Haldol administration masks the psychosis and he appears relatively normal while its effects are waning.
The effects of haldol wear off approximately 4-5 days after administration. His last dosage was on or around July 4, 2014. Four days later, July 8, 2015, the brachykinesia had disappeared. The next day, however, the psychosis was reappearing:
The morning of July 9, 2015, at 10:30am, Alt arrived to bring B from where he was staying to his appointments that day. B was drinking very strong coffee. Alt sat with him, unaware of his current state of mind. She was taking notes so that she could understand where she was bring him and when, but when she frowned in confusion, he aggressively asked, “What that frown for?” and was apparently getting agitated by her and her note-taking. Recognizing this paranoia, she exited the room and went to her car to call his attorney who asked that she have him bring B to his office. When Alt went back into the house and mentioned that his attorney, Mc, wanted him to stop by his office before his Drug Court appearance that was scheduled for 12:30, he became extremely agitated, saying “I have no time for this. I’m in no rush. I have a car” repeatedly as he poured himself his third or more coffee. His speech was very repetitive and abnormal. C Bell was present and she and I de-escalated the situation.
Approximately 45 minutes after this scenario, he came to Alt’s car, slammed the door, and said, in a manic, somewhat agitated and repetitive speech, “Let’s go. Let’s do this. I have no time for this. I have no time for this ****” over and over. As the car turned the corner, they happened to have to follow a police vehicle, the sight of which made B explosively rageful. He started yelling repeatedly, “YOU GONNA ARREST ME! YOU GONNA DRUG ME UP! YOU GONNA PUT A NEEDLE IN MY ARM AND **** ME UP! OH YEAH! **** ME UP! **** ME UP!” as he punched the dashboard. He then directed his attention to Alt, saying in agitation, “YOU’RE DRIVING. YOU’RE DRIVING. NO TIME FOR THIS. NO TIME FOR THIS ****!”
He had $40 on him and said he needed “to get something to calm him down” so Alt turned into a CVS parking lot and let him out. Fearing for her safety and the safety of the public as she was driving, she called Attorney Mc and sought advice. She drove out of the parking lot but looped around because she wanted to see where he might have gone. He was emerging from the CVS corner, saw that she had left the parking lot, and proceeded to approach the vehicle with thug-like ape arms. She locked the doors and tried to hand him her phone through the passenger window saying, “Mark wants to talk to you.” He threw the phone into the passenger from seat and said he doesn’t want to talk to him and started walking away. Alt continued to follow him because it was the way out of the parking lot and someone was behind her. B turned back towards Alt’s car and aggressively said, “YOU’RE NOT GOING TO DRIVE ME?!?” to which she replied, “No, B, I’m scared.” They then went in opposite directions.
According to C, B had purchased a Monster energy drink and nicotine gum at CVS as that was what he had on his person when she then drove him to his 12:30 court appearance. He returned $20 of the $40 that he had borrowed from her.
That same night, B attended an AA meeting at Bergen Regional Medical Center where he consumed copious amounts of caffeine and nicotine. At 9:00 when C picked him up, he was reeking of cigarette smell. When C mentioned the smell and suggested he maybe shouldn’t have been smoking, he told her to “stop watching [him]” and “telling [him] what to do.”
At home, he proceeded to chop a roasting chicken in the kitchen and when C suggested that he use spices, he “went off” according to C, saying “don’t tell me how to make chicken. I know how to make chicken.” Sometime after, he put the tea kettle on but then forgot he had done so as the whistle blew and blew. C asked him if he had forgotten it and he said that he did not turn the kettle on.
He then proceeded to hold a picture of himself that was taken about 5 years or so ago in his hands and looked at it close to his face and then away and back and forth again saying “This isn’t me. This can’t be me. Why is my hair like that?”
He sat down and put his head in his hands with his elbows on his knees, looking up at C through his fingers and looking away, back and forth again.
At some point later, he went to the computer room. As it was getting late, C went to the room and quietly approached, touching his arm. He jumped up and screamed, “WHY ARE YOU TOUCHING ME?!” She calmly said it was getting late and suggested he go to bed. He just looked at her with a wild look in his eyes.
He then went downstairs back to the kitchen and started throwing things all over. One of the items was ear plug head phones and he threw them on the floor saying they were crappy head phones. C told B as calmly as possible, because he was in the area of the kitchen where there are knives, that he was scaring her. This angered him and he grabbed her hand roughly to his arm and said, “Do you know what it’s like…to have a needle in your arm??” as he moved her hand up and down his arm where IVs are usually placed.
C then tried to retreat to her bedroom but followed her closely as if trying to provoke her and he blocked her from closing her door with his body. He started rummaging through her things at one point putting a floppy hat of hers on his head and said he was “going out.” He eventually left the room, saying he was going to “get his keys and headphones” [which are in R] so C closed and locked her door. She then heard him walk out of the house. This was approximately 3:30am.
At 5:20am July 8, 2015, the O Police Department left a message with Alt informing her that they had gotten a report of a man sitting on a park bench screaming. The police officer had approached him, obtained his name, and was given Alt’s phone number by the W Police Department. According to the O Police when Alt phoned them at 6:45am, he was not in custody so apparently B had composed himself enough for the officer to not have deemed him a danger and had let him walk away.
At 7:00am, Alt drove to C’s and parked her car in front of the house. For the next hour, she received the above information from C. At 8:25am, Alt was in the back yard on the phone, when C quickly told her through the back door that “he’s coming in.” Knowing that she is a trigger, Alt left the yard and went out of sight.
At 8:34, C texted Alt, “He’s cursing and getting agitated, talking to himself.” Very likely, the sight of Alt’s car triggered him. At 8:36am: “Very loud, scaring kids.” C then continued communication by text with S, telling her that she was scared and didn’t think he should be there. Knowing that a 911 call could wind up in a very dangerous situation, S texted her that it is her (C’s) call to make. She also texted that if she could just de-escalate him until the probation officer arrived, then a disaster might be avoided.
According to C, he was calming down and was now saying that he had gotten hit by a car and maybe needed a hospital. C tried to talk him into going, would call for an ambulance, but he was too resistant.
He then ate chicken and for the following few hours, C maintained the situation. The probation officer called C and changed the home visit appointment to a probation meeting at the Drug Court at noon.
C brought B to the noon meeting at which he was presenting his symptoms to the probation officers. They were able to talk him into voluntarily going to the hospital but it had to be Bergen Regional likely for procedural reasons as apparently the Drug Court was so concerned about him that they had actually intended to press charges against him for aggressive-provoking behavior towards people at the AA meeting the night before. Since the Drug Court personnel were able to witness his behavior firsthand, instead of hearing a report that he was just aggressive without these compounded mental health issues, the probation officers decided that he needed psychiatric help instead of the incarceration section of Bergen Regional Medical Center.
B has silver amalgam fillings and root canal that likely are causing mercury toxicity. Mercury is clearly linked to schizophrenia. This plus the trauma and possible drug abuse has caused him to go into a psychotic state with schizophrenic presentation.
What appears to be acute reactive schizophrenic psychosis must have been triggered by the May 28 arrest experience and continued to be triggered by his treatment at Bergen Regional Medical Center. He abused copious amounts of caffeine and nicotine during that approximate ten day intermission mid June. From the time of the July 7 discharge to readmission July 10, he has not used any substances except excessive amounts of caffeine and nicotine.