Purdue University Global Science Question

Check for plagiarism and fix it please.

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Sarah Smith case
Name
Institution affiliation
Course
Tutor
Date
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List your differentials for her current problems. Remember you should have at least three
different differentials for each problem. Include rationale for each differential.
The first differential diagnosis for this patient is wheezing and coughing in the positive
range. As a result of these clinical indications, the patient may be suffering from a respiratory
ailment. Another piece of evidence supporting her troubles is that she has been diagnosed with
asthma, and she is also a former smoker, both of which could have contributed to her problems
(Urden et al., 2019).
Sarah’s second differential is that she is suffering from pain. Initially, the patient
presented to our office with a complaint of a wound. In this scenario, pain is taken into
consideration because it is the source of the discomfort that this client is experiencing. Pain is the
fifth vital sign that must be addressed in order to increase the patient’s comfort levels. Increased
blood glucose levels are the third differential diagnosis for the patient. Sarah has type 2 diabetes,
but she does not keep track of her blood sugar levels. She is also not taking her prescriptions on a
consistent basis. These disorders have an effect on wound healing and may be a contributing
factor to the difficulties the patient is facing at the moment.
2. At this time, what medical diagnoses are you most concerned about? Do they impact
other diagnoses? If so, how?
The first medical management for this patient is prioritizing the airway. The patient has
an oxygen saturation of 95% and a respiratory rate of 22 breaths per minute. This shows that
despite the absence of labored breathing, she is experiencing respiratory problems. The presence
of expiratory wheezes also makes airway maintenance to be a priority in the management. The
symptoms that the patient is experiencing are related to COPD or asthma. Although she has
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presented herself to the office for management of the wound, that procedure can be delayed, and
airway managed first (Urden et al., 2019).
3. What diagnostic images would you order? Provide your rationale. What are you trying
to rule in or out?
An x-ray of her chest is required to diagnose the reason for her coughing and wheezing.
This test can be used to detect lung disorders such as asthma, emphysema, and other respiratory
ailments. In addition, because her left foot is sore and swollen, an x-ray of the affected area will
be performed to rule out any other problems (Urden et al., 2019). This method can be used to
diagnose symptoms such as pain, edema, and soreness in the body.
4. What laboratory work would you order? What would you anticipate to be abnormal?
Provide your rationale for each.
Glycosylated hemoglobin test (hgbA1c)
Because she is a confirmed diabetic, this test is crucial in determining how well her blood
sugar levels are under control. Poor control can be predicted because she has not taken her
medication regularly.
Wound culture and sensitivity
Because of the odoriferous discharge, it is vital to examine the site for signs of infection. This
test can be used to determine which antibiotics are the most successful in treating the infection
and speeding up the healing of the wound.
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5. What is your comprehensive plan of care? Include your rationales.
Oxygen and medication will be used to treat her asthma. The patient should be able to
demonstrate an efficient airway breathing pattern following the aforementioned intervention
(Shastri et al., 2020). She will also need to know how to care for wounds properly. Depending on
the wound culture and sensitivity results, an antibiotic will be prescribed for the wound.
Insulin may be used to treat diabetes if it is deemed essential, especially in the case of
blood sugar fluctuations (Meng et al., 2019). Health education is also quite important. During the
treatment, the patient will learn about proper eating habits, blood sugar monitoring, and the
administration of hypoglycemic medications.
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References
Meng, J.-M., Cao, S.-Y., Wei, X.-L., Gan, R.-Y., Wang, Y.-F., Cai, S.-X., Xu, X.-Y., Zhang, P.Z., & Li, H.-B. (2019). Effects and Mechanisms of Tea for the Prevention and
Management of Diabetes Mellitus and Diabetic Complications: An Updated Review.
Antioxidants, 8(6), 170. https://doi.org/10.3390/antiox8060170
Shastri, M. D., Chong, W. C., Dua, K., Peterson, G. M., Patel, R. P., Mahmood, M. Q.,
Tambuwala, M., Chellappan, D. K., Hansbro, N. G., Shukla, S. D., & Hansbro, P. M.
(2020). Emerging concepts and directed therapeutics for the management of asthma:
regulating the regulators. Inflammopharmacology, 29(1), 15–33.
https://doi.org/10.1007/s10787-020-00770-y
Urden, L. D., Stacy, K. M., & Lough, M. E. (2019). Priorities in Critical Care Nursing – E-Book.
In Google Books. Elsevier Health Sciences.
https://books.google.com/books?hl=en&lr=&id=jySDDwAAQBAJ&oi=fnd&pg=PP1&d
q=priorities+in+nursing+management&ots=YKx5jO1LF&sig=blJ4xJiqWcd1zc4eCxbJIiokZNU
“Caring for the Mental Health
Needs of Special Populations
in Primary Care”
Unit- 7 Discussion
By: Sanaz Niksefat
Elderly/Geriatrics Population
• According to Census Bureau’s 2018
Population, 52 million Americans are
age 65 years and older. In state of
California approx. 14.8% of
population are elderly. The largest
senior population growth in
California is in Los Angeles and
Central Valley regions. In these
regions respectively, 32% and 34% of
population are 65+ YO. the older
adult population in the Los Angeles
region is expected to almost double,
from approximately 1.1 million to
more than 2.1 million individual in
year 2030.
Statistic of 2018 for age 65Years and older indicates:
Median Household income $39,400 annually
Homeownership is 65.1%
Education Status 72.7% has high school or higher degree
Almost 1/3 (29%) of the California seniors live below 200% of the Federal
Poverty Level. This is considered a significant number.
https://laborcenter.berkeley.edu/aging-californias-retirement-crisis-state-and-local-indicators/
Diagnosis & Criteria: DSM-5
• Mental and neurological disorders among older adults account for 6.6% of the total disability (DALYs) for this age
group. Approximately 15% of adults aged 60 and over suffer from a mental disorder.
• Common DSM-5 mental health problems in elderly population are: Affective disorder, anxiety, Alzheimer,
Parkinson and suicide rate.
State of California Emotional/Mental Health Problems in Elderly 65+ YO:
Number of cases 11,000 Percentage 7.6% Prevalence nation wide 9.9%
 National Suicide Rate
The incidence of suicide is particularly high among older, white males (30.3 suicides per 100,000). Particularly, the
rate of suicide in the oldest group of white males (ages 85+) is over four times higher than the nation’s overall rate
of suicide (www.acl.gov).
• Firearms are the most common means of suicide in older adults (67%), followed by poisoning (14%) and
suffocation (12%). Older adults are nearly 2x as likely to use firearms as a means of suicide than are people under
age 60.1 years old (www.acl.gov).
Affective Disorders
• 8 %-16% percent of community residence (SNF, Rehab, Boarding Care)older adults have depressive symptoms. A
recent study found that more than ¼ approx. 27% of older adults assessed by aging service providers met criteria
for having current major depression and near 1/3 approx. 31% had clinically significant depressive symptoms.
Depression is often under-recognized and under-treated in older adults.
Continue Diagnosis & Criteria: DSM-5

Anxiety
14% of older adults meet the diagnostic criteria for an anxiety disorder. One-quarter (27%) of
aging service network reported anxiety in elderly.

Cognitive Health Issue
Hippocampal sclerosis (HS) is a common cause of dementia in the older adult individuals aged
85 or older. Based on year 2021 Alzheimer’s Association report:
• Approx. 6.2 million Americans aged 65 and older are living with Alzheimer’s dementia.
•72% percent are age 75 or older. 1 in 9 people aged 65 and older (11.3%) has Alzheimer’s
dementia.
• Parkinson Disease (PD) is the 2nd most common age-related nerve degenerating disease after
Alzheimer’s. The incidence of PD is 1 percent of the population over the age of 60. This
increases to 5 percent of the population over age 85.
http://healthpolicy.ucla.edu/publications/Documents/PDF/2016/MentalHealthOlderAdult-Report.pdf
https://www.chcf.org/wp-content/uploads/2018/03/MentalHealthCalifornia2018.pdf
http://healthpolicy.ucla.edu/publications/Documents/PDF/2016/MentalHealthOlderAdult-Report.pdf
https://acl.gov/sites/default/files/programs/2016-11/Issue%20Brief%204%20Preventing%20Suicide.pdf
Treatment Plan
 Both pharmacologic and nonpharmacologic treatment approaches have been found to be helpful in reducing
depression, and improvement of cognitive impairment.
 Nonpharmacological treatment: Since majority of depressed mood in elderly population is due to their
loneliness, attending social events such as Adult Health Cares or Adult Health Day Care can improve their mood.
o Other treatments including behavioral therapy, cognitive-behavioral therapy, Problem-solving therapy, Brief
Psychodynamic therapy, and Life Review/Reminiscence therapy.
 Pharmacological Treatments:
 Choosing a right medication is important since many psychotropic medications are sedative, cause drowsiness
and increase risk of all.
 It is important to correct dose. Majority of elderly has low visceral protein storage and in result have higher
toxicity develop with high dose of medication. Calculating anthropometric such as assessing muscle mass and
checking Albumin and Prealbumin labs values are important prior to prescribe psychotropic medication to elderly
person.
 Many Psychiatric medication bind to plasma protein, and protein binding can influence the drug’s biological halflife. low albumin levels which is common among elderlies are associated with delayed clearance and increased
drugs toxicity. https://www.psychiatrictimes.com/view/psychotropic-drugs-and-falls-older-adults
Memantine: Is the medication of choice for Dementia. This drug reduces excessive glutamate receptor signaling,
Prenatal/Lactation Population
 Mental disorders are common during pregnancy, affecting 15%–29% of all pregnant women in U.S.
 Prevalence of antenatal depression and/or anxiety ranges from 8% to 30%.
One study indicated that infants of perinatally depressed mothers are more likely to have a difficult
temperament, as well as cognitive and emotional delays.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3083253/
• The neonatal and lactation infants whose mother took psychotropic medication showed 7% more
neonatal complications, 5% more fetal distress compared to infants who were in placebo group.
• Selective serotonin reuptake inhibitors (SSRIs) are among the most investigated psychotropic drugs
used during pregnancy
• One study indicates that mothers who take SSRI medication during pregnancy or breast feeding their
children has more prevalence of having Cardiac defects, ADHD and Autism development.
• The cohort study done on 136
pregnant women that half took
psychotropic mediation and half
didn’t take any psychotropic
medication. The result of this study
indicated that infants whose
mother took psychotropic
medications had approx. 11.3%
higher preterm, Low Birth Weight
prevalence’s compared to mothers
who didn’t take psychotropic
medications during their pregnancy
(Laura A Michielsen, 2017).
(Study done at Vincent van Gogh Institute for
Psychiatry and Vie Curi Medical Centre in Venlo).
Diagnosis & Criteria: DSM-5
Based on DSM-5 alcohol is a neurobehavioral teratogen, and prenatal alcohol
exposure has teratogenic effects in central nervous system (CNS)
development and subsequent function.
Diagnostic Features in infant with mother who consumes alcohol during
pregnancy on regular basis:
Impairment in neurocognitive
Behavioral impairment
 Adaptive functioning and association impairment
Treatment Plan
 FDA Approved some Psychotropic medication intake during lactation and pregnancy.
• Note: Lactation risk categories are as follows: L1 = safest; L2 = safer; L3 = moderately safe
Pregnancy risk category A = controlled studies show no risk; B = no evidence of risk in humans.
L2 Medication Safer during Lactation
B category Medications during Pregnancy
Zaleplon (Sonata)
Maprotiline (Ludiomil) TCA
Carbamazepine (Tegretol)
Zolpidem (Ambien)
Valproic acid (Depakene)
Buspirone (Buspar)
Amitriptyline
Bupropion (Wellbutrin)
Amoxapine (Asendin)
Clozapine (Clozaril)
Clomipramine (Anafranil)
Desipramine (Norpramin)
Paroxetine (Paxil)
The medication that are safe during lactation are not necessarily safe during pregnancy and vice versa.
Other Psychotropic medication that are not L2 or B category may have risk factors respectively during lactation and pregnancy.
Pregnant women and fetus need to be under monitorization of MD while taking any psychotropic medication.
Continue Treatment Plan

Non-Psychotropic treatment
Pregnancy is a major psychological, as well as physiological, event: environmental, family, internal stressors, have impact
on pregnancy.
Antepartum and Postpartum depression are very common among women who already have mental health problems prior
their pregnancy.

Collection of history at the first visit of pregnancy to determine psychological state as well as categorizing high risk
mothers.

Assess for Socio economic background such as low income, inadequate housing in case of financial need refer to Social
Worker.
Assess for Physically persistent or stressful work environment.

Psychological aspect of history includes inadequate personal, family and friends support, ineffective coping mechanisms.

Personal history like use of tobacco, illicit drug use, alcohol abuse
Assess to find if they eat adequate nutrients and fluid in case of need refer to Dietitian.
Assess to find if able to do ADLs.

Lab evaluation for Pregnant and Lactation infant
Triple Screen Test (or Triple Marker). The Triple Screen is a blood test capable of determining whether your baby may be
at risk for birth defects, such as Spina Bifida, or chromosomal abnormalities.
Nuchal Translucency Screening Test. During 11-14 wks. of gestation, this screening test, also known as the nuchal fold
scan, uses ultrasound to measure the translucency, or clear space, at the back of the developing fetus’s neck.
Amnio synthesis Test: Sample of amnio fluid tests for chromosome abnormalities.

Infant Blood Sugar, Drug level, Alcohol level.
Pregnant women lethal drug test, Alcohol test, Urine drug test, liver enzyme test , Check: CBC, CMP, TSH, T4, NH3 test.
https://www.omicsonline.org/open-access/need-for-psychological-assessment-during-pregnancy-a-nursing-perspective-.php?aid=79722
https://www.omicsonline.org/open-access/need-for-psychological-assessment-during-pregnancy-a-nursing-perspective-.php?aid=79722
Pediatric/Adolescents Population

1 in 6 U.S. children between the ages of 6 and 17 has a treatable mental health disorder
such as depression, anxiety problems or attention deficit/hyperactivity disorder (ADHD)
www.aafp.org.

This is estimated 16.5 percent of U.S. children between the ages of 6 and 17 approx.
about 7.7 million who suffer mental health issues.

Nationally, 49.4 percent of children with a mental health disorder did not receive
necessary treatment or counseling from a mental health professional. Prevalence rates
varied significantly throughout the country,

In California, nearly 1 in 13 kids suffers with a mental disorder severe enough to disrupt
daily living. California has fewer than 1,135 child and adolescent psychiatrists to serve
children and teens suffer from mental health issues. This mismatch means many kids do
not have access to care.

Due to Major Depression Disorder the Suicide rates are skyrocketing . The suicide rate in
adolescents and young adult currently is the third leading cause of death nationwide.

Medi-Cal covers mental health services, but the number of providers who accept it is limited and
most have a waiting list
•https://www.aafp.org/news/health-of-the-public/20190318childmentalillness.html
•https://centerforhealthjournalism.org/2019/04/22/there-s-huge-shortage-mental-health-providers-kids-who-need-help
Diagnosis & Criteria: DSM-5
 Mental health issues of children and indolence’s in U.S are:
Depression- 3.2% of children aged 3-17 years (approximately 1.9 million).
Anxiety problems- 7.1% of children aged 3-17 years (approximately 4.4 million).
Attention Deficit Hyperactivity Disorder (ADHD)- 9.4% of children aged 2-17 years
(approximately 6.1 million).
Autism-approximately 1 in 54 children in the U.S. is diagnosed with an autism spectrum
disorder (ASD).
Behavior problem 7.4% of children aged 3-17 years (approximately 4.5 million).
Bulimia and Anorexia-4% of adolescents and teens, ages 13 to 18, suffer from an anorexia,
bulimia, or binge eating disorder.
www.cdc.gov
https://www.cdc.gov/childrensmentalhealth/data.html#:~:text=3.2%25%20of%20children
%20aged%203,1.9%20million)%20have%20diagnosed%20depression.
TREATMENT PLAN

ADHD treatment plan
•Parent training in behavior management.
•Behavioral interventions in the classroom.
•Peer interventions that focus on behavior.
• Organizational skills training.
Parent Education and Support
•CDC funds the National Resource Center on ADHD (NRC), a program of Children and Adults with AttentionDeficit/Hyperactivity Disorder (CHADD). The NRC provides resources, information, and advice for parents on how to help their
child.

Medication for ADHD approved- Qelbree, a new non-stimulant medication for children with attention deficit hyperactivity
disorder (ADHD). Other medications: Strattera (atomoxetine), Intuniv (guanfacine), and Kapvay (clonidine).

Side effect: Sleep problems., Decreased appetite, Weight loss., Increased blood pressure, Dizziness, Headaches and
stomachaches, Rebound irritability when the medication wears off, Moodiness and irritability.
Note: Medication for ADHD should be considered when there is significant academic or social impairment, or there is a risk of
accidental injury due to impulsivity or hyperactivity.

Depression and Anxiety treatment plan

Screening is important part of treatment plan. Use peds/adolescents screening tools
•Cognitive behavior therapy and interpersonal therapy should be used for the treatment of mild depression. Psychotherapy
should be used in combination with medication for the treatment of moderate to severe depression in children and
adolescents.

Medication for depression and anxiety disorder for peds and adolescence-Tricyclic antidepressants should not be used in the
treatment of childhood and adolescent depression. Fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft) are
recommended as first-line treatments for childhood and adolescent depression.

Side effect SSRI feeling agitated, shaky or anxious feeling or being sick, indigestion, diarrhea or constipation. TCA
Anticholinergic effect.
www.cdc.gov
Continue w/ Treatment Plan
Autism treatment plan- Applied Behavioral Analysis (ABA) assessment, occupational
therapy, speech therapy, physical therapy, social skill Tx and pharmacological therapy.
• Medication Tx: Anticonvulsants, Anti-anxiety medications, Stimulants (increase focus and
decrease hyperactivity),SSRI (reduce the frequency and intensity of repetitive behaviors;
decrease anxiety, irritability, tantrums, and aggressive behavior; and improve eye
contact, and TCA (treat depression and obsessive-compulsive behaviors).
Bulimia and Anorexia• Early in the treatment, clinicians invite the family to share a picnic meal. That gives them
a sense of family meal patterns. It also allows them to suggest ways parents can get the
child to eat more.
Cognitive-behavioral therapy helps individuals change the unrealistically negative
thoughts they have about their appearance and change their eating behaviors.
Interpersonal psychotherapy helps individuals improve the quality of their relationships,
learn how to address conflicts head-on and expand their social networks.
• https://www.apa.org/topics/eating-disorders/treatment
LGBTQ Population
Bases on U.S Census 2020 approx. 1,012,000 LBGQs live in U.S. %54 of this
population are married.
Note: More Lesbians than Gays live in U.S.
One of the biggest headlines in the 2020 poll is the emergence of Generation Z
adults, those 18 to 23: 1 in 6, or 15.9%, identify as LGBTQ. In each older generation,
LGBTQ identification is lower, including 2% or less of respondents born before 1965.
In California City of San Francisco, have a higher percentage of same-sex households
is 3.0% than the national rate, according to the American Community Survey.
Many LGBTQ+ people experience mental health struggles. The bisexual and
transgender communities have the highest rates of mental health concerns within
the LGBTQ+ population. Younger members of the LGBTQ+ community struggle the
most with mental health concerns of all the age groups.
One study even found that LGBTQ+ people used mental health services at 2.5 times
higher rates than their “straight” counterparts. They are particular at risk for
experiencing shame, fear, discrimination, and adverse and traumatic events.
 https://www.mhanational.org/issues/lgbtq-communities-and-mental-health
 https://www.census.gov/library/visualizations/2019/comm/living-together-same-sex.htmlcouple live together and 46% unmarried and live together.
Diagnosis & Criteria: DSM-5
 DSM-V-Includes a separate, non-mental disorder diagnoses of gender dysphoria to describer people who
experience significant distress with the sex and gender they were assigned at birth.
In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric
Association has changed the diagnosis of gender identity disorder to gender dysphoria (GD).
Lesbians and Gays in comparison to heterosexuals show increased rates of mood and anxiety disorders.
 Higher rates of substance use compared to heterosexuals.
One in six gay men have made one suicide attempt in their lifetime.
Additionally, couples may face stressors that differ from those experienced by an individual. These can
include stress related to disclosing relationships to family, concerns for being safe in public spaces.
Discrimination towards gay men can affect access to work, health insurance and financial stability.
Additionally, patients may find it harder to disclose identity to healthcare providers and access health and
social supports. This risk of adverse health outcomes including HIV acquisition and decreased use of the
healthcare system.
LGBTQI youth and young adults have a 120% higher risk of experiencing homelessness — often the result
of family rejection or discrimination based on gender identity or sexual orientation
Mood disorder vividly seen in cross dressers.
file:///C:/Users/13106/OneDrive/Desktop/Mental-Health-Facts-for-Gay-Populations.pdf
Treatment Plan
 Facilitate emotion awareness, regulation, and acceptance.
• Provide trauma-informed care- LGBTQ people often experience trauma as gender minorities.
Common clinical concerns specific to LGBTQ individuals can be addressed by implementing the
following principles: Understand the impact of identity-based trauma on cognition, emotion,
behavior, and perception. Provide physical and emotional safety by meeting patient needs, clearly
establishing and communicating safety procedures, creating a predictable environment, and fostering
respectful relationships.
• Create an inclusive environment- Health Care Providers should ensure an inclusive environment by
collaborating with LGBTQ clients in program design, individual service planning, and the creation of
policies and procedures.
• Screen for trauma-Providers should consider specific stressful life experiences when assessing trauma
in gender-diverse people.
Immigrant/Migrant Workers
There are 3.1 million asylum seekers and
more than 25 million refugees, half of
whom are under 18 years old.
In U.S, 22,491 refugees were admitted in
the fiscal year 2018.
• systematic reviews show that prevalence
estimates of mental health disorders for this
population vary widely from 20% to 80%
specifically.
As seen in this graph only 3% referral are made to Mental Health Services, and this shows
that they are not receiving mental health care adequately as they need it.
psychiatry.org
Diagnosis & Criteria: DSM-5
The mental health disorder is varying among immigrants. It has wide variant base
on the socioeconomic status, the country they come from and the exposure they
had to stress and trauma.
Based on psychiatry.org research document:
4 to 40% for anxiety
 5 to 44% for depression
9 to 36% in PTSD
Treatment Plan
Providing mental health care for refugees and asylum seekers should be done in
partnership with the other social, cultural, and family supports around the individual
(psychiatry.org).
Refugees may be resistant to seeking mental health care due to beliefs that
diagnosis will interfere with jobs and housing. Also, culturally they have stigma
against receiving mental health treatment.
Helping patients engage with family strengthening and building social networks can
improve socialization and minimize isolation in result improved mental health.
Ethnic Minority Groups (specific ethnicities)
The most recent United States Census officially recognized five racial
categories (Black or African American, Asian American, American
Indian/Alaska Native, and Native Hawaiian/Pacific Islander).
• California’s population: 39% of state residents are 15% are Asian or Pacific
Islander, 6% are African American.
Which racial group is most likely to receive mental health services?
• Outpatient mental health service use in the past year was highest for adults
reporting American Indian or Alaska Native adults (7.7 percent), followed by
black (4.7 percent), and Hispanic (3.8 percent).
• https://www.samhsa.gov/data/sites/default/files/MHServicesUseAmongAdults/MHServicesUseAmongAdu
lts.pdf
Diagnosis & Criteria: DSM-5
Latino Population
• 18.3% of U.S Population is estimated to be Latino.
• Hispanic 16% reported to have mental issues.
 10% contact a mental health professional.
19% had no form of health insurance, according to a 2018 report.
National Alliance on Mental Illness (NAMI), common mental health
conditions among Latinos are generalized anxiety disorder, major
depression, post-traumatic stress disorder (PTSD) and substance use.
African American Population
Depression is one of the most common mental health problems among
African American.
11.5% of Black adults in the U.S. had no form of health insurance
American Indian or Alaska Native population – is U.S 109,751 (2019)
Native Americans, it is estimated that up to 70 percent of this population
will suffer some sort of mental health disorder during their lifetimes.
 higher rates of frequent distress-nearly 13 percent compared to nearly 9
percent in the general population.

Homepage

Treatment Plan
 Care provider need to consider these mentioned below before start psychiatric
behavior therapy
Cultural sensitivity and awareness- Being aware that cultural differences and
similarities between people exist without assigning them a value
Avoid stereotyping individuals base on their culture
Provide resources that help with that culture and ethnicity.
In case of language barrier provide translators.
Many cultures like to involve their family in decision making but again this is individual
bases. Effective communication is the key to find what is that person believe system is
despite the cultural back round they come from.
https://www.apa.org/pi/oema/resources/brochures/treatment-minority.pdf
References:
• https://laborcenter.berkeley.edu/aging-californias-retirement-crisis-state-and-local-indicators
• http://healthpolicy.ucla.edu/publications/Documents/PDF/2016/MentalHealthOlderAdult-Report.pdf
• https://www.chcf.org/wp-content/uploads/2018/03/MentalHealthCalifornia2018.pdf
• http://healthpolicy.ucla.edu/publications/Documents/PDF/2016/MentalHealthOlderAdult-Report.pdf
• https://acl.gov/sites/default/files/programs/201611/Issue%20Brief%204%20Preventing%20Suicide.pdf
• https://www.psychiatrictimes.com/view/psychotropic-drugs-and-falls-older-adults
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3083253/
• https://www.aafp.org/news/health-of-the-public/20190318childmentalillness.html
• https://centerforhealthjournalism.org/2019/04/22/there-s-huge-shortage-mental-health-providers-kids
-who-need-help
• https://www.apa.org/pi/oema/resources/brochures/treatment-minority.pdf
• https://www.samhsa.gov/data/sites/default/files/MHServicesUseAmongAdults/MHServicesUseAmongAd
ults.pdf
• psychiatry.org
• file:///C:/Users/13106/OneDrive/Desktop/Mental-Health-Facts-for-Gay-Populations.pdf
• https://www.apa.org/topics/eating-disorders/treatment