Has Anyone Had An Assessment With A Forensic Psychiatrist?

[Hashi]

I wonder could you clarify what you mean by 'litigation'?

You're right, I don't know why I'm using that word. I think I'm just too tired to try to be rational. I'm not sure I agree about capacity vs liability, but I'm not going to attempt that now since I obviously can't think straight enough.

I'm just trying to say that I think an assessment is more likely to be about treatment than legal action. I don't see a need to "lawyer up" at this point. Maybe you disagree, in terms of how things are practised?

 

[Laura 2]

@Hashi
Many thanks for your response.

I was genuinely confused! (Which is more or less status normal...sigh)

So I thought it would be a good idea to be as clear as possible about our terminology - for Stenni's sake as well as anyone else who comes looking for similar info.

I stand by my original humble opinion which is yours too: that the forensic psychiatrist appt is most likely about risk (to self and others) assessment and appropriate treatment in the light of the episode of recent dangerous behaviour.

 

[Pencil]

The forensic psychiatrist is a result of Stenni driving into the entrance.

 

[Sandstone]

@Hashi I had no knowledge of Forensic Psychiatry, and the two links you posted are the ones I looked at which confirmed my instinctive alarm. The two passages

"a specialty which helps mentally disordered people who are a risk to the public" and
"deals with some of the most disturbed and difficult to manage patients in psychiatric practice. Its focus is the assessment and treatment of mentally disordered offenders, and other patients, presenting with severe mental disorder in association with significant behavioural disturbance. Treatment settings vary from high security hospitals through to medium secure units and community forensic services, as well as the opportunity to treat patients in prison settings"

are enough to terrify anyone.

At the time the idea was put forward, I only felt that the Psych. had expected me to resist the idea, and that the explanation he gave - to assess the risk you may do it again - was not the whole story.

So far as that risk goes - I have more knowledge now.

I know that if I take repeated doses of sleeping pills and anti-histamines, or of Lorazepam they won't work as I intended to keep me out of harm. Instead they will affect my thinking to the stage where a substantial overdose looks like a good idea and an effective solution. So I'm refusing to have any pills in the house, even when offered a prescription for just a few
I know that it is a bad idea for me to drive at the moment because pills and the car are my two favoured ways out.
I know that since the keys to my husbands car are availabIe to me I need to have fixed in my mind a crash place that will reduce risk to others, so I've picked out a farm gate on quiet track nearby, that I could get to without driving anywhere busy.

It seems that in the meeting I don't recall, I was asked if I was likely to do it again, and said I couldn't know that. I've had a chat with my former private therapist and she says I need to stop being so literal and honest (!) and express more emotion. But it seems to me bad enough that I've done the deed, I don't think I have the right to go round emoting about it.

 

[Pencil]

are the ones I looked at which confirmed my instinctive alarm. The two passages
"a specialty which helps mentally disordered people who are a risk to the public" and
"deals with some of the most disturbed and difficult to manage patients in psychiatric practice. Its focus is the assessment and treatment of mentally disordered offenders, and other patients, presenting with severe mental disorder in association with significant behavioural disturbance. Treatment settings vary from high security hospitals through to medium secure units and community forensic services, as well as the opportunity to treat patients in prison settings"
are enough to terrify anyone.
At the time the idea was put forward, I only felt that the Psych. had expected me to resist the idea, and that the explanation he gave - to assess the risk you may do it again - was not the whole story.

And I was trying to avoid a discussion that would scare the hell out of you. And I was trying to get you to see that you need to go into this informed. So, I'll repeat: I think legal advice is crucial. You need to ask the following:
1. Can I be prosecuted for intentionally driving my car into the entrance hall?
If not, whoopee, let's party. (NOT. Of course you are liable)
If yes, a) what is the best course of action / plea / defense.
b) Why does the NHS want me to see a forensic psychiatrist? Where are they going with this? Is it to determine whether I'm fit to stand trial? If yes, what are the implications. If not, what are the implications.
c) If they insist on culpability, can I argue that I should have received the treatment that I requested on numerous occasions and in which they failed me. If I do, how will the court AND the NHS respond to this?
d) If I argue that I did not know what I was doing because I had taken 9 different meds, how will that be dealt with? Will it reduce or increase my culpability?

And so on and so forth. I'm a little rattled by the Anthony's post on death of a loved one at the moment, and don't want to argue my viewpoint. So, I won't go on. Stenni, please just ignore if you think I'm off the mark. But as far as I can see from your posts, you've now been referred to TWO psych evaluations: One for a dx and treatment plan, and another to a forensic psychiatrist relating to the car incident. Ultimately, forensic psychiatry (world wide) is involved in criminal matters - it is where psychiatry and the law meet. And it is not simply to decide whether you are fit to stand trial or not, although it is part of it. It is also about risk - to decide whether you are a long term risk to yourself and society (based on the reasons for deciding whether you are fit to stand trial or not.)

I

 

[ghotiff]

private therapist and she says I need to stop being so literal and honest (!) and express more emotion. But it seems to me bad enough that I've done the deed, I don't think I have the right to go round emoting about it.

I really agree with this advice.

Honesty is a relative thing. If you put a different personality type inside you you will see that a different personality type would answer this question differently.

A silly example, but I know many people who tell me that they will be somewhere at 7pm, but Iook at where they are driving from and know that based on where they will be prior, the traffic etc they will not be able to be there at 7pm. They want to be there at 7pm...so thats what they say.

My point is, you do not want to do this again. You are putting things in place so you won't do this again. So answer that it won't happen again. Yes, there is always a risk....but sometimes I think people with our types of past interpret risk at a different level than others. Maybe its your hyper-vigilance that makes it hard for you to commit to the statement 'it won't happen again'.

And, regarding emoting. You need to do this. You need to show that you feel bad/regret/? about what happened etc. I know you do feel, you just need to be able to emotionally show that. I know people at work who don't believe me unless I express a sufficient level of emotion when I say something....and this is a work task which should have no emotions to it. My point is, if you are talking to someone who needs to see emotion....then you will need to show it.

My wording in this post is strong and I can't seem to tone it down, but I'm hoping it reads as supportive (which is what I am intending).

 

[Sandstone]

But I can only show emotion in a safe place, and right now there are hardly any of those. Being shut in a room with two or more people feels incredibly unsafe and I immediately begin to react as I did as a child. I'm planning to take my panda with me in future as he is a good source of comfort and security and perhaps I'll be able to speak better with him present.

You need to show that you feel bad/regret/? about what happened

I've written to the people I did it to - they know. The people I'm dealing with now weren't there, they work in a different building.

I wrote
"I am writing to apologise to you for endangering you and for the distress I know I will have caused by crashing my car as I did.
I was acting under the influence of self-administerd drugs, but that is no excuse for treating you as I did.
I am sorry, and I hope you are recovering with the support of your families and colleagues."


To me it goes without saying that it was an appalling thing to do, and I couldn't have done it unless under the influence of drugs. You can't treat people like that - it's wrong. I'm starting from that as a base and I assumed that the Psychs, being intelligent people would know that.

 

[Laura 2]

I'm starting from that as a base and I assumed that the Psychs, being intelligent people would know that.

I don't believe that we can assume anything about Psychs. They are just people. When they get upset or freaked out they cling to the rules, the law or even lash out (usually bureaucratically) at patients.

 

[ghotiff]

But I can only show emotion in a safe place

I can understand having difficulty showing emotion in these types of situations. You can show 'emotions' in other ways than body language that might suit you better.

Can you show it with words....are you able to state in words what you feel? Maybe have a couple of phrases at the ready to throw in that you strongly believe (if you believe them then a good psyc will see the truth, even if your body language is closed and guarded). Eg from above you wrote "it was an appalling thing to do", "is no excuse for treating you as I did", "I am sorry", "it's wrong"

Hope that helps.

 

[Sandstone]

I can really only do it on paper or to some degree over the phone. Once face to face with anyone who wants to poke into me I fold up and collapse. It starts in the waiting room where I am trapped and exposed, with all those competent people walking past me and the risk of encountering former colleagues who will see my abject failure.

By the time I've got into the room I can't think properly, can speak very little and I'm sure I don't really hear what they are saying. If I do manage to get it together, I end up in formal work mode and act/speak as if I'm in a meeting.

 

[ghotiff]

I can't think properly, can speak very little and I'm sure I don't really hear what they are saying. If I do manage to get it together, I end up in formal work mode and act/speak as if I'm in a meeting.

I do that too! ...I tend to always go into work-mode at the most "inappropriate" times :banghead:

Good luck.

 

[Laura 2]

Gosh, I do the same thing as you guys....
=get tongue-tied and/or formal. I thought it was just me.

First time I've really thought about it past that. But, for me, like @stenni, I don't want to expose myself to the world randomly and possibly former colleagues. (This actually happened: a victim support worker turned up once when I was very broken down. Turned out I had been 4 tiers above her in the chain of command at our then work. It was embarrassing that she waxed lyrical about me as some sort of admirable whizzkid back then and then shockingly threw her arms about me. She was unable to see past who I'd apparently been and thus shockingly unable to grasp that, due to the terrifying, abusive therapist who used to maul me, physical touch is such a trigger.)

Also, @ghotiff, I must have written hundreds of thousands of words explaining it all. Having been an academic and working alongside professionals from many public services, I know how to write reports etc. So I can find no other way but to write logically and formally. When they read this rational analysis stuff, they seem to assume that I'm not as broken as I am in day-to-day life...'Oh,' they say, 'You have a great deal of insight!' and leave me to it which, in practice, means that I degenerate further.

MH services et al seem only to be able to deal with people who go psychotic. But I would strongly argue that people perhaps often only go psychotic when they are not being listened to or they are being ignored or mislabelled...

Thus, as far as I see it, MH services are to a large degree part of the problem: e.g. making one wait and wait for treatment/support - which, when it comes, is very expensive due to all the complications produced by this 'Watch and wait' policy. (How much of the chronic NHS's financial crisis is caused by failure demand...?)

A low-cost stitch in time saves nine very costly and sometimes fatal stitches. In their hubris and what seems to be self-righteousness, they don't or won't get this simple equation.

...which brings us back to our topic and Stenni's awful need to literally crash into them to wake them up to her desperately dire chronic suffering...