I was at the CMHT when I got a call from the Criminal Justice Liaison Nurse. He had been asked to see Stella, a 62 year old woman in the local Police Station, who was under arrest on suspicion of attempted murder.
“I’ve just seen her,” he said. “She gives long rambling answers to even the simplest questions. I asked her about her next of kin, and she said: ‘I usually I do everything in 12’s and 24’s because I used to be a Playboy Bunny’. She isn’t making any sense. She’s not fit to be interviewed. She needs an assessment under the Mental Health Act.”
Stella had called for an ambulance late the previous evening. When it arrived they found her husband with a kitchen knife sticking out of his ribs. The police were called and arrested her. Her husband was now in intensive care.
I went with our local psychiatrist and a s.12 doctor. Stella had no psychiatric history, so we had very little information to go on. The only thing I’d been able to find out was that her husband had spent a brief time in a psychiatric unit over ten years ago being treated for “alcoholic hallucinosis” – vivid and often frightening hallucinations resulting from acute alcohol withdrawal.
The custody officer told us that when the police had attended, they found a man with a knife embedded in his chest, and with only one other person in the house they reached the conclusion that the uninjured person had inflicted the wound on the injured person, and had therefore arrested Stella. The police do have suspicious minds.
“The reports we’ve had from the hospital so far suggest that the husband is mentally ill himself. He says there are people hiding under his bed who want to kill him. He says he stuck the knife into himself. They think he’s psychotic. They’re arranging for him to have a mental health assessment as well,” the custody officer told us. “And we’ve had reports from the officers investigating the incident that indicate Stella’s known in the area for being ‘different’ to say the least.”
Stella was a slight woman, conservatively and appropriately dressed, with evidence of good self care. She seemed intelligent and articulate. She maintained good eye contact with us throughout and cooperated with the interview.
I began by explaining to her why we were there, then I asked her to tell us what had happened the previous evening.
She proceeded to tell us at great length everything she had done, giving us a minute by minute account of the entire evening. We were quite keen for her to tell us how her husband had come to have a knife in his abdomen, but she could not be diverted from answering the question in as much detail as possible.
She’d gone out on her bike to the supermarket and had then visited a friend. She gave us more details than we wanted of what they had said to each other and how many cups of tea she had drunk. She’d eventually returned to the house at 10.00 pm. She said she felt there was something wrong, as her husband seemed to be staring at something in the corner of the room and was mumbling as if talking to someone. To snap him out of it, she suggested they have a cup of tea, and he had then gone into the kitchen.
When here husband hadn’t returned, she went into the kitchen. She saw blood on the floor and found her husband collapsed in the corner with a knife in his chest. She then rang for an ambulance.
Throughout our interview, Stella appeared lucid and coherent. There was no evidence of being under the influence of alcohol or drugs. She was fully orientated. There was no evidence of dementia, or emotional lability or abnormal mood. In fact, there was no evidence at all of any mental disorder.
The only thing of note was that she seemed somewhat detached, with little evidence of emotional distress at either the situation she was currently in, or of the events that had led up to her arrest for attempted murder. But this was not sufficient to cause us undue concern.
“The person who spoke to you earlier said something about you ‘thinking in 12’s and 24’s’. Could you tell us a bit more about that?” I asked her. On the face of it, this seemed at the very least an unusual, if not irrational, comment to make.
She explained that when she was in her 20’s she had trained as a Playboy bunny. This mainly entailed learning how to work in a casino, including operating the blackjack and roulette tables. This, she told me, required an ability to calculate quickly in multiples of 12. A rational enough explanation.
The two doctors and I had a discussion. We concluded that, whatever may have occurred that night, Stella was not suffering from a mental disorder of a nature or degree sufficient to warrant detention in hospital under the Mental Health Act.
I told the custody officer it was our view that Stella was fit to be interviewed. The custody officer gave us a look.
“You’re sure about that, are you?” he said. “Perhaps you’d better have a word with the officer dealing with the case.”
He called in the detective sergeant.
“We’ve spoken to the neighbours,” she told us. “Stella’s known locally as ‘Psychedelic Stella’. One of the neighbours told me she’d known her for 10 years and had ‘never had a sensible conversation with her’. They told us she was ‘not on the planet’. They’ve said she often rides round on her bike wearing ‘green lycra and fairy wings’. You should see the house and front garden. There’s rubbish and junk everywhere. You can hardly get to the front door.”
Even if Stella did indeed ride her bike dressed in green lycra and fairy wings, it still didn’t justify detaining her under the Mental Health Act. I saw no reason why this should influence our decision.
“But what if we have to bail her?” the detective sergeant asked.
“Then she’ll go home,” I answered. “At the present time both her account and that of her husband seem to corroborate each other. Of course, if there is evidence that she was the perpetrator and he was just covering up for her, then a further psychiatric assessment might be appropriate.”
The custody officer and the detective sergeant didn’t seem that impressed with our conclusion. But that was no reason to change our minds.
The next day I contacted the medical ward where Stella’s husband was being treated. He had been fortunate. He had missed damaging any internal organs. He had had a psychiatric assessment and had been given medication to help with acute alcohol withdrawal; he had had alcoholic hallucinosis again.
I spoke to the detective sergeant who was satisfied the injury had been self inflicted.
I rang Stella to talk to her about the assessment and to see how she was. But she wasn’t terribly happy with me, and told me politely but firmly that she wanted nothing more to do with me
I couldn’t blame her, really.
No comments:
Post a Comment