Jennifer Axelson, LCSW, CCM, MSCC, CLCP 
Martha Kern

 

Matthew’s psychiatric history was infinitely more complex than his criminal history.

Six diagnoses — Schizoid Personality Disorder, Attention Deficit Hyperactivity Disorder, Tourette Syndome, Asperger’s, Oppositional Defiant Disorder and Obsessive Compulsive Disorder — had made a young life of just 26 years incredibly difficult.

Matthew’s criminal history was far simpler: There had been no trouble at all.  His record was perfectly clean until poor social insight and a broken heart changed everything.

An Up-and-Down Journey
Matthew’s parents could not have been more delighted when, in his mid-twenties, Matthew settled into a job he liked and began his first long-term, significant romantic relationship.  It had been no easy thing to get this far.

Matthew’s early life had been seriously complicated by a string of psychiatric diagnoses that interfered with his ability to function in school and experience even modest social success.  He attended an alternative high school and, upon graduation, held a series of short-term jobs.  Each of these jobs began with promise and ended in termination.  Matthew lost interest in the jobs and disliked being around people, causing his performance and reliability to slip.

The most recent job was different.  It was in a public retail environment but the specialty product line catered to a smaller, niche audience.  More important, the products – puzzles and games – were of great interest to Matthew.  He liked it there.  And shortly after he started, he met a young lady who would become his girlfriend.

Eight Months of Happiness and One Bad Night
Jane appreciated Matthew’s good looks, his keen intellect, his quirky interests and the tremendous devotion he showed her.  The relationship worked in its own way and somehow succeeded despite Matthew’s historic self-neglect (poor hygiene and a squalid environment) and unusual interpretations of social cues.prisoner_figure_behind_cell_window_bars_1600_clr_13549

When Jane eventually broke it off, Matthew was devastated.  His interpretation of what it all meant and how he should respond was anything but ordinary.

He super-glued nails and insulation in the muffler of Jane’s car.  He also slashed her tires and left screws on the driveway.  Worst of all, he posted intimate pictures of Jane on the internet.

Matthew was arrested outside his workplace and charged with criminal mischief, stalking, possession of an illegal weapon and posting an image of another individual for harassment.  He spent two weeks in county jail before his parents could post bond.

A Professional Plan for a Serious Problem
Matthew’s parents, well-meaning and involved as they were, understood immediately that it would take a proactive plan with professional insight to keep their son from going to jail.  They hired Lifecare Innovations to develop and facilitate a mental health plan that would establish rules and expectations, offer life coaching and identify clear rewards/consequences when expectations were met/unmet.  We worked closely with Matthew’s probation officer.

Matthew’s probation officer was informed at least monthly of the following:

  • Compliance with psychiatric treatment
  • Compliance with medication
  • Any breeches of the mental health plan
  • Any legal issues that arose

Weekly life coaching was also introduced and consisted of:

  • Vocational counseling
  • Job searching
  • Job coaching, once Matthew was hired
  • Monitoring of activities of daily living, such as bathing, eating, etc.
  • Compliance with community service orders

Not essential to the court plan but important for Matthew’s personal growth as a self-sufficient adult, were the following initiatives:

Development of a budget that included a weekly allowance when rules were followed (i.e. compliance with the plan).  LCI professionals delivered the allowance at weekly meetings – if Matthew cancelled the meeting, he lost his allowance for the week.

Promotion of independence, minimizing the role of Matthew’s weary parents and offering rewards for success.  Because of his parents’ generosity and continued willingness to solve problems he caused with his own behavior, Matthew had become somewhat entitled and out of touch with basic adult responsibilities.

Prompts to pay bills, shop for food and eat – Matthew was very much prone to neglecting these fundamental tasks.

In addition to keeping Matthew out of the penal system, it was our express goal to strengthen his independence and help him move toward adult responsibility, something his parents did not always have the heart to enforce.  He took their support for granted and knew they would rescue him when he failed to pay bills.  A person with Matthew’s impairments must often experience uncomfortable consequences (i.e. having cable TV shut off when a bill is unpaid) before they can fully absorb and understand the impact their actions have on their lives.

More than a year into this effort, Matthew is progressing.  His probation officer is pleased with his steadfast compliance – we accompany Matthew to his appointments which affords the probation officer insight into how Matthew is really doing.  Matthew’s attention to activities of daily living has improved, and his understanding of actions and their consequences is becoming more ingrained.

Consistent, professional intervention can successfully keep individuals with developmental or psychiatric issues who commit non-violent crimes out of penal environments that might do them great harm.   A clinically-skilled care manager can relieve family members of the policing role, offer encouragement and coaching, and maximize compliance with community service, probation appointments and court orders.

© Lifecare Innovations