You are working for a crisis agency and receive a call from a Social Worker in another state. They are concerned about their client who has recently moved to your area without knowing anyone.

They provide you with the following information. The patient has a history of violent behavior three years ago when he attacked his sister at his Mother’s funeral with a machete. The sister required medical treatment.

She stated the patient receives disability and has a payee. The payee called her yesterday to tell her of a call received from a motel manager where the patient stopped at. The manager stated the patient showed up in his lobby with a machete and he made the patient leave the machete at the front desk in order to continue staying there.

You contact the payee who tells you about her client.

He came to your town two weeks ago and called his Payee, reporting that his luggage was stolen at the bus station. The payee stated she wired him $450.00 for expenses.

At the patients request she began mailing him checks every Friday for $250.00. He would not give her an address and insisted she mail them to your local post office to "General Delivery.” She stated she has mailed two checks so far and neither of them has been cashed.

The payee stated he spent his first week at the Grand Inn but left after reporting there were swastikas on the office manager’s wall. She also indicated he presented as tired and irritable on the phone from sleeping outside for several nights, but was rational, coherent and goal-directed during the conversation.

On the morning of the phone call, the payee stated he arrived at the Best Value Inn and the owner allowed him to call his payee. The payee offered to mail his check to the motel, but he refused and stated he was heading to the post office to pick up his other checks.

The payee stated she had attempted to contact the Post Office three times without success to determine if he had picked up his checks.

The payee and the Social Worker contacting you are afraid the patient may be a danger to self or someone else.

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·     Do you have enough information to contact Law Enforcement and request a welfare check? Why?

·     What other information would you need to have?

·     Is the patient’s refusal to have the payee send check to a specific hotel related to paranoia?

·     Is the patient’s purchase of a machete a problem for you?

·     What other reasons could explain his purchase a machete?

·     Did his report of a swastika indicate possible hallucinations?

·     Would you call the motel where the patient saw a swastika and ask about it?

·     Would you contact the last motel he was at, where the owner let him call out-of-state on the phone to his payee?