Bellevue Hospital Center
462 First Avenue
New York, New York 10016

These notes are aimed at helping volunteers selected to work with those suffering from mental disorders in our hospital. The information is not meant to substitute parts of a comprehensive book on psychiatry. Rather, it should give the reader some idea about some practical solutions to the care of the mentally ill and create general awareness.

A) MOOD AND APPEARANCE:

They may be unkempt - wearing dirty clothes and appear to have neglected their hygiene.
They may be found talking to themselves or behaving as if talking or responding to some imaginary objects. They may appear very excited and unusually happy, smiling at anything.

B) SPEECH:

They may talk in a way that one may need help understanding or following even though the language is familiar.
They may talk a lot or sometimes refuse to talk at all.
They may be mute and will not talk or respond to questions even from people they know and are close to them.

C) BEHAVIOR:

They may laugh or giggle inappropriately.
They may stand in one place for a long time, refusing to sit down or move.
They may be aggressive or violent without any provocation.
They may overspend money-buying things they have not planned for, or they do not need.
They may give money away.
They may be promiscuous.

D) ABNORMAL BELIEFS

The following abnormal beliefs may be expressed:-
Claiming to be somebody they are not
They believe they possess special powers to do impossible or big things.
Claiming that some innocent people are enemies and that people have conspired to kill them
The belief is that the food or drink provided is poisoned.
The belief that somebody has been passing some gasses, particularly at night, into their rooms, or some chemicals are being sprayed on them.

E) ABNORMAL PERCEPTIONS

They may see things or hear voices that nobody else sees or hears.
The voices that they hear may be telling them to do things. Some may resist, and others may obey the voices and act on their instructions.
They may refuse to sleep in a room or live in a house because they claim their lives are in danger without proof.
Some may smell or feel what nobody else can.

THE ABOVE SYMPTOMS WILL BE TYPICAL OF A PATIENT DESCRIBED AS BEING PSYCHOTIC.

A person suffering from a psychotic illness is not likely to be convinced to stop acting or behaving in the manner they are found in.
They will not benefit from being chained or locked up in a room.
They will continue to be a nuisance or destructive if he is left alone without help.

Dr. J. Holland MD Psy.D Ph.D

John, please review my notes before distributing this to the volunteers. Also, could you check with the NYPD for their paperwork on this case as soon as possible? My good friend Detective Martinez in Midtown is the contact over there on this one. – Cadwallader

10:15 a.m. - Tuesday, Jan. 03