Thursday, March 26, 2009

Who Are You?

The DOC badge said his name was John X. Doe and that he was born on 1/1/81. The medical information system said his name was John Y. Doe and that he was born on 2/4/84. The legal information system said that John Y. Doe plead guilty to misdemeanor theft and was given six months. John X. Doe has an open robbery charge. John Y. Doe has been through the system three times and has always screened negatively for mental health issues and never needed psychiatric services. John X. Doe was in our forensic hospital for six months being restored to competency. The patient insists he's John X. Doe in spite of both information systems that link him through his DOC number.

I've never treated either of these guys before, have no old records of my own and have no way of knowing if they're actually one and the same person who just lies about different things at different times. Someone just shoot me now.

So is John Doe someone with no previous psychiatric history who is malingering now because he's facing a serious felony charge? Or is he a chronically mentally ill person who is going to relapse if I don't put him on meds? (And relapse in a big way if it required a six month hospitalization.)

Oh yeah, one more thing---he won't answer any questions other than to confirm his middle name and birthdate (which may be a lie). When I try to do a mental status examination he sits there and stares at me.

Gawd, ya gotta love this work.

Any suggestions?


FooFoo5 said...

You're posting at 3:00 am?

The whole business of "are you playing me?" with correctional patients & the "truth"(be it suicide or denying symptoms) made me crazy. I pretty much decided that having been put in a tenuous position, ad-seg or the hospital was at my disposal; not as a punitive action, but as a necessary precaution. "You'll be safe & I won't be sorry." The consequence, as you might imagine, could be loud. I never regretted the choice.

Aside, I got an email today from Robert Hare's site that a documentary, "The Psychopath,"was airing on the CBC (apparently the story of a criminal who reads about psychopathy and sets out to have himself diagnosed). Will he go by John X. or John Y.?

Anonymous said...

This might not be possible in your situation. I am not a psychiatrist nor have I ever been in a jail. This is what comes to mind, though.

I might try getting to John Doe through a clergy person. Do you have clergy make rounds visiting inmates? Why not give a list of questions to a clergy person? Have the clergy ask John questions. Have the clergy ask if John has any relatives or friends he'd like contacted. See what you can find out through the back door. Also, you might go through official channels and see if the legal system or prison might already know someone in John's family. See if a family member can tell you about John. You might not be able to ask medical questions, but you might be able to ask about former incarcerations or former arrests and about the real name.
Yet another idea: what about having "someone" in the legal system compare the official fingerprints or John X. and John Y. You should be able to determine definitively if they are one and the same.

My thoughts: The John X. Doe who was in your forensic hospital for 6 mos. being restored to competency is the one MORE likely to be refusing to talk to you. He's got something to hide and a reason to hide it. John Y., negative for mental health issues would talk to you. I would consider putting THIS John on the meds that would be appropriate for the guy discharged after 6 months.

Anonymous said...

Well, I will give it a try. Do they have similar height, weight, eye color, blood type or distinguishing characteristic in their medical file? And can that be linked/related to any other files that you can access? Does one have a unique tatoo? These are just suggestions...I work with large datasets in my job.

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Anonymous said...

If John Y. has been in the system three times, someone in the DOC, probably someone you know, must remember him well enough to give a description or something. If John X. was in the forensic hospital for 6 months, surely one of your colleagues must know him and could tell you about him. Whom can you call in the forensic hospital? I'm sure you must have someone.

Aqua said...

fingerprints? DNA?

Midwife with a Knife said...

Ooh, I like the fingerprint idea.

Anonymous said...

No cameras to take photos of these people?

trading computers said...


Alice said...

Is it possible/ethical to try to get in touch with the OTHER John, who may be able to confirm which John the guy you have is NOT?

ClinkShrink said...

Thanks for all the input. Here's the followup:

Foo: I wasn't up at 3 am, it was a scheduled post. I put the guy on seg as a precaution, and yes it was loud but it was the right decision.

Fingerprints confirmed he was John X; however, the legal information system confirmed that he was also incarcerated under the John Y. alias. He was one and the same person. After a couple days the forensic hospital was able to locate his chart, however by then his illness had already declared itself.