Psychiatric Consultation Notes

Introduction

• Dr. Taylor is the on-call psychiatrist.
• Patient: Andy, referred by family doctor.
• Discussion about distressing experiences Andy has been facing.

Patient's Concerns

• Andy believes his housemates are working for MI5.
• He feels they are affecting his brain and are hostile towards him.
• Distressing experiences have persisted for about two months.
• Andy feels like he is being watched and manipulated.

Specific Experiences

• Initial Realization:
  • Noticed the TV was moved, leading him to believe his housemates were MI5 agents.
• Voices:
  • Hears three housemates' voices when they are not present.
  • They comment on his actions, e.g., packing his bag.
  • Feels they are always discussing him negatively.
• Thought Insertion:
  • Feels he is receiving thoughts that are not his own (e.g., thoughts about a character from a show he does not watch).
• Sensation of a Device:
  • Believes he has a tracking device in his head, which he can feel moving.

Coping and Safety Measures

• Andy feels unsafe and reluctant to leave his room.
• Avoids eating because he suspects his food is being poisoned.
• Has obtained a knife and baseball bat for self-protection, but does not intend to use them unless necessary.

Mental Health Evaluation

• No previous incidents of aggression or trouble with the law.
• No current health issues aside from the experiences discussed.
• Denies any suicidal intent, but has thought about taking an overdose.
• Regular use of cannabis (smokes daily) and occasional use of speed (last used about a week ago).

Family and Support

• Expressed concern about involving his parents and MI5 targeting them.
• Feels safe at parents’ home but does not want to expose them to his concerns.

Conclusion and Next Steps

• Dr. Taylor acknowledges Andy is experiencing a difficult time.
• Conveys uncertainty about the cause of distress (not necessarily MI5).
• Suggests involving Andy's mother in the discussion for support.
• Emphasizes the need for a collaborative approach to help Andy find appropriate support.