Forensic

Question 1

Erotomania - Assessment ABC

Answer 1

• A:
  
  • What were you planning? What was the aim? Do you plan to harm her?
  • How do you feel towards her? Do you believe she loves you? On what basis? How convinced are you?
  • Have you been following her? Do you know where she lives? Do you know her friends?
  • Do you have any sexual/violent fantasies about what you want to do to her?
• B:
  
  • Do you have a weapon on you?
• C:
  
  • What is your plan now? What would you do if prevented?

Question 2

Erotomania - Assessment Background

Answer 2

• Do you have any history with this person? Were you ever rejected by them?
• Have you ever done something like this before in a previous relationship?
• Have you ever been in trouble with the police?
• Do you have any history of violent/sexual crimes?
• Do you drink alcohol/use drugs?
• Have you ever had thoughts of harming yourself?
• Who else is at home?

Question 3

Erotomania - Explanation to victim

Answer 3

• Acknowledge can break confidentiality due to risk but only limited details around risk specifically
• Explain Mr X has a belief you are in love with him, were you aware of this?
• Have you been aware of him following you? Trying to contact you?
• From assessment I suspect diagnosis of Erotomania - a condition in which a person had a firm and unchallengable belief that others are in love with them.
  
  • N.B no one thinks you are responsible for this
  • Type of delusional mental illness

Question 4

Erotomania - Advice to victim

Answer 4

• Share concerns about risk - does he know where they live? their contact number?
  
  • Did he share his plans? fantasies?
• Would advise against heading home for the time being
  
  • Stay with friends or family if possible, else hospital can arrange accomodation
  • We can arrange transport from work
• May be appropriate for you to take a break from work - will inform management of this
• Don’t agree to see/speak to patient, if he makes contact call police and record
• If you see him make you way to a public place, avoid unlit isolated places
• Keep phone on you
• Tell people ytour plans if going out
• Inform friends and family of ths situation
• Police will continue to search for him, if found likely to be detained for further MH assessment (not here)

Question 5

Morbid Jealousy - Assessment of beliefs

Answer 5

• How is your relationship with you wife at the moment?
• When did you start believing she was being unfaithful?
• Who do you think she is having the affair with?
• What triggered your suspicions?
• What evidence do you have of this?
• Have you searched her belongings/messages for evidence?
• Have you followed her or the other party?
• Have you confronted either party about the affair?
• On a scale of 1-10 how convinced are you about your beliefs?

Question 6

Morbid Jealousy - Assessment of risk

Answer 6

• What are your plans for the situation? Do you plan to confront your wife or the other party?
• What will you do if she denies it?
• Do you have any plans to hurt either party? Have you got a weapon?
• Do you have any children at home? How old are they? Have you thought about harming them?
• Have you had any thoughts of harming yourself? How?
• Have you suspected partners in the past of infidelity, what happened?
• Have you ever been in trouble with the police? Have you ever been violent in a previous relationship?

Question 7

Morbid Jealousy - Other Questions

Answer 7

• Have you been using alcohol/drugs recently?
  
  • How much and more than usual?
• Have you had any sexual problems with your wife?
  
  • In what way and how long for
• Have you had issues with previous relationships?
• Have you been low in mood, hopeless recently?
• Have you had any unusual experiences like hearing voices?
• Do you believe other people might be out to harm you?
• Would you be willing to come in to hospital?
• May I speak with your wife?

Question 8

Morbid Jealousy - Management (Explaining to Partner)

Answer 8

• Check understanding of situation
• From my assessment he has a strong belief that you are having affair with no reasonable evidence for this - we call this morbid jealousy and it is a type of delusional disorder
  
  • The belief is firm and unshakeable even in the face of contrary evidence
• I am concerned about his risks to you and believe that he should come into hospital, if he does not agree with this he may need to be detained under the Mental Health Act for a period of treatment.
• As an inpatient he may be started on medication - antipsychotics which help with these types of delusional ideas
• Later when he is more stable we could try talking therapies, a commonly used one in these situations is called cognitive behavioural therapy
• He will be assessed by an MDT and we will support you and communicate with you throughout this process.
• Later when he is better we might try him on leave with accompaniement by a nurse
• When he ready for hom he will be followed up by the community menal health team.
• You will be invited to be involved in decisions where possible.

Question 9

Sexual Offence (Child) - Event Assessment

Answer 9

• Are you aware of the current allegations around the offence?
• Given the natureof the offence I will need to ask some personal questions, is that okay?
• A:
  
  • What happened today?
  • How do you know the victim? How long for? How frequently do you care for them?
• B:
  
  • Where were you?
  • Was anyone else present?
  • Were you sexually aroused by what happened?
• C:
  
  • Did you masturbate after?
  • How do you feel about what has happened?

Question 10

Sexual Offence (Child) - Psychosexual History Assessment

Answer 10

• Are you in a relationship? How long for?
• How is your relationship going?
• Have you been in previous relationships?
• Do you recall what age you reached puberty?
• What age did you first masturbate at?
• What age did you have your first sexual experiences?
• Do you watch pornography to satisfy your desires?
  
  • What kind?
• Do you engage in other behaviours to achieve arousal?
• Are you attracted to children?

Question 11

Sexual Offence (Child) - Background/Risk

Answer 11

• Do you have any personal/family history of mental health problems?
• Have you ever been in trouble with the police before?
  
  • What happened?
• Do you have any regular contact with children at the moment?
• Do you use any drugs?
• Do you drink alcohol?

Question 12

Firesetting - Assessment of event

Answer 12

• Can you tell me what happened to lead you to be detained here?
• A:
  
  • What happened before you started the fire?
  • Did you make any plans before or was it impulsive?
  • Were you on your own?
• B:
  
  • How did you start the fire?
  • Did you use anything to fuel it?
  • How did it progress?
• C:
  
  • What happened after?
  • How were you caught?
  • Did you think about the consequences to yourself/others/property?
  • How do you feel about it now? (remorse/victim empathy?
  • Would you do it again?

Question 13

Firesetting Assessment - Background

Answer 13

• Is this the first time you have been involved in setting a fire?
  
  • If not what was the biggest fire you caused?
• How did you feel before the fire? Were you tense?
• How did you feel after the fire? Better?
• Do you ever feel sexually aroused when setting a fire?
• Did you intend to end your life?
• Any major traumas in the past?
• Any difficulties with the police?
• Drugs/ETOH
• Screen for depression/psychosis