Mallory is an 18-year-old 12th grade student at Thornhill Secondary School. She is in her fifth year of high school. He is currently taking 2 subjects, English and Art. He lives with his parents and 12-year-old brother. She was brought to the emergency room by her mother after expressing suicidal ideation. Mallory has had contact with various members of our department. He had a brief hospitalization at 7-North about a year ago. She was first evaluated in CAMHOP by Dr. Propst when she was 12 years old. She was seen at CAMHOP by both Dr. Propst and Mr. Larry Schein. She was treated with medications and individual and family therapy. He also received group therapy through his CAMHOP. Mallory was also seen by me at our emergency room about 6 months ago. She is transitioning from children's mental health services to adult mental health services and has an appointment with Dr. Joan Tucker in February 2014. Previously, Mallory was taking psychotropic medications, specifically various antidepressants. His most recent antidepressant was Effexor, but he stopped it in the spring of 2013, saying he was experiencing side effects including nausea and dizziness. She didn't think the drugs were particularly helpful either. You last saw Mr. Schein about 2 weeks ago. Saw Dr. Propst about 2 months ago. He finished group psychotherapy at CAMHOP about 2 weeks ago. Mallory has repeatedly experienced suicidal ideation in the past. Suicidal ideation is passive rather than active in nature. He has never attempted suicide. A couple of days before arriving at the emergency room he began to have thoughts of self-harm again. Sh... middle of paper... reasonably well with colleagues and staff. His mannerisms were found to be consistent with those of a person under the age of 18. He asked for leave and said he wanted to go back to school so he wouldn't risk losing his credits. IMPRESSION AND PLAN: Mallory presents as an adolescent with a diagnosis of trichotillomania, learning disability, parent-child relationship problem, and cluster B traits. She is not currently taking any medications and I do not recommend the use of an antidepressant. I explained to both Mallory and her mother that she is a reasonably healthy person with some limited coping skills, but that she does not require prolonged hospitalization as this may reinforce the idea of ​​a sick role. Mallory can be discharged from 7-North. Follow-up will be done with CAMHOP for now and with Dr. Tucker starting in February 2014.