Miriam

A 35-year-old woman presents to the psychiatry clinic with persistent paranoid delusions about her neighbours. She has been on haloperidol for 10 years but her symptoms are escalating. Take a focused mental health history, conduct a thorough mental state examination including risk assessment, and formulate an appropriate management plan.

1. 1Take a sensitive mental health history
2. 2Conduct a thorough risk assessment (homicidal toward neighbours, suicidal)
3. 3Explore relevant past psychiatric, family, and developmental history
4. 4Perform a comprehensive mental state examination
5. 5Rule out substance-induced and organic causes
6. 6Provide a working diagnosis with relevant differentials
7. 7Review current haloperidol therapy and consider escalation
8. 8Plan admission considerations, MDT referral and safety planning