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2. The Responsible Authority's case
The clinical case argued that the patient has a chronic and enduring mental illness. It is
unclear whether the mental disorder responds to treatment as the patient has not engaged
consistently with treatment. Currently, the patient has been assessed without medication
as Mr Cordell does not accept that he requires psychotropic medication. Mr Cordell
presents with a number of persecutory, paranoid thoughts in relation to his beliefs that the
police and his neighbours are in some way targeting him. Mr Cordell also exhibits thought
disorder and some tangentiality in his response to questions posed. The professional
evidence argued that the nature and degree of the mental disorder warranted the patient's
continued detention of assessment which is justified in the interests of the patient's health,
safety and the protection of others.
3. The patient's view
Mr Cordell was polite and courteous towards the panel. He told the panel that he did not
accept that he has a mental illness or any need for medication. He said he experienced
anxiety and distress at his accommodation. He indicated that the 48 allegations between
6.7.2016 and 2.10.2018 set out in the medical report from an Enfield Council Report
regarding concerns and breaches of his tenancy agreement were all fabricated. He did not
accept that he was in any way at fault. He repeated on several occasions that his
neighbours had submitted a litany of complaints to council officials about him in order to
undermine his occupation of the premises. He said that he has been stopped from
organising festivals and had set up a website to air his frustrations about his perception of
the injustice of his treatment. He told the panel that he would remain as a voluntary
patient
4. The nature and degree of the mental disorder
As to the nature of the mental disorder, the patient's illness appears to be a chronic illness
which has persisted for some time. It is unclear as to the patient's response to treatment
as yet. Mr Cordell told the panel that he did not take the psychotropic medication
prescribed following his last discharge in 2016. The clinical team have sought the first
recommendation for Section 3 and intend to commence treatment with psychotropic
medication in due course. Mr Cordell displayed no insight into his mental health difficulties
and sought to minimise his actions prior to the current admission.
As to the degree of the mental disorder, the patient's evidence was tangential, guarded
and there was clear thought disorder. Dr Greensides told the panel that he had looked at
Mr Cordell's website which indicated the presence of thought disorder. The panel asked Mr
Cordell about a telephone conversation with Mr Appadoo which is detailed in the social
circumstances report; the patient is alleged to have used foul and threatening language
throughout the conversation. Mr Cordell did not dispute the telephone conversation and
sought to minimise his actions stating that the content was out of context. He was unable
to contain his thoughts on the question posed as to whether, reflecting on the matter now,
he thought his response was inappropriate.
The nursing evidence in contrast to the panel's observation, indicated that the patient has
not exhibited any psychotic symptoms. On a positive note there has been some
improvement in the patient's presentation overall as he is no longer challenging, irritable
or confrontational.
5. The detention is justified in the interests of the patient's health, safety and the
protection of others
As to the patient's health, the professional evidence indicated that psychotropic
medication is to be commenced and the patient's response to treatment is to be
monitored. The clinical view is that a period of treatment is now required to address the
patient's psychotic symptoms. The clinical view is that the patient is unlikely to engage as
an informal patient and a previous attempt at treating the patient in the community was
unsuccessful.

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