A. Identifying Information
The client is a 26 year old, single, male, African American. He is an active duty ship’s serviceman seaman serving in the United States Navy, aboard the USS Belleau Wood (LHA-3). Seaman (SN) Fisher is residing on board the USS Belleau Wood (LHA-3) that is permanently stationed at San Diego Naval Base, 32nd Street in California. SN Fisher was given orders to report to Navy Mental Health Services Department on base as Involuntary Command Referral for diagnosis and treatments, to get an evaluation and expert psychiatric recommendation about whether the service member is mentally fit to stay in the United States Navy. SN Fisher is unwilling to begin counseling, expressing to Lieutenant Commander (LCDR) Davenport, the attending psychiatrist, that he has “no problems,” and declaring that the Navy can order SN Fisher to report on prescribed dates, but LCDR Davenport can’t force him to talk about his anger, and rage when taunted by fellow sailors. B. Setting.
The setting is the Navy Mental Health Services Department, Pacific Fleet. Services provided are intended for crisis prevention such as Fitness for duty evaluations, Diagnostic Evaluations, Health psychology assessments, Individual and group therapies, Limited Duty reports, Pharmacotherapy, Medical Board reports and addendums, Temporary Duty Retirement List (TDRL) periodic physical evaluations, Involuntary Command Referral for diagnosis and treatment, Psychological testing, Military Court evaluations, including insanity boards , Department of the Navy Central Adjudication Facility (DONCAF) evaluations and Special assignment evaluations. Through the capability of a full range of mental health services including substance abuse treatment to the Fleet and Marines, to all other military beneficiaries and other Tricare Prime patients on a space available basis is the primary mission of the Mental Health Department, utilizing mental health providers from multiple specialties to support the mission of Navy Medicine. The department zealously implements the highest level of training to Psychiatry Residents and Psychology Interns as well as supports and initiates research that is pertinent to the mission of Navy Medicine, the USN and the Department of Defense (www.med.navy.mil, 2012).
C. Reason for Referral/ Presenting Problem.
SN Fisher was given a direct order to report for an evaluation at the Navy psychiatric department before their next underway period by his Commanding Officer. During the Captain’s Mast, SN Fisher was found guilty of article 128 for assaulting a higher ranking non-commissioned officer which resulted in SN Fisher going on restriction for 45 days, with forfeiture of $200.00 of his paycheck for two months, and a reduction of rank from ship’s serviceman third class petty officer to ship’s serviceman seaman. In addition, SN Fisher was restricted to ship’s boundary for 45 days and was given 45 days of extra duty while on restriction.
The ship’s commanding officer was concerned about SN Fisher’s behavior onboard the USS Belleau Wood (LHA-3). SN Fishers’ chain of command has reported that he is mostly a quiet sailor who performs his duties on an exemplary manner congruent to the Navy code of conduct. For the most part, SN Fisher keeps to himself; he performs well when working alone and associates himself only with a few friends within their division. However, his chain of command is also aware that he is an angry, lonely young sailor, from his uncalled-for altercation with fellow shipmates and his overall character early in his naval career. SN Fisher shows his disregard for authority even during the Captain’s Mast in front of the highest ranking officials on their command. During SN Fisher’s initial visit to LCDR Davenport, he was disinclined to begin the assessment process. He disputes his disagreement about his anger and rage outburst onboard the ship and made it clear to LCDR...