ABSTRACT
Wayne Phillips is a 32-year-old prisoner on remand. He has a diagnosis of paranoid schizophrenia and he fatally stabbed a co-resident at the hostel where he lives. Often patients who have committed these types of violent offences spend long periods of time in custody before being assessed by the forensic teams. In this case, the forensic team are there to assess whether the prisoner’s mental illness had a direct relationship to the fatal stabbing. The mental state examination should focus on Schneiderian first-rank symptoms pertaining to the stabbing. It is possible that the prisoner’s own symptoms and the offence are totally unconnected. For the acute management, Section 48/49 of the Mental Health Act allows transfer from prison to a psychiatric hospital for a prisoner who has not been sentenced yet. The prisoner would then be able to receive specialist mental health care that is not available in prison.
