Page 728 - 2015 2nd Half No Table

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Progress Notes
Page 90 of 106
EAS/ECRHTT entry.
Joint assessment conducted together with Dr Cushion from the Enfield
Assessment Services at patients’ home.
We could not gain entry to his flat and therefore we had to make a
telephone call to his mother who we asked to give us a code for access to
communal door of the property. Same given as 0123. His mother is called
Lorraine and her phone number is 02082457454.
Upon knocking on the door to his flat there was fierce barking of his dog
from the flat. He was suspicious of people knocking on the door and
asked, Dr Cushion Who are you?
We calmly introduced ourselves and called out purpose for our
attendance. We then asked him to put his dog away and let us in. He
complied without any issues. The front door was secured with a heavy-
duty metal door and as soon as he opened the door, he instantly
bombarded us with volumes of information, about who he is, he talked
about what the police have done to him, explained what his neighbour is
doing to him (following him about) and what he is doing to clear his name
regarding his assumed criminal or police records. This pattern continued
even when we sat down to interview him. He would not allow continuous
flow of conversation; he had rapid speech, he was disruptive and jumping
topics. He had many volumes of files to refer to and try to prove his
points and assumed mistreatment by the police and misdiagnosis by the
medical professionals. However, he could be interrupted without him
becoming angry. He could not facilitate conclusive dialog or interview no
matter what method of interviewing we employed. We kept going around
the circle without end.
He appeared to be mentally disordered and without understanding of his
illness (not insightful). We advised and offered him support for his mental
disorders which he declined saying that he is not ill and will not take
medication.
His mother reported family history of mental illness. His grandmother
suffered from schizophrenia. This could be the start of his schizophrenia
acerbated by drug use. Finally, we had to summarise purpose of our home
visit. We told him that we had attended in order to address his medical as
well as social issues:
Medical: We told him that after the interview, we felt that he needed
support/treatment for his mental disorders.
We explained and offered him home treatment which he declined. I do not
think that he would engage with the HTT.
If he continues to take drugs he will continue to deteriorate in mental state
and being paranoid about harm to him from others including the police
and neighbours
Social issues: A 34-year male of mixed race, white black (mother is
white, and father is black). He was known to CAMHS as a child.
He accessed mental health services in 2008, 2012, 2013, 2014 and this
year with no records of previous admission.
He admits to using skunk cannabis daily supplied by people.