Using only the case study set out below demonstrate

Case Study of X:


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Ten is a White British Female Offender whose day of the month of birth is 21.06.1979

She has one dependent, a 3 twelvemonth old girl. She comes from a working category background, and is an lone kid who had a settled upbringing with no maltreatment. She gets on good with close household. Ten lives entirely, although has a spouse, on a council estate in rented adjustment.

She attained some GCSE ‘s at a hapless degree and left school at 16yrs. She has a had few occupations before being diagnosed with current metal unwellness.

Previous strong beliefs = ownership of category B drug in 1997 ( cautiousness )

Possession of category B drug in 2004 ( cautiousness )

Current offense: 23.01.05 pleaded guilty ( X was assessed as tantrum to plead ) to ownership of 17 ecstasy tablets ( category a ) controlled drug with purpose to provide ( s5 ( 3 ) abuse of drugs act 1971 ) . Ten was bailed to return for condemning on the 23.04.05.

Ten was non remanded in detention. No Psychiatric studies were ordered by the tribunal, and the pre- sentence study was considered sufficient in X ‘s instance. The tribunals preliminary sentence indicants were that the offense was serious plenty to justify a community punishment, but did non govern out detention

The tribunal adjourned for a full pre sentence study by the probation service, and the study identified the undermentioned factors that can be used by campaigners:

Ten was assessed as low – medium hazard of injury to others and self.

Probation officer stated, along with the mental wellness worker that detention could hold a really damaging consequence.

Dynamic factors lending to piquing were ; Emotional good being ( isolated ) ; believing and behaviour manner ; instruction /training/employment ; lifestyle and associates ; fiscal direction. The supervising program after condemning by the probation service reflected working on these countries ( utilizing outside bureaus to assist aim some of them )

Unsuitable for an commissioned programme as inactive information means OGRS are merely 12. ( Needs to be 40+ ) . Unsuitable for Community penalty due to her mental wellness issues

How and why did the offense ( s ) occur?

Ten stated that a party had been organized to take topographic point at another house nearby and some friends had given her money to purchase ecstasy tablets for them which she agreed to make. The drugs had so been dropped off at her place but the intended receivers had non been to roll up.them as the house party had been cancelled. She was inexorable that she was non involved in providing drugs for commercial net income. She felt some force per unit area in holding to buy the drugs for other people in the first case due to feelings of anxiousness and emphasis. It would look from all available grounds that X felt she was making other people a favour and had small thought that by making so she would set herself in such a serious place.

Ten suffers from really mild schizophrenic disorder with terrible anxiousness ( i.e. Psychosis: two types of functional affectional upsets, the anxiousness / obsessive ideas being more outstanding than the schizophrenic disorder.The peculiar type of schizophrenic disorder is unexpressed – campaigners can lucubrate if they wish ) . Ten has been a client of the Community Mental Health Team since 1998. Her mental wellness worker has worked with her for about three old ages. She presently is on prescribed medicine ( unexpressed – campaigners should notice on what may be appropriate and why ) . Ten is non ever compliant with her medicine. She is frequently dying and afraid. As a consequence she becomes easy stressed and finds it hard to go forth the confines of her place. He confirms that she has supportive household and friends who are happy to assist. He besides echoes the concerns about her current adjustment and the troubles she has encountered with local adolescents. He is of the sentiment that her current gestation may worsen this state of affairs.

Her head-shrinker has been instrumental in supervising her mental wellness and turn toing her anxiousness issues. He offers the sentiment that a tutelary sentence would hold a detrimental consequence on. Her troubles are compounded by the nature and location of her current adjustment, a one bed roomed level located in an country of high offense and societal upset. She says she has experienced a batch of torment from local adolescents who sometimes take advantage of her and which frequently causes her to “ conceal ” off in the kitchen of her place.

Double Diagnosis: Ten drinks intoxicant ( one time hebdomadally ) and fumes cannabis ( day-to-day ) She on occasion takes rapture. This is all on top of her medicine for her mental wellness jobs.

The result of sentence:

2 old ages Community Rehabilitation Order.

Ten must follow with supervising program agreed with Probation service, and to describe harmonizing to National Standards 2005.

Ten must besides follow with petitions of her Mental Health Key Worker

Very compliant with this order so far

Mental wellness:

The up to day of the month significance of X ‘s diagnosing?

Mild schizophrenic disorder refers to the upset that is characterized bycardinal and characteristic deformations of thought and perceptual experience.[ 1 ] This is mild in X’s instance and it is extremely likely this means that Ten has merely a twosome of the pathognomonic symptoms that are used in the diagnosing of her schizophrenic disorder. From the psychiatrist’s diagnosing these symptoms would include behavioural backdown from aliens and the wish to fulfill other demands, i.e. passiveness to the influence of others. This is tied to a terrible instance of anxiousness and obsessive ideas which are associated chiefly with environmental factors, such as frights and concerns. In this instance of Ten this is tied in with her schizophrenic disorder, which exacerbates her psychosis. The demand for safety and backdown from the general populace is diagnostic of her unwellness where it would intend that unfamiliar milieus would do her unwellness worse, because her anxiousness in a safe topographic point is offset with her obsessive traits that make her feel comfy. To take her out of this environment would make a state of affairs where she is a greater danger to herself and others. Her passiveness and the easiness that she can be controlled by others makes it extremely likely to perpetrate offense if in a high offense country. Therefore X’s psychosis can be reduced non merely by medicine but besides emotional and environmental factors ; every bit good as a web to guarantee that she is placed on the least destructive way. In short there needs to be more facets to her wellness attention programme than medicine

What typically are the current prescribed medicines for this type of upset?

For schizophrenia anti-psychotics are normally prescribed, such as fluphenazine or flupentixol and untypical medicines particularly of import for backdown, such asin the instance of X, which includes Clozaril. However it can besides be treated without anti-psychotics such as sulphride. It depends on the patient and whether there are any inauspicious side effects that will impact non merely the physical wellness but besides mental and emotional wellness. For illustration in the instance of adult females particularly if a drug causes rapid weight addition it is less likely that the patient will go on to utilize the drug [ 2 ] . This is particularly of import in the instance of Ten who has a inclination to halt taking her medicine. The drugs for the anxiousness upset include ; tricyclics ; monamine oxidase inhibitors ; beta blockers ; and benzodiazepines. It is of import that the medicines are suited for X to cover with both her upsets and make the safest possible environment for herself and others. It is possible that the antidepressants can do the schizophrenic disorder worse so at that place has to be careful monitoring for the right drug and dose.

What are the tell-tale marks of her mental wellness jobs for those oversing her?

The revealing marks of her mental wellness job for those oversing her include backdown from her safety zone, i.e. her household and her mental wellness workers. The addition of schizophrenic inclinations, e.g. does she go easier for others to command or is her perceptual experience going clouded and more susceptible to hallucinations and or paranoia. Besides if her obsessive inclinations increase to do her feel safer will be another revealing mark or increased anxiousness and figure of panic onslaughts. These are marks that should alarm there are mental wellness jobs and the aggravation due to the decrease or complete fillet of her medicine or that her psychosis is acquiring worse.

How can it develop ( household history relevancy ) ?

X’s mental wellness jobs have developed from a series of familial and environmental factors. The psychosis is caused by a chemical instability in the encephalon, which can be affected and exacerbated by environmental factors that causes X to experience insecure. X’s medical history may be of import to trap down any other possible familial instances of schizophrenic disorder. The anxiousness and obsessive upset has most likely been born out of her mild schizophrenic disorder and the environmental factors of being outside her safety zone makes this worse. This can be seen in her re-offending due to the environmental factors of a high offense country, particularly when she has a inclination to be influenced by others in order to non be harassed or maltreated by others. This makes the household place really of import as a topographic point of support and construction, i.e. community attention [ 3 ] .

Dual Diagnosis & A ; Treatment/Supervision Plan to halt Drug Re-offending?

The double diagnosing would be usually be treated through a clinical backdown from the extra drugs and drink, because of the danger it poses to her wellness and since she is on medicine. This would non be the best mode because it creates a state of affairs where she is taken out of her safety zone and off from her household, which is the ground that a tutelary sentence is non in her best involvements. Rather there needs to be a supportive and structured attack to guarantee that the imbibing and recreational drugs are stopped. The first facet would to travel her out of the high offense country, but near to her household and spouse but the likeliness of obtaining the drugs is decreased. This would besides assist to diminish the farther oncoming of her mental wellness jobs. Besides this attack would be more effectual than medicines to withdrawal of the extra drugs and besides because she is non a frequent user, except for hemp a clinical backdown and medicine would non be relative to her actions [ 4 ] . In much the manner a tutelary sentence would non be relative. The probation service needs to guarantee that they have the right to seek X’s place for drugs, which is either through a warrant or intuition that she is about to perpetrate a offense ; particularly in the first twelvemonth when she is more likely to re-offend. There is already a tribunal order that allows for a supervising program, but it would be more effectual if X is moved from the high offense country. She needs both place and office visits of describing to the probation and/or mental wellness worker. If her environment is less contributing to taking drugs so it is more likely that she will non re-offend at all [ 5 ] . Therefore the 2 twelvemonth order would be long plenty to find the viability of her new environment ; nevertheless to maintain her in an country that has exacerbated her mental upset and her susceptibleness to offense will ensue her re-offending if non during her 2 twelvemonth order so decidedly after the supervising has ended. There is a definite causal nexus between her mental wellness jobs and her offending, because her offense was to delight others to do herself safe and non the mark she has been in this high offense country. X demands to experience safe therefore her environment is extremely of import. The more unsettled she is the less likely she is to take her medicine and the likeliness that she will re-offend additions ; every bit good as her mental wellness jobs increasing and the higher danger she is to herself and others.

Application of the UK legal model1983 Mental Health Act ( MHA ) :

Section 136Topographic point of Safety:

This subdivision allows the constabulary to take any individual that seemingly has a mental upset to a topographic point of safety ; this is non admission to a infirmary but taking the person for reappraisal. There if at any clip X poses a greater injury to others or herself the probation service and mental wellness workers can hold the constabularies take her to a topographic point of safety. The individual can be held for 72 hours and must be examined by a physician and approved societal worker to result any farther intervention. Therefore if X broke her sentence due to an increased oncoming of her mental wellness jobs so it is likely she would be remanded in a infirmary for intervention, because her offending is tied to her mental unwellness. Yet as suggested the best avenue to cut down re-offending is to travel Ten from her current environment. This subdivision deals non with condemnable offenses but behaviour that poses a danger to others, so this can be used at any point where there is an honorable belief that there is a mental wellness job and the single poses a danger to themselves or others.

Sections 35-38:

These subdivisions trade with the mentally sick when they have committed a offense, subdivision 35 trades with the case that the single needs appraisal to stand test. In the instance of Ten it is determined without farther appraisal she can stand test so there is no defence of lessened duty. Yet her mental unwellness is a mitigating circumstance because it is due to this she was influenced to perpetrate the offense ; even though she knew it was incorrect. It was determined that subdivision 36 was non necessary, i.e. she did non necessitate to be remanded to hospital for intervention because she was non a high danger if decently medicated and supervised in the community. Therefore under subdivisions 37’s care under infirmary supervising was non appropriate because any kind of tutelary sentence would do the state of affairs worse ; hence care was granted to the Mental Health Worker and the Probation service. If it is deemed that later Ten is determined to be a greater danger to herself, others or to re-offend so it is possible that a subdivision 38 may be obtained, as the offense could hold got a tutelary sentence. If a subdivision 38 order was obtained so X would be remanded in infirmary for up to 12 hebdomads, which may alter to a Hospital Supervision order or released back on the earlier guardianship order. This is merely for the continuance of the 2 twelvemonth sentence. In the instances of infirmary captivity the tribunal may enforce limitations on the individual’s release under subdivision 41. Besides if X re-offended and was given a tutelary sentence under subdivisions 47 and 48 she may be transferred from prison to a infirmary internment.


Ten will most likely non re-offend if the environmental factors that are doing her more permissive to piquing were removed. Therefore her intervention is non merely through medicines, but besides supervising and environmental factors and the usage of community attention. [ 6 ]


Bhui ( 1999 )Cross cultural psychopathology and probation pattern: a discourse on context, issues, and patternProbation diary 46, 2, June 1999

Barnes & A ; Maple ( 1992 )Womans and Mental Health: Challenging the Stereotypes, venture imperativeness

Hodgins ( 1993 )mental upset and offenseSage

Long, 2000,The Mental Health Resource Centre, Mental Health Organization can be found # f20

Pharmaceutical Journal, 2002,Schizophrenia,The Pharmaceutical Journal 268 ( 7184 )

Rassool, g, H ( Ed ) ( 2002 )Treatment schemes and InterventionsinDouble DiagnosisBlackwell

Watson & A ; Grounds ( 1993 )The mentally broken wrongdoer in an epoch of community attention: new waies in provisoCambridge

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