Part I

A. History of illness

1. Mr. O dropped out of high school prior to completion due to attendance problems and
challenges learning due to an intellectual disability.

2. The onset of his illness occurred when he was 21 years old, at which time he started
experiencing command auditory hallucinations and suicidal ideation.

3. Since that time he has been hospitalized in multiple occasions because of noncompliance to the
treatment and rapid psychiatric decompensation.

4. He has a lengthy history of arson and assaulting family members in response to paranoia and
command auditory hallucination.

5. Despite that his mother allows him to live in their house but when he becomes psychotic she
kicks him out, and then allowing him to return again after treatment in the hospital.

6. After that Mr. O has had a long treatment with his hospital, his most recent diagnosis is
Schizoaffective affective disorder bipolar type, Mr. O stopped taking his medications reportedly
because he could not afford them.

7. He did not report this to his case manager and started to experience auditory hallucinations and
paranoia that others were laughing at him.

8. He set fire to his mother’s home in an attempt to get rid of the “demons and voices.”

9. He has been hospitalized for 3 years and during the course of his hospitalization he has been
adherent to his medications and he has not had any residual symptoms of his illness.

Family of Psychiatric illness

Answer: None
Course of treatment
1. He has been hospitalized a couple of times due to noncompliance to medication and rapid
psychiatric decompensation.

2. Mr. O has a lengthy history of receiving care from his local CSB. He has a case manager, but he
has not found stability, and the most of his CSB interactions have been through Emergency
Services and Acute Care.

3. Mr. O reportedly stopped taking his meds in the months preceding up to the NGRI infraction
because he couldn't afford them.

4. He has been hospitalized for three years. He has been compliant with his prescriptions
throughout his stay and has had no lingering effects of his condition.

5. His engagement in treatment programming has been negligible, both in the hospital and in the
community, on escorted and unescorted 8-hour passes.

6. While he has admitted to having a mental disease that necessitates ongoing treatment, he has
little understanding of the benefits of medicine and/or the implications of ceasing it.

7. He has had difficulty finding structured activities that he enjoys, so he decides to attend day
therapy five days a week.

8. Mr. O has successfully completed 48-hour passes to an assisted living facility, despite his
reluctance to admit that he requires this level of care and frequent mentions of his future
discharge to an apartment.

9. His passes, on the other hand, have gone smoothly, and workers at the ALF say he's doing well
and socializing with his peers.

10. The therapy team and CSB are planning for conditional release at this time.