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Behavioral and Mental Health Case Studies


Scenario 1: A 23-year-old male, who dropped out of high school freshman year, still lives with his mother and father, both of whom would really like to see their son begin a new life in Job Corps.  While in school he was (1) diagnosed with ADHD, (2) chronically truant and oppositional with teachers and authority figures.  At 16, he was caught with alcohol and cited. He has no other criminal history. The applicant has been unable to hold a job more than 4 months, with his last job at a fast food restaurant. He denies any present drug or alcohol use and his last IEP places him at the 7th grade level for math, reading, and writing.

Disposition: Since this applicant has no significant legal history and, therefore, is eligible for Job Corps. He is not an imminent danger to self or others so per PRH-1 and does not meet criteria for direct threat. This applicant would likely be enrolled with considerations for reasonable accommodations.


Scenario 2: A 22-year-old female applicant was molested by an uncle while growing up and placed in foster care at 16 because her parents were unable to care for her. At 17 she assaulted a man with a knife in response to an alleged attempted rape. She was convicted of assault with a deadly weapon. She was offered multiple treatment programs but eventually went AWOL after a few weeks in each setting (3 settings). Each time she was found with prostitutes and pimps in an inner city area of town. Her psychological evaluation, in juvenile hall, describes her as superficially appearing compliant but can become angry and enraged quite easily with poor coping skills. She also suffers from post-traumatic stress syndrome which is documented in the file.

Disposition: This applicant would need an interview with the CMHC and based on the outcome of that interview the CMHC would consider either a direct threat or health care needs assessment to be submitted to the Regional Office for disposition. If the applicant’s current behavior and/or symptoms place her at imminent risk, then a direct threat assessment would be completed. If the applicant’s current behavior and/or symptoms do not rise to the level of direct threat but there are still safety and/or health care management concerns, then a health care needs assessment should be completed. If the applicant’s current behaviors and symptoms indicate she continues to have significant impulse control difficulties that impact her safety and the safety of others, she may be recommended for denial at this time.