Note: Psyc 353 Students. The following is an example of a report using the movie “Nuts”, starring Barbara Streisand and Richard Dreyfus. Because it was a competency to stand trial evaluation, there are some legal sections that won’t apply to your assignment, such as the recommendation section and the legal questions. Still, it does give you an idea of how to write it.

PSYCHIATRIC EVALUATION

BELLEVUE STATE HOSPITAL

BELLEVUE, NEW YORK

Herbert Rosenthal, M.D.

Chief, Unit N-0-2

Prison Ward

The Honorable Judge Stanley Mudoch

State Supreme Court No. 7 of New York

New York, New York 00011

Re: Claudia Francis Draper

Mrs. Claudia Francis Draper was referred to the Bellevue State Hospital for a psychiatric evaluation to determine her competency to stand trial., pursuant to Article 730 section of the Criminal Procedure Law of the State of New York. She is currently charged with voluntary manslaughter.

Sources of Information

In preparation of this report, the following sources of information were reviewed.

  1. Psychiatric Examination, dated 2/13/1979, to ascertain the patient’s mental condition, determined by her general behavior, her attitudes, her ideation, her thought content, her various affects, and the general stream of her mental condition
  2. Psychiatric Examination by Dr. Alvarez, dated 2/13/99
  3. Medical Records from the Bellevue State Hospital
  4. Police Reports
  5. Interview with the District Attorney and Mr.

The interview was conducted at Ward N-O-2 of the Bellevue State Hospital. I assured Mrs. Draper that the information from this interview could not be used against her in any criminal proceeding by reading the following statement:

“Technically, this interview isn’t confidential and privileged, but I’m here to help you, and you can trust me not to repeat any damaging or incriminating material.”

It was doubtful that Mrs. Draper understood my statement as she called me a liar.

Personal Background:

Mrs. Draper is the only biological daughter of Bill and Rose Smith. Her parents were divorced when she was five years-old and her mother married Arthur Kirk a few months later. Mr. Kirk owns several businesses and Mrs. Kirk works primarily as a housewife. According to the Kirks, Mrs. Draper was a quiet, but well-adjusted child. She reached all developmental milestones without delay (i.e. walking, talking, beginning school, puberty onset). According to Mrs. Kirk, Mrs. Draper showed no significant attachment difficulties following her biological parents’ divorce and developed a solid emotional bond with Arthur Kirk, her stepfather. Discipline was not a problem for the Kirks as there appears no evidence of physical abuse. According to the Kirks, Mrs. Draper received financial rewards for performing various household activities.

Vocationally, Mrs. Draper was reported to have been an above-average student in high school She has held no significant employment prior to her marriage to Peter Draper, whom she met while in college. She dropped out of college to get married and worked primarily in the home. Later, Mrs. Draper re-enrolled in some college courses while still married, but did not complete a degree. It is not clear how Mrs. Draper supported herself following her divorce due to her lack of contact with family. She was briefly employed as a “massage therapist”, but this appears to have been a guise for her prostitution.

According to the Kirks, Mrs. Draper did not cope following her divorce and had a nervous breakdown. She eventually withdrew from her family and did not return any correspondence. It was evident from the police reports that she became a prostitute to support herself financially.

Behavioral Observations:

Mrs. Draper was a 30 year-old, white, divorced female of average height and slim build her appeared her stated age. At the time of her interview, she was oriented to person, time, and place. She appeared slightly disheveled, but her hygiene and personal grooming were adequate. She was apparently opposed the idea of receiving psychiatric treatment and her behavior was negativistic. When the patient came for the examination, she brought a notebook and pencil with her (I should add that I have never had a patient arrive with a notebook and pencil). She sat down, opened the book to a clean page, put the pencil beside the notebook, and folded her hands. She did not say hello, or good morning, or volunteer any greeting. I said good morning and asked her what her notebook was for. She displayed a mocking, almost threatening, smile. She was very guarded with this examiner and refused to speak. She first spoke when I asked her “why are you here?” ( which is a standard opening question for this type of examination).

Mental Condition.

During the interview, I found Mrs. Draper to be generally withdrawn and aloof, with a tendency towards inappropriate humor. Suspicious, often hostile. Never showing any sponteneity in answering questions. Whenever I asked a question, if the patient did answer, there was a long silence between question and answer. At one point I suspected a psychomotor retardation. But since there was not always a long delay in her responses, I reserve judgment on the diagnosis of psychomotor agitation.

It is clear to me that the patient was severely out of touch with reality. Often, her answers to my questions made no sense to me at all. She was obsessed with the idea of conspiracy and obviously regarded me as part of one. She made it clear to me that she mistrusted my most innocent of actions. For example, I offered her a cup of coffee and she said “Is the Thorazine in it? I can do without my dose of poison today”. As the examination went on, she withdrew more and more. She refused to comprehend I was a physician and here to help. At one point, she accused me of trying to kill one of the other patients on the ward. A second example, I asked the patient if she believed I was siding with the district attorney and she said “Luke 11:23; He that is not with me is against me”.

Diagnostic Impression:

Acute Schizophrenia, Paranoid Type

Opinion:

It is my professional opinion that the patient, Mrs. Draper, suffers from Paranoid Schizophrenia. A paranoid state is a mental condition in which the patient believes that people are against him, sometimes some people, sometimes all people. Because of this belief, the patient feels continuously threatened. And when a patient feels threatened all the time, he’s likely to act out his violent impulses against all those supposed enemies.

In this patient’s case, she’s so convinced that the district attorney and her parents and I are conspiring to put her away instead of letting her stand trial that I don’t see how she could distinguish between a criminal charge and persecution.

Prognosis

Perfect candidate for treatment. Should respond well to tranquilizers, such as Thorazine, to reduce her paranoia and hysteria. Furthermore, she should respond well to traditional psychotherapy as I found Mrs. Draper to be intelligent, not too insensitive, and –most important- not too far gone from reality.

Summary.

In my professional opinion, the patient, as a result of a mental disease or defect, does not have the capacity to under stand the charge against her, or the proceeding, nor can assist in her own defense. Furthermore, the pressure of this proceeding would do terrible harm to this patient, as I believe that she is very close to hysteria. Consequently, it is recommended that she be hospitalized at the Bellevue State Hospital pursuant to Article 730 section where she can receive further care and treatment.

Herbert Rosenthal, M.D.

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