Santa Rosa Medical Institution File:Libby Smith

Medicaid Number: 4001169-G49236512

Date:08/29/1998

Client Name: Libby Smith

DOB: 12/29/1979

Sex: Female

Age: 32

Date of Admission: 08/29/1998

Address: 2014 Ocean View Drive

Los Angeles, California 90219

Contact Person: Sally Lowen

Phone: 917-243-6537

Address: 2019 Ocean View Drive

Los Angeles, California 90219

Relationship to Patient: Neighbor and Friend

Referral Source:

Current Living Arrangements: lives alone, currently

Primary symptom described in "specific observable behavior" that requires acute hospital care (include: precipitant events leading to admission): seems severely depressed, will not eat any solid foods, only applesauce and water. Possible schizophrenic: claims to hear whispers. Has an irrational fear of polar bears and certain numerical patterns. Suicidal thoughts and signs, gives obscene amounts of money away to strangers. Seems to be mentally traumatized for some unknown reason.

Other Relevant clinical information, including inability to benefit from less restrictive setting (attach additional pages or documents, as necessary): Might have abused medications before she dropped out of medical school. Has a degree in clinical psychology. Upset about death of husband. Death was of natural causes. It was her third marriage. Traumatized for unknown reason, Will look at previous documents to find out. Has journal.

Psychiatric Medications (include daily doses): Prozac 1500 MG twice a day for depression, Thorazine 100MG twice a day for antipsychotic medications

Present and part drug/alcohol use: didn't drink heavily until after the end of her first marriage in 1989 and started drinking extremely heavily after death of third (and final) husband in 1998. Mixing prescription cough syrup and alcohol regularly.

Past Psychiatric Treatment: occasional therapy. Once a month. Says running helps her a lot.

Previous number of inpatient admissions: none

Previous ambulatory/outpatient treatment (prodder or facility): n/a

Dates of most recent inpatient stay: N/a

VI. Current Diagnosis: anorexia, schizophrenia and severe depression/suicidal thoughts

Additional Diagnosis: N.A.

Number of days requested: ninety days at the least

Projected Discharge Date: 11/29/1998

Signature: Genna Lipton MD

Print Name: Genna Lipton

License Number: 40052-1924-6499912-G49

Date: 8/29/1998