Considerable factors to minimize the potential of violence while discharging patient of schizophrenia and polysubstance abuse.

Family and friends will play a fundamental role in motivating Joe with schizophrenia to continue medication and get the benefits of long-term treatment. Also, strategies can be made to ensure that the patient adequately complies with the treatment. This function can be very important since sometimes people with psychotic symptoms and schizophrenia can cause violence and be reluctant to go to the doctor (Bo, Abu-Akel, Kongerslev, Haahr, & Simonsen, 2011). According to Quinsey et al. (2006), the schizophrenic people display more criminal offences compared to the non-schizophrenic people. Hence, before discharging someone with violence potential, appropriate measures must be taken to reduce violence outbreak.

A positive approach

The family must be made aware of the role to provide the support and encouragement necessary for schizophrenic person to improve. A positive approach could be useful and much more effective in the long term than criticizing the schizophrenic person, who takes drugs and makes violence, whose thoughts and behaviors may be altered by their condition (Soyka, 2000).

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Raise awareness

A frequent opinion of people who do not know the disease is that people who suffer from schizophrenia are “violent criminals” or have a “personality split.” Family members and friends can help raise awareness about schizophrenia by being open about the disease and talking about its impact. Fostering a positive relationship between patient with schizophrenia and the people around him can help improve the confidence that the patient has in himself contribute to his adaptation and integration in society (Fazel, 2009).

Journal entry

• Who is responsible for providing Joe’s care and monitoring in the community?

For Joe’s care primarily Joe’s mother is responsible for the care of her son and the monitoring in the community as well. The reason for this is Joe has no one around except for his mother. Joe shall idealize his mom and with positive techniques reduce violence and usage of drugs.

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• Does justice health still have a role or now he’s out on bail is it the Local Mental Health Services’ duty of care?

The entire responsibility of Joe when he is out of bail is of the Local Mental Health Services because he not under the judiciary presently and he has been given bail. If he would have been in jail so it will be the responsibility of both the justice health and the Local Mental Health Services.

• What rule and responsibility does the Court Liaison Service have?

The court liaison service has a clinician who takes care of the mentally ill patients and tries to figure out what is going through the patient yet the person who is in judicial custody.

• Do you consider his mother and his estranged girlfriend to be at risk of harm from Joe? So is it appropriate to contact them without his permission? And if so who should talk to them?

I think patients like Joe who are suffering from mental illness and schizophrenia have multiple hallucinations. The girlfriend and the mom are at risk even after proper medications and strategies. If someone talks to them, it should be the medical counselor so that in no case Joe gets offended.

• Who might you speak with or what facts might you clarify before your meeting with Brenda?

Brenda must be given a file of the entire medical and custody details of Joe, so that she may be aware of Joe’s situation that what violence he has done in past and what threats he can come up with even after proper medicines consumed.

• And what medical/legal mechanisms are available in this complex situation?

A family education program and skills for patient management must be included for patients like Joe; psychotherapy and group therapies; and rehabilitation to maintain a routine, get a job, continue with studies and make a normal life such complex situations.

• On a personal level, I’d also like you to consider what might be your anxieties about meeting somebody like Joe if you were in Brenda’s position and what have your past experiences been like in dealing with patients like Joe?

There is no effective way to prevent schizophrenia, but it is clear that you have to limit the consumption of tobacco and alcohol and avoid drug use altogether. Once the disease appears, it is essential to have discipline and follow healthy lifestyle habits, which include regular schedules, a balanced diet, moderate exercise and the prohibition of ingesting exciting substances.

References

Bo, S., Abu-Akel, A., Kongerslev, M., Haahr, U. H., & Simonsen, E. (2011). Risk factors for violence among patients with schizophrenia. Clinical psychology Review, 31(5), 711-726.

Fazel, S. (2009). Schizophrenia, substance abuse, and violent crime. JAMA, 301(19), 2016-2023.

Quinsey, V. L., Harris, G. T., Rice, M. E., & Cormier, C. A. (2006). Violent offenders: Appraising and managing risk. American Psychological Association.

Soyka, M. (2000). Substance misuse, psychiatric disorder and violent and disturbed behaviour. The British Journal of Psychiatry, 176(4), 345-350.