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weight, LFTs, prolactin etc.

17 Oct - referred for MHA due to history of physical and verbal aggression
towards his neighbours. EANLT MDT agreed that he is a risk to others and his
behaviour could also put him at risk from others. Simon refused to engage with
MHA. Application for 135(1) was made - Judge found insufficient evidence for
136. Forensic referral sent on 17/10

25 Oct - Simon was arrested as the police called to his flat re him breaking a
harassment order and he assaulted the police who attended. He was taken to
Wood Green police station. Found to be him thought disordered, hypomanic with
flight of speech and grandiose delusions. Detained under MHA.

On initial review he had pressured speech, difficulty interrupting, appeared elated
in mood, and had grandiose beliefs e.g. started talking about owning a couple of
local festivals and engaging in multiple charities involving children. At the time he
has limited insight; he does not want any medication, and has never believed he
has a mental health disorder.

His UDS was positive to THC.

He immediately appealed his section. The tribunal was done on 8/11/18 which he
lost.
On 5/11/18, Dr Greensides reviewed the patient and made an application for
Section 3 as there are risks to his health and to others. It was felt that it would not
be beneficial to take against his will unless he is subsequently detained on a
section 3. However, there was a delay in the assessment so he was started on
Risperidone 2mg ON which he refused to take.

Admission He had a MHAA for a Section 3 on 14/11/18; it was felt that there was no
Summary
evidence of Simon posing a risk of harm/safety to himself or others and there was
no obvious risk of neglect. As a result he was not sectioned.

It was decided that as a result of this, there was no reason for Simon to remain on
an acute psychiatric ward as we are unable to treat him. He was discharged as a
result, with Dr Greensides emailing his CC about arranging an O/P consultant
review and emailed the forensic consultant regarding an O/P forensic opinion.

Thank you for your continued care.

Here is his MSE on admission:

Simon is a 37 year old male, who was appropriately dressed. He engaged in
conversation and made eye contact throughout. Calm and polite, no aggression
but did become mildly restless at points.

Pressurised speech, difficult to interrupt. Flight of ideas noted.

Described mood as good. High levels of energy and labile mood.

Paranoid delusions about the police and MH services and some grandiose
delusions noted.

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