Reportonconditionallydischargedrestrictedpatient.doc

Report on conditionally discharged restricted patient Mental Health Casework Section Please return the completed form by email to: cdreportsfax@noms.gsi.gov.uk or by fax to: 0870 3369163. If you feel that the patient presents an increased risk to others since the last report, please telephone the Mental Health Casework Section as soon as possible. If you do not have the caseworker’s direct line, the switchboard number is 020 3334 3555 (office hours) or 020 7035 4848 (other times). Patient’s details Name of patient Any other names by which patient is known MHCS reference number Current address Nationality Ethnic origin Date of birth Any alias dates of birth Date of conditional discharge Index Offence Key Risk Factors/Indicators Please indicate whether the patient is MAPPA eligible, and if so at what level the case is being managed. If MAPP meetings are taking place, please list any action points from the last meeting: MAPPA Status Please set out details of the other statutory agencies working with the patient Involvement of Other Agencies Supervisor’s details Your name Address Telephone number Email address Occupation (please tick one) Approved / forensic social worker CPN Consultant forensic psychiatrist Consultant psychiatrist Locum psychiatrist Other (please specify) Other occupation, if applicable Date of last interview with patient Is there likely to be a change in either psychiatric or social supervisor soon? If so, when? Is the patient seeing any other specialist practitioner (e.g. psychologist, drug/alcohol awareness counsellor)? Date of this report 1. Mental state 1.1 Please provide a brief description of the patient’s mental state. 1.2 If there have been any changes in the patient’s mental state since the last report, please explain the nature of those changes in relation to the risk factors and what, in your view, is the reason for them. 1.3 Please provide deta