Clinical overview
Psychosis is a medical emergency until proven otherwise on first presentation. Schizophrenia, schizoaffective disorder, and delusional disorder are longitudinal diagnoses. A Hollywood PMHNP-BC practice can maintain antipsychotics, monitor metabolic effects, and coordinate therapy once the person is outpatient-stable. We do not claim to run an inpatient unit, a clozapine REMS program by default, or a first-episode psychosis research clinic.
How we evaluate
New-onset hallucinations, command suicidal or homicidal content, severe disorganization, or catatonia go to emergency care. In clinic we review diagnosis duration, mood episodes (to separate schizoaffective from bipolar-with-psychosis), substances, and medical causes (steroids, encephalitis, delirium). Family collateral is requested when insight is limited.
Treatment stance
Maintenance may include an oral or long-acting injectable antipsychotic, metabolic labs, and movement-side-effect monitoring. Hormone or wellness services are not treatments for schizophrenia. If clozapine, court-ordered care, or assertive community treatment is required, we refer. Florida telehealth is not appropriate when the patient cannot participate safely or is not in Florida.
When to seek care
Call 911 or go to an emergency department for first-break psychosis, inability to care for self, or dangerous command hallucinations. Use this clinic for ongoing outpatient medication management after stabilization.