Case Study
Patient Demographic: Client Age: 22 Sex: Male Gender: Male Sexuality: Homosexual Ethnicity: Latino American Relationship Status: Single Counseling Setting: Community Mental Health Center Type of Counseling: Individual Presenting Problem: Depression Diagnosis: Major Depressive Disorder, Moderate
Mental Status Exam: Mental Status Exam: The client is pleasant and dressed in age-appropriate attire. He is tearful when discussing his family and states this has been difficult for him. The client has had no previous suicide attempts. He is observed biting his nails. He describes feeling sad daily and states he sleeps during the day because he cannot sleep at night. He is slightly underweight but denied any difficulties with appetite. The client’s speech is coherent and clear. He denies suicidal ideation but often questions his worth and purpose. Fam
Presenting Problem: You are providing counseling services at a Community Mental Health Center. A 22-year-old Latino male, accompanied by his aunt, presents with symptoms of depression. The aunt is concerned about the client’s social isolation, feelings of hopelessness, and excessive daytime sleeping. Four months ago, the client’s parents kicked him out of their home after discovering a suggestive social media post of him with another male. He is close with his aunt and uncle, who have allowed him to stay in their basement. The client’s father refuses to speak to him and has told him he is “less than a man” and an embarrassment to the family. The client’s symptoms worsened last month when he was laid off from his job as a server.
Other Contexts:    ily and Work History: The client was recently laid off from his job as a server at an upscale restaurant in the downtown area. He misses the sense of family he had with his previous co-workers and feels “stuck” and “unable to move forward.” The client is a third-generation Cuban American whose paternal grandparents immigrated to the United States during Castro’s regime. His parents worked hard to put him and his siblings through Catholic school and instilled in him traditional heteronormative religious values and “familism” (i\. e., the belief that the family unit is more important than individual needs). The client also has a strong work ethic but states he is poorly motivated to seek another job because he doesn’t want to be “shot down.” History of Condition: The client reports that he has struggled with bouts of depression from a very early age. He explains that he never felt like he fit in. In middle school, he was bullied and harassed. He remembers locking himself in his room, crying, and asking God for help during this time. He continued to ask for forgiveness and bargain with God as he grew older. In his mid- to late-teens, he began drinking and vaping, “because I couldn’t keep my end of the bargain,” he explains. Despite finding acceptance in the community, he still feels guilty for disappointing his parents. The client reports feeling “defective” and carries a significant amount of shame related to his sexual orientation

Question: Given the client’s background, all of the following factors may place him at higher risk for suicide EXCEPT:
(A): Previous suicide attempt
(B): Social isolation
(C): Sexual orientation
(D): Job loss

Correct Answer: Previous suicide attempt
Explanation: Job loss, social isolation, sexual orientation, and previous suicide attempts all place individuals at higher risk for suicide. The client has experienced job loss and social isolation. His depressive symptoms were further complicated by his family’s response to his sexual orientation. However, the client denied suicidal ideation as well as previous suicide attempts in his mental status exam, so this factor would not place him at higher risk for suicide. Therefore, the correct answer is (D)
Competency: intake, assessment, and diagnosis