Mental Health Assignment Critically Discussing Medical Scenarios

Question

Mental Health Assignment Task:
For each of the following scenarios, provide the following:

1. The diagnosis provided or the diagnosis you suspect based on the information provided
2. Whether there are any questions about fitness to stand trial based on the information available to you (and if so, on what basis)
3. Whether you think the person in each scenario might be found NCR based on the information available to you (just take an educated guess!) and provide one reason for your answer

1. Mr. R has a long-standing history of schizophrenia and of not taking his medication while living in the community. According to Mr. R’s co-workers and family, Mr. R was not taking his medication at the time of the offence, appeared to be hearing voices and was laughing to himself. Mr. R had also begun telling co-workers about his super human powers. Mr. R had a history of making threats against his boss, stating, “I’m going to come get you some day”. On the day of the offence, Mr. R attended at work and entered into a verbal argument with his boss about his showing up late for work daily. As the argument escalated Mr. R pushed his boss onto a desk. He then said, “If you tell anyone about this, I won’t just push you next time”.
2. Ms. Q had never been seen by a psychiatrist before or hospitalized for mental health reasons. She reported she suffered depression when younger but denied any current symptoms. According to family and friends, Ms. Q had become increasingly preoccupied with the television show the X-files and referred to herself as Scully in the weeks before the offence. On the evening of the offence, Ms. Q’s sister arrived home and began making dinner in the kitchen. Ms. Q suddenly appeared from the bedroom rambling about how she was going to save her sister, grabbed the knife from her sister and stabbed her in the arm. On admission to hospital, Ms. Q admitted stabbing her sister so she could release the alien who was poisoning her blood.
3. On the night of the index offence, Mr. W consumed 24 beers and smoked two grams of cocaine. Mr. W was charged with making harassing phone calls after making 30 phone calls over a period of two hours to a local community centre. Mr. W was generally incoherent during these calls but would scream into the phone “Help me! They are coming to get me!”. On admission to the hospital Mr. W was disorganized and talking about how people were trying to kill him. A few days later Mr. W did not present with any symptoms of mental illness, could not recall the phone calls and was sorry about his phone calls to the centre.
4. Mrs. Y has a long-standing history of bipolar disorder. She was charged with mischief after causing a disturbance in a coffee shop. She acknowledges a history of mental illness but does not want her lawyer to pursue an NCR defense. She can describe the roles of the judge, the crown, her defense lawyer, an oath and understands the court process. She believes her lawyer is involved in a conspiracy with the crown and judge to have her hospitalized.
5. Mr. X was charged with uttering threats after threatening his ex-girlfriend. He was high on cocaine at the time of the offence. He has previously been convicted of uttering threats, assault and carrying a weapon for which he was found guilty. He denied he threatened his ex-girlfriend or using any illegal substances. He refuses to discuss the charges or any court related issues.

Answer

1. Mr R
The scenario analysed in this section of mental health assignment shows that Mr R is suffering from schizophrenia. When this disease occurs, people lose their judgment and control over their anger (Marx et al., 2020). As a result, Mr R forgets everything and pushes his boss away, saying that in the future he will not only push but will do more if he tells anyone. He also used to laugh alone when he heard a sound, which is often the result of hallucinations. He also told his colleagues that he is a man with supernatural powers. All these behaviours are indicative of his disease. It is also a criminal offence to push or threaten someone.

2. Ms Q
In this scenario, psychosis can be considered as a disease of Ms Q. It is a kind of hallucination where she has observed unnatural actions related to aliens. As a result, she felt that her sister had to be protected from the aliens, and she thought that she had done so to protect her sister from the aliens poisoning her blood.

This type of disorder can be considered as NCR (Not Criminally Responsible) because she thinks stabbing her sister in the arm can save her. In this type of visual hallucination, people get excited when they see something unnatural and unusual, which requires proper treatment (Marques et al., 2020).

3. Mr W
This scenario shows that after taking twenty-four beers and two grams of cocaine, Mr W in the next two hours, calls the community centre thirty times and says that someone is coming to catch him. He was hallucinating as a result of drinking too much. Because too much drinking increases a person's anxiety, depression and unnatural thoughts. As a result, he can see such scenes that someone is coming to kill or catch him, so he called again and again. It is not a permanent psychiatric disorder, since he later admitted his mistake and apologized, although he did not remember anything.

4. Mrs Y
This scenario also shows the case of Mrs Y who has been suffering from bipolar disorder and she admits it. She was charged with misconduct in a coffee shop but her lawyer wanted to get help from NCR but Mrs Y stopped him. Her idea is that his lawyer, Judge, Crown and others want to send him to the hospital through this conspiracy. Her activity suggests that she also has a paranoid personality disorder. So he thinks that the lawyer and the others have conspired against him. As a result of this disorder, a person is suspicious without any reason. Since she is already suffering from bipolar disorder, she is more likely to get paranoid personality disorder because it is proven (Rantala et al., 2021).

5. Mr X
Mr X could not be diagnosed with any mental illness or disorder.

The scenario clearly shows that he repeatedly threatened his ex-girlfriend and at the same time he was already involved in various criminal activities such as threatening, assaulting, possessing weapons etc. One more thing that has been observed is that he is addicted to cocaine.

He is criminally responsible for his behaviour because possession of weapons and making threats while intoxicated is never forgivable but must be a punishable offence. He also denied the crime. It can be said that he may have been addicted to cocaine while having crimes but a proper investigation is needed (Cassidy et al., 2020).

References:
Cassidy, C., Carpenter, K., Konova, A., Cheung, V., Grassetti, A., & Zecca, L. et al. (2020). Evidence for Dopamine Abnormalities in the Substantia Nigra in Cocaine Addiction Revealed by Neuromelanin-Sensitive MRI. American Journal Of Psychiatry, 177(11), 1038-1047. https://doi.org/10.1176/appi.ajp.2020.20010090

Marques, A., Beze, S., Pereira, B., Chassain, C., Monneyron, N., & Delaby, L. et al. (2020). Visual hallucinations and illusions in Parkinson’s disease: the role of ocular pathology. Journal Of Neurology, 267(10), 2829-2841. https://doi.org/10.1007/s00415-020-09925-x https://link.springer.com/article/10.1007%2Fs00415-020-09925-x

Marx, W., McGuinness, A., Rocks, T., Ruusunen, A., Cleminson, J., & Walker, A. et al. (2020). The kynurenine pathway in major depressive disorder, bipolar disorder, and schizophrenia: a meta-analysis of 101 studies. Mental health assignment Molecular Psychiatry, 26(8), 4158-4178. https://doi.org/10.1038/s41380-020-00951-9 https://wayf.springernature.com/?redirect_uri=https%3A%2F%2Fwww.nature.com%2Farticles%2Fs41380-020-00951-9

Rantala, M., Luoto, S., Borráz-León, J., & Krams, I. (2021). Bipolar disorder: An evolutionary psychoneuroimmunological approach. Neuroscience & Biobehavioral Reviews, 122, 28-37. https://doi.org/10.1016/j.neubiorev.2020.12.031 https://www.sciencedirect.com/user/institution/login?targetUrl=%2Fscience%2Farticle%2Fpii%2FS0149763420307065