Analysis of A Forensic Assessment - Assignment Example

 Analysis of A Forensic Assessment CASE THREE Introduction A Forensic Assessment and Report is usually founded on the quality of information accessed from a number of sources with regards to the client for instance mental and medical health records, criminal and employment records, family as well as school records in addition to other important information. To begin with I would recommend an objective testing for the client, Mr. H given the aforementioned scenario. Mr. H appears to be of sound mind apart from a few questionable characteristics that he seems to exhibit. Therefore, in order to understand the true character of mental derangement in any given scenario requires the exertion of great discernment, incorruptible integrity as well as of extensive knowledge (Humphreys et al, 2005) . It is important to determine the true mental health status of Mr. H in the course of the forensic assessment report and that is the reason as to why it is being carried out at the end of the overall evaluation when he is at most ease and some degree of rapport has been established between the interviewer and Mr. H (Phil et al, 2001). Those professionals practicing in forensic settings are usually utilized in making legal determinations and are expected to apply higher standards as per the demands of forensic psychology. Such legal determinations incorporate sources of information for instance interviews of others or records as well as use of psychological test instruments. In the case of Mr. H the assessment instruments that will be used to evaluate the client are forensic psychology assessments. These are instruments administered and utilized in determining the potential risk of a person behaving in a violent manner (Humphreys et al, 2005). From the case study, it is quite obvious that Mr. H has acted in a violent manner with no concrete reason apart from the fact that his neighbor was becoming a nuisance in regards to the loud music playing night after night despite his warnings to the neighbor. For a sane individual it may be quite difficult to understand the character or rather behavior of Mr. H given the fact that he is a believing Christian who professes to have heard the voice of God commanding him to commit the crime so as to please God. Forensic psychological assessment is an instrument that enables people to understand individual uniqueness (Najat 2008). It also helps in explaining the relation between psychological functioning and the behavior of a particular person which in this case is Mr. H. An interview was also conducted as a way of investigating Mr. H’s background and mental history. Interviewer : Kindly state your name and age Mr. H : My name is Mr. H and I am 24 years of age Interviewer : Do you have any brothers and/or sisters? Mr. H : Yes, I have one brother and one sister, all of whom are younger than I Interviewer : How would you describe your relationship with them? Mr. H : Every family has its own issues but I would generally say that I have a close relationship with my family and especially with my parents Interviewer : Is there any history of mental illness within your family? Mr. H : God has been kind enough to watch over our family and keep it healthy, mentally or otherwise. I have not heard of any issue regarding mental illness within my family Interviewer : I can tell that you are a believer. How strong would you say your relationship with God is? Mr. H : I would say very strong indeed as He sometimes speaks to me and asks me to carry out some of His work for the betterment of the world. Interviewer : How sure are you that it is God speaking to you and not some voice in your head or subconscious thinking? Mr. H : {Looking rather annoyed} I know it is God speaking to me otherwise I would be considered insane, don’t you think?! Reason for Referral This is a case where a certain Mr. H, 24 year old, has been charged with murder in the second degree because of shooting a man in his apartment complex for playing his music loudly night after night. Mr. H admits to committing the murder and justifies it as he argues that he had attempted to request his neighbor to turn down his music but in vain. The most appropriate Forensic Assessment that would be applicable in this particular case study is that of mental health treatment evaluation. Mental health evaluations are important in the determination of issues such as diminished capacity, insanity, sentencing mitigation as well as competency to stand trial (Chaloner & Michael 1999). According to this particular case study, the main reason for referral is the fact that Mr. H may not be quite aware of his problems and that is what motivated the researcher to carry out this study. Mr. H’s personal medical records are also important to the mental health evaluation process as they tend to form the foundation of expert opinion. Therefore the main objective of carrying out this study is to figure out whether or not Mr. H requires a mental health evaluation. Despite the fact that Mr. H presented no irrational thoughts or hostility during his questioning after admitting to murdering his neighbor, historical records revealed that he had recently lost his father to a tragic car accident and since he had moved from home at that time, he experienced feelings of guilt even though he also wanted to be independent (Phil et al, 2001) . Based on the forensic assessment report as well as the mental status components identified in this particular case study, Mr. H said that on the night of the shooting he was apparently instructed by God of his universe to get rid of the noise that was annoying the angels. Referral Questions 1. As a Forensic Mental Health Professional what factors need to be considered in my psychological testing for the forensic assessment report? 2. What are my assessment options in working with the client? 3. What behavioral observations do I make about the client by reading the case vignette? 4. How will I recognize and evaluate my client’s offender behaviors associated with malingering and deception? 5. What is the purpose of the Forensic Assessment and Report? 6. What is the nature of the problem presented in my selected case vignette? 7. What is the case scenario I have selected? 8. What is the reason for referral? 9. What is the background of my client? What are the symptoms displayed by my client, and the significance they have in this case? 10. What is the mental status of my client? Elaborate on every major component addressed in the mental status examination. 11. What Interview Type and approach I used with my client. 12. What tests are appropriate to use in my Forensic Assessment Report? Identify one intelligence test, one objective personality test, and one projective test. 13. How will I present my impressions of the client? 14. What collateral information will I use in the process of evaluation? Presentation From the above interview it is clear to observe that even though Mr. H appears to answer questions rationally, there are still some questionable doubts as to his state of mind especially where his belief in God is concerned. Mr. H’s behavior also indicated to be that of a sane individual and when he appeared to get angry or annoyed, he seemed to take control of his emotions. As the interview went on, he seemed to show more remorse but left doubt to the interviewer as to whether or not it was genuine. There was also a feeling that the suspect might have been manipulating the interviewer. Another reason as to why Mr. H’s mental health status is in question is because according to the Forensic report, he has also begun experiencing auditory hallucinations such as the one he had experienced earlier on which he indicated led him to shooting his neighbor (Landsberg 2001) . Medical History Even though Mr. H’s historical records reveal no history of mental illness, the forensic report also mentions the fact that Mr. H also heard voices on one other occasion while driving his car to the grocery but ignored the incident (Chaloner & Michael 1999) . This scenario gives rise to the question of Mr. H’s mental condition at the time of the shooting as it does not seem to be the behavior or thinking of a person considered to be of sound mind. It is important for psychologists and experts on mental health disorders to consider such disorders within the context of school, community, home, family and peers. Developmental psychopathology tends to encourage consideration of the relations between the person who in this particular case is Mr. H and his social and physical environment at the time that symptoms of mental disorder are considered (Phil et al, 2001) . As per the DSM-IV criterion majority of mental disorders are diagnosed by their signs and symptoms together with the individual’s functional impairment. It is encouraging to observe the fact that forensic mental health evaluation systems have undergone huge transformations for the last 20 years where assessments of competence to stand trial as well as criminal responsibility are compared using different systems for forensic mental health evaluation (Phil et al, 2001). In the past cases such as Mr. H’s were handled on an inpatient basis for instance in large secure hospitals where there were specially designated units for those considered criminally insane. It is only recently that majority of states around the world begun providing forensic evaluations on an outpatient basis in the society (Chaloner & Michael 1999) . In this particular case study the mental health evaluation was carried out by a single clinical psychologist charged with the responsibility of gathering information, report writing, courtroom testimony as well as clinically evaluating Mr. H (Landsberg 2001). Ethical as well as legal responsibilities with regards to confidentiality were also employed in this case study. Psychological History For comprehensive results the assessment required examination of a wide range of psychological factors which incorporated personality and intellectual functioning that was further broken down to elements such as intellectual development, educational, physiological, emotional and cognitive (Phil et al, 2001) . Forensic psychological assessments are important in that they allow the assessor to corroborate interview information as well as clinical impressions in addition to going beyond the interview and gathering information of a much broader psychological complexity with regards to the client. The assessor is also in a better position to determine just how similar or different this particular client is as compared to others. There are a number of ethical as well as multicultural issues that tend to face a number of forensic psychologists and those individuals who choose to employ psychological tests for instance considering one’s traditions, beliefs, culture and religion. It is important for psychologists to keep in mind that each individual is unique irrespective of whatever their similarities to previous clients are and therefore each situation should be handled or rather treated differently (Phil et al, 2001) . Mr. H appears to be a rather religious individual from what has been depicted in the Forensic Assessment Report and therefore I am required to consider handling his case scenario from a religious but more logical and legal point of view. I am also required to consider the cultural background of Mr. H while interviewing as well as explaining his legal rights to him together with the consequences likely to be faced as a result of his crime. I should make every reasonable effort in correcting any misunderstanding or misinterpretation of testimony and evidence while avoiding any out-of-court statements. Objective Testing Some of the tests chosen for this particular case study include Wechsler Adult Intelligence Scale – III or WAIS-III which is generally a test of intelligence (Chaloner & Michael 1999) . This particular test is used to evaluate an individual’s competence in acting purposefully, dealing effectively with the environment as well as thinking rationally. Minnesota Multiphasic Personality Inventory – 2 or the MMPI-2 is yet another objective test utilized for this case study. It is important in that if gives findings along numerous dimensions that include personality patterns, severity of disturbance and psychological stressors (Landsberg 2001) . These two objective tests were selected as they proved relevant for this case study and were bound to provide accurate results in regards to the mental health condition of Mr. H before, during and after the criminal act. In order to apply the WAIS-III objective test to Mr. H, I will utilize both verbal and performance WAISE scales for effectiveness. Under the verbal WAIS scale I will include questions that consists general knowledge, a few mental arithmetic brief story type problems and questions focusing on issues of social awareness. Under the Performance WAIS scale I will incorporate a set of small pictures where Mr. H will be required to arrange them into a logic sequence, object assembly which include small jig-saw type puzzles and another set of small pictures having one vital detail missing which is to measure Mr. H’s attention to fine detail (Najat 2008) . On the other hand the MMPI-2 test will be self administered to Mr. H where numerous True/False questions will be asked. As a consideration to the individual’s nationality or race, this particular test can be administered in Spanish, Hmong, French and English (Chaloner & Michael 1999) . Another reason for administering this particular test on Mr. H is to develop effective treatment strategies in addition to providing strong empirical basis for a clinician’s expert testimony (Landsberg 2001) . Findings Based on my study my analysis of the symptoms displayed by my client is that Mr. H suffers some minor form of mental illness which he is not yet aware of and most of his beliefs and observations are directed to religion. The case study cites that he has also experienced recent losses and transformations that have lead to increased stress and responsibility. This means that Mr. H is suffering from depression which is suppressed and the situation with his neighbor caused him or rather led him to act out his suppressed guilt and depression (Humphreys et al, 2005) . The case study also indicates that Mr. H is not aware of his mental status and does not have any ill feelings towards his relationship with his parents. His mother is said to have supported him once he moved into his own apartment before he found some form of employment. The report shows that he experienced grief from his father’s death two years ago but instead of mourning, he chose to direct his emotions to his moving away and not being there for his family during that particular time even though he desired independence. What is rather interesting is the fact that Mr. H is not remorseful of his actions and he justifies it with religion and his belief that it is God who actually commanded the murder. Mr. H’s case requires a few issues to be addressed for instance multicultural and ethical issues. These are issues that are bound to be experienced in the course of administering the aforementioned tests as a way of validating Mr. H’s scenario. Diagnostic impression My professional role and relationship with the third party requesting the evaluation is that of a clinical psychologist. I am also acting as a witness for the defendant who in this case is Mr. H in court. According to the information that has been provided in the Forensic Assessment Report regarding Mr. H’s case the hypothesis that I have developed is that Mr. H suffers from Schizophrenia, a mental condition which himself is not yet aware of and instead justifies it with his religious beliefs. The tests mentioned earlier in the report that were used to carry out the mental health assessment of Mr. H were chosen as they specifically tend to analysis what is required in the assessment, that is, the mental stability of Mr. H. They were considered the most appropriate in determining the psychosomatic traits as well as personality traits of Mr. H. The two tests that are the WAIS-IV and the MMPI-2 are commonly utilized by majority of psychologists and mental health professionals in trying to investigate the correlation between personality variables and types of habitual behavior, disorders, critical life occurrences and other psychological determinants (Chaloner & Michael 1999). The tests were therefore considered as the most appropriate assessment tests for Mr. H. Conclusion Based on the mental status examination, personality tests, symptom analysis and the interview, my hypothesis is that Mr. H does suffer from Schizophrenia due to his past experiences which apparently he has learned to suppress with time. The reason for my hypothesis is the fact that as per the report, he has been having hallucinations and hearing voices in his head which are common symptoms of Schizophrenic individuals (Phil et al, 2001) . Though he appears normal and to some extent logic, his action, that of killing his neighbor because God apparently instructed him to do so, do not show any signs of normalcy thus the need for mental status assessment. The Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM-IV criteria was applied in the assessment process of Mr. H. This is a manual developed by the American Psychiatric Association covering all mental health disorders for both adults and children (Humphreys et al, 2005) . It is used to assess 5 main dimensions of clinical assessment that is developmental disorders and personality disorders which include mental retardation and paranoia, clinical syndromes such as schizophrenia and depression, severity of psychosocial stressors such as unemployment and general events in one’s life (Landsberg 2001) . The manual also assesses physical conditions for instance brain damage and highest level of functioning which is the individual’s level of functioning both at the present time and the highest level within the previous year (Najat 2008) . According to the DSM-IV criteria for Schizophrenia there needs to be characteristic symptoms of hallucinations, affective flattening or delusions present for a significant portion of time in the course of 1 month (Chaloner & Michael 1999) . Assessing Mr. H’s condition and behavior he is observed to have been experiencing hallucinations and hearing voices in his head in the course of 2 years during which time his father also passed on in a tragic accident. The DSM-IV states that if delusions appear bizarre or hallucinations consist of a voice running commentary on the person’s thoughts or behavior, or even two or more voices conversing with each other, then only one Criterion A symptom is required (Phil et al, 2001) . Not only did Mr. H experience hallucinations but he also confesses to the fact that he was instructed by God to commit the crime. According to developmental principles any given mental disorder is as a result of the interaction of an individuals and their environment. From the case study it can be observed that Mr. H has in the course of time experienced a number of losses and transformations which he has adapted a way of dealing with them by suppressing his emotions. Recommendation As it was earlier mentioned in the course of the report there are some potential ethical dilemmas that might arise in my assessment of the client for instance conflict of relationships where a psychologist may provide therapy to an individual they know from church or another organization, confidentiality where psychologists may be tempted to break the ethical code of psychiatrists and forensic psychology itself where a psychologist may become more willing to testify in court and distort his testimony for those clients willing to pay more (Najat 2008) . As a way of preparing myself to defend my evaluation in the court setting or to relevant third parties I would ensure that I support my theory regarding the client with a thorough life history investigation as well as any expert or lay witnesses available at that time. I would also ensure that I have written a comprehensive report with no bias for or against my client as a way of providing the residing judge with all the information regarding psychological evaluation of my client’s mental condition. If I recommend treatment for my client, the evidence based approaches used with the disorder I diagnosed would include the evaluation of the treatment where formulation of answerable questions would follow. I would then gather and critically evaluate the evidence available regarding the recommended treatment for my client. The intervention or treatment should be used with care while researching for evidence of its efficacy and thus monitoring the outcome of the treatment (Phil et al, 2001) . REFERENCES Chaloner C. Michael C (1999). Forensic mental health nursing: Current approaches. Oxford: Wiley-Blackwell Colin D. Tony T, Phil W. (2001). Forensic mental health: issues in practice. Tindall: Elsevier Gerald Landsberg (2001). Forensic mental health: working with offenders with mental illness. Kingston: Civic Research Institute, Inc., 2001 Health Sciences McMurran M, Najat K(2008). Forensic Mental Health, Criminal justice series. Cullompton: Willan publishing Stuart Wix, Martin S. Humphreys (2005). Multidisciplinary working in forensic mental health. New York: Elsevier Health Sciences Read More