Page 1472 - 6. 2016 Diary 1st half New 26-05-21 No Table

Asked about energy levels - reports being up every morning at 6am, says he works all the
time.
Reports physical health is good. Simon has Crohn’s disease.
Claims he is not a danger to himself or others.
Says the police are claiming he is other people.
When explained that he is held under section 2 and won’t be released as there is an ongoing
period of assessment Simon became extremely angry, stood up, pacing up and down the
room, shouting loudly, does not think he is unwell.
Simon then left the room for a period of time, heard shouting in the corridor, then asked to
return to room, said he would calm, he quickly started shouting at mother and uncle who also
shouted back. Explained we wanted to give anti-anxiety medication called lorazepam, Simon
became very irate saying we were trying to ‘stich him up’ we were trying to ‘end his life’.
Extra nurses had to be called and Simon had to be escorted from the room.
Collateral from Mother
Mother also claims that the police unplugged the CCTV outside his house. Claims that son is
not paranoid about the police, claims they have persecuted him for over 20 years, always
send 15+ police to his house when they want to speak to or arrest him. Claims there have
been numerous arrests of Simon where he has been innocent, but they have charged him.
Claims that he should not have been found guilty of throwing an illegal party for his friend.
Reports got carbon monoxide poisoning in 2014, feels that’s when his health deteriorated.
Mother does not want Simon to receive injections. We have explained we cannot guarantee
this, and there may be some emergency situations we need to give injections where we will
not be able to guarantee that we can inform
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them before but could inform them after. We have explained that if he repeatedly refuses
tablet medications, we may need to consider long term injections as treatment, however we
would discuss this with them first if possible, and this would depend on his mental state. Also
explained that if lorazepam is not sufficient by itself, we may need to consider further
treatments i.e. antipsychotics.
Mother reports Simon often thinks things said on the TV are about him, and if you tell him
otherwise, he gets very angry.
When discussed with family on their own, mother and uncle did express the view that Simon
is unwell. Saying he seems ‘manic’.
Brief mental state examination:
A - Appearance, slightly unkempt. Erratic behaviour S - Pressured speech, rapid rate, loud
volume. De-railing and tangentiality.
M - Simon is angry and frustrated at being detained. Seems hyper-aroused, shouting.
T - Thought disorder present. Paranoid delusions. Grandiose delusions.
P - No obvious abnormal perception although cannot be sure.
C - Cognition not formally assessed. Orientated to time place and person.
I - No insight into mental health
Brief risk assessment:
To self - Moderate (With his behaviour towards others)
To others - Moderate Other - n/a
Capacity to decide about suggested treatment plan: No
Consent to admission: No
Consent to treatment/medication: No
Current regular medication: None
Physical Examination: no
Blood tests: no