Sue Hernandez, a 35-year-old female, has been diagnosed with Schizophrenia Disorder exhibiting
delusions and hallucinations. Sue identifies as a white, Hispanic, straight woman who has never
been married. Sue is an Iraq War veteran. She served as a liaison to human resources and then as a
paramedic and was honorably discharged in 2009. Before she served, she received a degree in
medical technology at a local community college. Her father was a veteran and she grew up on
army bases. She attended five high schools in four years. Her mother was a secretary and a teacher.
She has not seen her family for two years; she lived with them after her return from Iraq, but both
parents and Sue could not find a peaceful way to live together. Sue can often be seen walking to
and from the downtown area and the local grocery store. She spends most of her days on the
streets. A case manager working downtown saw her walking through the rain and called a friend
working for a shelter. She asked if she could refer Sue. The outreach team located Sue during one of
her walks the following week and learned that Sue cleans up several local businesses late at night.
She sleeps in the places she cleans. Sue appeared sober but complained of hearing voices. She
believes that she is in danger from wild animals most of the time. Sue also often fears for her life
and believes her parents will find her and kill her. Sue has never been arrested and indicates she
doesn’t want to live in a house, and does not want to live with anybody around. People and noises
scare Sue and she has trouble sleeping. The outreach worker referred Sue to you, a case manager
at a local homeless shelter providing comprehensive care. Reluctantly, Sue agreed to come to an
initial interview.
How does someone engaging in self-injurious behaviors differ from someone who is suicidal? What interventions would you apply when working with a
How does someone engaging in self-injurious behaviors differ from someone who is suicidal? What interventions would you apply when working with a client engaging in self-injurious behaviors?