation & Accommodation
-
|
|||||
Phase
|
20190817
(SAT-RT)
|
Note
|
|||
-
|
|||||
Accountability
|
Pending
|
We would like Mikel’s to buy
into this case and therefore become more accountable
|
|||
Addressing Dread
|
Ongoing
|
Buster is getting over the
Dread of both Rochester and Brand New Day’s Jeff Gibb’s
|
|||
Address Mistaken Beliefs
|
Ongoing
|
Hard to detect due to lack of
didactic conversation
|
|||
Adjustment
After 3 Months
|
A3M
|
Three month adjustment phase
closed
Mikel’s probation is over when
landlord accepted payment for August 2019
|
|||
Capture
|
Adequate
|
This report is about our
priority capture with Mikel’s case
|
|||
Coping
|
Completing what we started
|
Generating this report is one
of “Buster’s” coping skills
It is an extension of
Journaling
|
|||
Defense
|
Sustain
|
This is Mentalation Solutions
Group’s (MSG’s) position – It is hard to sustain in all circumstances
|
|||
Hopeful
|
SoSo
|
One step at a time – Achieve
and sustain PEACE within the shared room
|
|||
Observe & Discovery
|
Good
|
We do this pro-bono
|
|||
Sharing
You Tube
|
Fully Executed (FE)
|
We hold this back for the next
report if a follow up report is necessary
|
|||
Transparency
|
Good
|
We continue with guarded
disclosure about Buster
|
|||
-
|
Date Phases set to rest: 20190817-SAT:
-
20190817-SAT: Table – Phase II Checklist - Assimilation
& Accommodation
Next Steps - Rough Outline – Items swapped in and out PRN
Phase
|
NSPH
|
Note
|
|||
Negotiations
|
Continue to negotiate with
landlord on Mikel’s behalf
|
||||
Sharing Doctor Nagel (PhD)
|
Important to share video and
photographs in context of our work with housing the disabled including
homeless
|
||||
Housing Advisory Board (HAB)
|
Bigger picture for county level
fixes about housing the disabled including the homeless
|
||||
Person Of Interest
|
Buster felt he was at the
beginning to August
Anxiety now under control
|
||||
RASR Environment
|
Renting A Share Room service
sector
A fix for homelessness
|
||||
Close Situational Awareness
|
With This Report (Begin August
18, 2019)
|
||||
Disposition – Passive
|
This
|
||||
Disposition – Active
|
Face-to-face transactions with
Mikel and landlord
|
||||
Scared Straight
|
Buster gets pretty mean at
times
Managed Passing Position (MPP)
|
||||
Address the Invega Crisis
|
We will get to this we promise!
|
||||
Cast Out or Keep
|
Buster’s fluctuating position
regarding Mikel
|
||||
1-Prevention & Early
Intervention (PEI) Value
|
Delivery is were we are going
|
||||
2-Community Services &
Supports (CSS) Value
|
Discernment is were we are at
now
|
||||
-
|
Date Last Addressed: 20190818-SUN: NSPH = Next Step Priority
Holder - Date Phases set to rest: 20190817-SAT:
-
Subsequent
Report Pending
Metadata
> 04_Case_Study_Mikel_Roby_19052901_Notes II Fixes
-
20190812-M to 20190817-SAT - Matrix – Respite – M6ON August
Respite
Respite for Buster – Including Friend Involvement
Productivity Pamper and Intimacy Respite (PPIR)
Controlling for Buster – Sleep Value Score (SVS)
-
|
|||||
Time
Stamp
|
Key Event
|
SVS
|
Note
|
||
-
|
|||||
20190812-M
|
Preparing to Share Preliminary
Findings
Going away lecture triggered by
crunchy food
Tried Image Awareness Method
|
M6ON-00
|
|||
20190812-M-ON
|
Mike O stealing others’
beverages in the night – Caught twice
Mike O still defying “M”
|
4.7
|
|||
20190813-TU
|
Begin at FVAnnex Facilities
Expect Self-care and pampering
All you can eat Mongolian BBQ
Parting remarks with Mike O
|
M6ON-01
|
|||
20190813-TU-ON
|
Night-01 – Address anxiety
& panic
|
With IB
5.0
|
|||
20190814-W
|
Target Publish Date
Meet best friend Gerard for
dinner
|
M6ON-02
|
|||
20190814-W-ON
|
Mature panic prevention
protocols (PPP)
|
With IB
4.8
|
|||
20190815-TH
|
Early checkout due to Buster
finding satisfaction
One day refund for next time
|
M6ON-03
|
|||
20190815-TH-ON
|
Hope for the best at home and
in room
Slight change found – William
Swapped back in
|
With IB
5.0
|
|||
20190816-F
|
Errands and most work at our
Fountain Valley Annex Facility (FV-AF)
|
Planned
M6ON-04
|
|||
20190816-F-ON
|
Mikel quiet time violations PM
& AM
|
4.8
|
|||
20190817-SA
|
Close Respite
Resume routine
|
||||
-
|
Last Reviewed: 20190817-SAT: SVS = Sleep Value Score: IB =
Intimacy Bonus
-
20190813-TU: Table - Signs Of Suicide (SOS) Capture
OCHCA 8 Item Screener
Compare Mikel with Buster
-
|
|||||||
##
|
Sign
|
Mikel
|
Buster
|
Buster
QUANT
|
Note
|
||
-
|
|||||||
01
|
INC alcohol or drug use
|
UNK
|
No
|
0.00
|
|||
02
|
Changes in sleep
|
Problem
|
SED
|
0.25
|
|||
03
|
Withdrawn
|
Yes
|
No
|
0.00
|
|||
04
|
Feeling hopeless
|
UTD
|
SoSo
|
0.50
|
|||
05
|
Feeling desperate
|
UTD
|
SoSo
|
0.50
|
|||
06
|
Feeling trapped
|
UTD
|
No
|
0.00
|
|||
07
|
Giving away possessions
|
Has near nothing
|
SoSo
|
0.50
|
|||
08
|
Putting affairs in order
|
UTD
|
SoSo
|
0.50
|
|||
-
|
|||||||
CALC
|
2.25/8
|
||||||
Signs of Suicide
Score (SSS) =
|
UTD
|
28%
|
|||||
-
|
Date Scored: 20190813-TU: Low Scores are Superior
-
Embedded Legend
DBM
|
Demonstrated By Mark
|
||
INC
|
Increase
|
||
SED
|
Strong Environment Dependency
|
||
UNK
|
Unknown
|
||
UTD
|
Unable To Determine
|
-
20190813-TU: Table = Critical Signs of Suicide – CSOS –
Capture
OCHCA Screener (11 Items)
If any of these signs are present, call 9-1-1 or a suicide
prevention hotline
In Honor of Those who died too Young (DTY)
Compare Mikel with Buster
-
|
|||||||
##
|
Critical Sign
|
DBRKM
|
Mikel
20190813
(TU-RT)
|
Buster
20190813
(TU-RT)
|
Buster
QUANT
|
||
-
|
|||||||
01
|
Threatening self-harm or suicide
|
DBO
|
No
|
0.00
|
|||
02
|
Threatening suicide
|
DBO
|
No
|
0.00
|
|||
03
|
Threatening homicide
|
UTD
|
No
|
0.00
|
|||
04
|
Threatening period
|
X
|
UTD
|
SoSo
|
0.50
|
||
05
|
Talking about death or suicide while intoxicated
|
UTD
|
No
|
0.00
|
|||
06
|
Seeking methods for self-harm
|
UTD
|
No
|
0.00
|
|||
07
|
Seeking methods for suicide
|
UTD
|
No
|
0.00
|
|||
08
|
Talking about death
|
X
|
UTD
|
The
concept not the method
|
0.00
|
||
09
|
Talking about suicide
|
DBO
|
The
concept not the method
|
0.00
|
|||
10
|
Acting anxious
|
X
|
Yes
|
SoSo
|
0.50
|
||
11
|
Acting agitated
|
We missed this one
|
Yes
|
SoSo
|
0.50
|
||
-
|
|||||||
CALC
|
1.50/11
|
||||||
Self-Harm Critical
Sign Score (SHCSS) =
|
UTD
|
>>>
|
13.6%
|
||||
-
|
Date Scored: 20190813-TU: UTD = Unable To Determine: DBRKM =
Demonstrated By Road Kill Mark: DBO = Denies By Omission: RT = Real Time: Low
Scores are Superior
-
Remembering those who Died Too Young: Road Kill Mark (RKM-KIA)
-
The Mandy Triad
The Mandy Triad
-
20190816-F: Table – Communication Issues Capture (CIC)
-
|
|||||
Brain Issue
|
Observation
|
Note regarding Mikel
|
|||
-
|
|||||
Dual Consciousness
|
Yes
|
One consciousness removed and in his own world
When pressed into being present completely different voice
and tone
|
|||
Hearing - Contextual
|
Poor
|
He will respond yet his response is hard to discern
|
|||
Hearing - Physiological
|
OK
|
When Mikel “Beams” in he can hear
|
|||
Denial By Omission (DBO)
|
Severe
|
This is a plague about Behavioral Health and Mental Health
|
|||
Pseudobulbar affect
|
Severe
|
Inappropriate laughter
Interferes with PEACE in the shared room
|
|||
SmartPhone
|
None
|
The promise of SmartPhone assistance is before him
|
|||
Remembering
|
Weak
|
We have to repeat things
|
|||
Responding Appropriately
|
SoSo
|
Better than not at all
|
|||
Tangential Responses
|
Yes
|
Sometimes very hard to fit his input into the conversation
|
|||
Transduction
|
Not in scope here
|
It would be nice to see some imaging of his brain
|
|||
Understanding
|
Poor
|
This is why we encourage people to write things down
|
|||
-
|
Last Update: 20190816-F:
-
-
Promotions
One Health
Promoting - One Health
-
One Health Initiative - One World
One Medicine One Health
Mission Statement
“Recognizing that human health
(including mental health via the human-animal bond phenomenon), animal health,
and ecosystem health are inextricably linked, One Health seeks to promote,
improve, and defend the health and well-being of all species by enhancing
cooperation and collaboration between physicians, veterinarians, other
scientific health and environmental professionals and by promoting strengths in
leadership and management to achieve these goals.”
-
WorldWafers
[STANDARD PROMOTION]
-
-
MSG Product in Development Stages
Images @ the End
It is just wrong that he is as ill and he is with little chance for improvement
Example of another Rent A Shared Room (RASR) tenant
Sleep a currency for better health & better outcomes
Mikel's Program
No one wonder he can't bring himself to attend as of late
Wellness Center West
-
Wellness Center West
Thinking As If....
This is Buster Smiling hopefully appropriately
He is responding after he sang a song at the Karaoke Bar
Audience is clapping
-
Steering Committee Gig - Free Food and Coffee
Steering Committee
Steering Committee
Wellness Center West
Wellness Center West
Rent A Shared Room (RASR) Triad
William on top just passing time until he dies
Mikel across the room in standalone bed
Buster taking photos
Buster lives in a "Cube"
-
-
Appendix: 20190814-W
Table - OCHCA & Other Community Resources Capture
Earned Value - Helpfulness & Usefulness
Sharing with Doctor Nagel
-
|
|||||
Resource
|
Description
|
Value
|
Connecting
|
||
-
|
|||||
OC LINKS
Navigator
|
Referral
|
NP4U
|
(855)-625-4657
|
||
OC LINKS
Chat
|
Online Chat
|
Looks Promising
|
|
||
Warmline
|
Phone driven sharing
|
NP4U
|
(714) 991-6412
|
||
BND
|
Brand New Day
|
Weak on Housing
|
(714) 741-0330
|
||
CAT
|
Centralized Assessment Team
|
NP4U
|
(866) 830-6011
|
||
MHA
|
Orange County Mental Health Association
|
Failing Mikel
|
MHA Homeless
(714) 668-1530
3.2 – 14 reviews
|
||
PERT
|
Psychiatric Emergency and Response Team
|
NP4U
|
(866) 830-6011
|
||
-
|
Created: 20190814-W: NP4U = Not Proven For Us
-
Shared with:
Metadata > 02_HAB_Market_18113008_Satisfaction V2019
-
This is the end our only friend – The End
999
-30-
-
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