| Course | D346 Advanced Psychiatric Mental Health Care of Adults and Older Adults Across Care Settings |
|---|---|
| Task | Task 2 |
| Paper type | Psychiatric care transition plan |
| Length | About 900 words, 3 pages |
| Format | APA 7 |
| School | Western Governors University (WGU) |
| Program | MSN Psychiatric Mental Health Nurse Practitioner |
| Updated | September 2026 |
Free sample paper for D346 Task 2
Care Transition Plan: A 34-Year-Old Army Veteran Leaving a Crisis Stabilization Unit Four Days After an Intentional Overdose
Student Name
Leavitt School of Health, Western Governors University
D346: Advanced Psychiatric Mental Health Care of Adults and Older Adults, Task 2
Course Instructor
Month Day, Year
Care Transition Plan: A 34-Year-Old Army Veteran Leaving a Crisis Stabilization Unit Four Days After an Intentional Overdose
Situation
A composite 34-year-old Army veteran, now working as a heavy equipment operator, is being discharged from a county crisis stabilization unit after a four-day stay. He was brought to the emergency department after taking about 30 tablets of his partner's prescribed trazodone with alcohol following the end of his relationship and a job loss. He was medically cleared after 24 hours of observation. Diagnoses: major depressive disorder, single episode, severe, and alcohol use disorder, moderate. He also reports nightmares and hypervigilance since a deployment; a posttraumatic stress disorder evaluation is pending. He started sertraline 50 mg daily on the unit. He now denies suicidal intent, has completed a safety plan, and agrees to outpatient care. He lives alone in an apartment. He owns two rifles, which his brother has agreed to hold. He is enrolled for care with the Veterans Health Administration but has not used it in three years.
Why the Transition Matters
The period after leaving psychiatric care carries a very high risk of suicide. A meta-analysis of 100 studies found a pooled suicide rate of 484 per 100,000 person-years after discharge from psychiatric facilities, highest within the first three months and among patients admitted with suicidal thoughts or behavior (Chung et al., 2017). Among veterans treated in emergency departments for suicide-related concerns, a brief safety planning intervention with structured telephone follow-up was associated with 45% fewer suicidal behaviors over six months and more than doubled the odds of attending outpatient mental health care (Stanley et al., 2018). This plan builds on both findings: no gap before the first appointment, a safety plan he helped write, and follow-up calls that do not depend on him reaching out.
What the Receiving Team Needs
Sent today by secure message to the veterans' mental health clinic and his new primary care provider: discharge summary with diagnoses, the overdose history and toxicology; current medications, including sertraline 50 mg started four days ago; the signed safety plan; the name and phone number of his brother and his consent for contact; the lethal means agreement for the rifles; the pending posttraumatic stress disorder evaluation; the alcohol use findings and his stated goal to cut down; and the crisis unit clinician's contact for questions.
Tasks, Owners and Timing
Before discharge (crisis unit clinician): confirm the first outpatient appointment is booked, not just referred, and that he has the date, time and address written down; dispense a 7-day supply of sertraline only, to limit stockpiling; complete lethal means counseling, including locking up or removing any stored medications, and confirm by phone with his brother that the rifles are at the brother's home.
Within 24 to 72 hours (crisis unit follow-up nurse): first caring phone call to review the safety plan, ask about suicidal thoughts, sleep, alcohol use and medication, and confirm the appointment. Calls then weekly until the first outpatient visit and for at least four weeks after, since structured follow-up calls are part of the approach linked to fewer suicidal behaviors (Stanley et al., 2018).
Within 7 days (veterans' mental health clinic, psychiatric-mental health nurse practitioner): intake visit, reassessment of suicide risk, review of sertraline and plan for titration, a new 30-day prescription with refills limited to what he needs, and referral for evidence-based psychotherapy for depression and trauma.
Within 14 days (veterans' substance use program): assessment for alcohol use disorder and discussion of treatment options, including medication for alcohol use disorder if he chooses it.
Within 30 days (primary care): general health visit, liver tests and review of sleep; primary care is informed that trazodone and other sedating medicines in the home should be minimized.
The Days When Patients Are Most Often Lost
Most failures happen between discharge and the first appointment, and after a missed appointment. To close these gaps: the appointment is inside seven days; the follow-up nurse calls if he does not attend, the same day, and then his brother with his prior consent; the veterans' clinic's caring contacts program sends brief text messages for 12 months; and he has the national veterans crisis line saved in his phone, with its three-digit number and the option to text (U.S. Department of Veterans Affairs, 2024).
Patient and Family Role
He agreed to keep his safety plan on his phone and in his wallet, to call his brother or the crisis line when he notices his warning signs, and to avoid alcohol for the first month while starting treatment. His brother agreed to hold the rifles until the outpatient team and the patient agree that it is safe to return them, to check in by phone daily for the first week and to call the crisis line if concerned. Both know who to call at the clinic and after hours.
Measures of a Successful Transition
Contact made within 72 hours of discharge; first outpatient visit attended within seven days; safety plan reviewed at each contact; rifles remaining with his brother at 30 days; alcohol assessment completed within 14 days; and no emergency visit or readmission for self-harm at 90 days. The crisis unit reviews each of these as part of its discharge quality process.
References
Chung, D. T., Ryan, C. J., Hadzi-Pavlovic, D., Singh, S. P., Stanton, C., & Large, M. M. (2017). Suicide rates after discharge from psychiatric facilities: A systematic review and meta-analysis. JAMA Psychiatry, 74(7), 694-702. https://doi.org/10.1001/jamapsychiatry.2017.1044
Stanley, B., Brown, G. K., Brenner, L. A., Galfalvy, H. C., Currier, G. W., Knox, K. L., Chaudhury, S. R., Bush, A. L., & Green, K. L. (2018). Comparison of the safety planning intervention with follow-up vs usual care of suicidal patients treated in the emergency department. JAMA Psychiatry, 75(9), 894-900. https://doi.org/10.1001/jamapsychiatry.2018.1776
U.S. Department of Veterans Affairs. (2024). Veterans Crisis Line. https://www.veteranscrisisline.net/
What the D346 Task 2 instructions ask
The second D346 task asks you to plan a safe transition of care for a psychiatric patient moving between settings. Most versions ask for the situation, the risks of the transition, information the receiving team needs, tasks with owners and timing, strategies for high-risk gaps, the role of the patient and family and measures of success. Evaluators look for a plan organized by who does what and when, with the highest-risk periods addressed directly. Evidence on post-discharge risk and on interventions such as safety planning should support the plan. A discharge summary without tasks, owners or follow-up checks does not meet the coordination aspects. Some versions ask how the plan reflects the patient's preferences.
How this D346 Task 2 example is built
The plan opens with the situation and a short explanation of why transitions are dangerous. The information section lists exactly what is sent, to whom and how. Tasks are organized by timing, before discharge, within 72 hours and within seven days, and each has an owner. A separate section addresses the gaps where patients are most often lost, such as between discharge and the first appointment. The patient's role includes a safety plan he keeps with him, and his family's role includes lethal means safety. Measures of success are specific and checkable. Sources include a meta-analysis on post-discharge suicide and a trial of safety planning with follow-up. The measures section lets a reader check the plan's success a week after discharge.
Where the D346 Task 2 rubric puts the marks
D346 Task 2 aspects are rated competent, approaching competence or not evident. A situation aspect checks that the transition and its risks are described. An information aspect asks what the receiving providers need and how it reaches them. A tasks aspect rewards specific actions with owners and timing. A gaps aspect looks for strategies aimed at the highest-risk periods. A patient and family aspect wants their roles defined. A measures aspect asks how success will be judged. Evaluators expect evidence on transition risk and interventions to be current and cited, and they notice whether lethal means safety is addressed explicitly. Evaluators look for the plan to name who calls the patient if the first appointment is missed.
D346 Task 2 help: what sends it back
Transition plans come back most often when tasks have no owner. Assign each to a role and a time. Second, the first appointment is referred rather than booked. Book it before discharge and confirm the patient has the details. Third, the gap after a missed appointment is ignored. Plan outreach for that event. Fourth, lethal means are not addressed. Include a plan for firearms and medications with the patient and family. Finally, measure the transition. Contact within 72 hours and a first visit within seven days are simple measures that show whether the plan worked. Give the patient a printed copy of every appointment and number.
Get a D346 Task 2 example written to your instructions
Send the D346 Task 2 instructions and rubric aspects, plus the transition your task specifies or the setting you have been placed in. We build a composite example to those aspects, with the handoff record written out and responsibilities assigned, and return it in 24-48h. The first custom sample is free.
More D346 papers
Other NP track sample papers
- D347 Task 1 Developmental Assessment
- D120 Task 1 Population Risk Analysis
- D344 Task 1 Psychiatric Evaluation Write-up
- D343 Task 1 Role and Scope Analysis
D346 Task 2 questions, answered
Which transition works best for this task?
Whichever your instructions allow, chosen for how much you can say about both ends of it. Inpatient to outpatient, emergency department to community care, residential to home and correctional release all give the plan enough friction to work with. Pick one where you can describe the receiving setting concretely, since vague receivers produce vague responsibilities.
How is this different from the treatment plan task?
The earlier task builds care for one patient in one setting and holds it against comorbidity. This one moves that care across a boundary, where information is lost, ownership changes hands and appointments fall through. Same patient, different failure modes, and most of the space belongs to communication, responsibility and verification rather than to intervention choice.
Do I need policy citations for a coordination task?
Support the claims that carry weight. Readmission risk after psychiatric hospitalization, the effect of early follow-up contact and the value of medicine reconciliation all have published evidence behind them, and an aspect asking for supported practice expects it. Local procedure can be described without a citation, provided you are clear that it is local rather than general.
Which transition works best for D346 Task 2?
One with real risk and several handoffs, such as discharge from inpatient or crisis care to outpatient treatment. The sample plans a veteran's transition after an intentional overdose.
Where can I find a free D346 Task 2 sample paper?
The whole transition plan is reproduced above with margin notes. Share your D346 instructions and case details, and a first tailored transition plan is prepared for you free of charge.