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CONFIDENTIAL
PSYCHOSOCIAL EVALUATION
Date
10/xx/22
Children
One
Name
Ted Lasso
Education
High School Diploma
DOB
4/26/57
SSI
Yes
Age
65
Insurance
Medicaid
Current Housing Arrangement
Incarcerated – previously residing in shelter system
Current Prescribed Psychotropic
Medication
Depekene (an anticonvulsant – for mood stabilizing)
Prolixin (an antipsychotic)
Medication Prescribed By
Correctional Health Services
IDENTIFYING AND REFERRAL INFORMATION
Mr. Ted Lasso is a 65-year-old, Italian Jewish male who stands charged in New York County
Supreme Court with one count of Robbery in the 1
st
Degree (PL 160.15(4), one count of Robbery
in the 3
rd
Degree (PL 160.05), and Petit Larceny (PL 155.25). Mr. Lasso was referred to
Manhattan Mental Health Court (MMHC) by the District Attorney’s office for the purpose of a
psychological evaluation and to determine appropriateness for Alternative to Incarceration (ATI)
court monitoring.
METHOD OF ASSESSMENT
-
Clinical interview with XXXr, Clinical Director, on 10/06/2022
-
Clinical interview with XXX, on 10/05/2022
-
Tests administered:
1.
Historical-Clinical-Risk Management-20, Version 3 (HCR-20
V3
)
2.
Structured Assessment of Protective Factors for Violence Risk (SAPROF)
-
Record review:
1.
Arrest record, dated 2/21/2022
2.
Criminal Complaint, dated 3/4/2022
3.
Correctional Health Services records, dated 4/5/2021 through 8/5/2022
CONFIDENTIALITY
Mr. Lasso was informed of the purpose of the assessment and the limits of confidentiality.
Specifically, it was explained that the information obtained during the evaluation was not
confidential, as it will be included in a report that will be seen by the District Attorney and the
Court. Mr. Lasso stated that he understood the limits of confidentiality.
PERTINENT BACKGROUND INFORMATION
The following background information was obtained from a review of all available records and
Mr. Lasso’s own report.
Social History:
Mr. Lasso reported that he was born in Yonkers, New York and raised in the
Bronx, New York. According to CHS records, Mr. Lasso mentioned that he is one of five
children with one of his brothers being deceased. Mr. Lasso stated that he was raised by both of
his parents, as well as his older sister and younger brother. Mr. Lasso reported his childhood as
“good” and denied any difficulties with reaching his developmental milestones. He stated that his
parents were married for 35 years before his father died in 1987. He reported that his mother died
in 1997. Mr. Lasso described his parents' marriage as “good”, noting that his father worked long
hours as a butcher while his mother was a homemaker. He denied witnessing any violence or
abuse at home and reported receiving physical discipline, “once in a blue mood”, from his
mother who would smack him on his hand with a spatula. Further, he highlighted his mother as
the primary individual whom he received affection from. When reflecting on his father, Mr.
Lasso became tearful, and remarked “I miss my father.” Overall, he described getting along well
and having positive relationships with both of his parents.
When asked about his current relationships with his older sister and younger brother, he
mentioned that he has been able to stay in contact with both of his siblings and was able to speak
with both his brother-in-law and sister over the phone last week. Specifically, he highlighted that
his brother-in-law and sister comprise his main source of social support. Prior to his current
incarceration, he stated that he has been street homeless, and was residing in a shelter on Ward’s
Island. Before being street homeless, he reported residing with his brother-in-law in Staten
Island.
Mr. Lasso stated that he first started dating when he was 14 years old, and that this relationship
lasted a few years before ending. He reported getting married in 1977 which ended in divorce in
1981. Mr. Lasso stated the dissolution of his marriage resulted from his wife’s infidelity. As a
result of this marriage, he reported having a daughter, aged 44. Regarding his relationship with
his daughter, Mr. Lasso stated “I haven’t spoken to her in years.” Of note, per CHS records, Mr.
Lasso reported having a son who died by suicide. Following his divorce, he reported
experiencing several short-term relationships with the most recent being around the time of the
instant offense. He stated these relationships have often ended due to challenges resolving
disagreements. Currently, Mr. Lasso reported having some friends from his stays at various
shelters and highlighted having a best friend whom he has known all of his life. He reported last
speaking to his best friend “a year ago”, prior to his most recent incarceration. Mr. Lasso
reported being raised as a Catholic and that he considers himself religious. Further, he mentioned
engaging with chaplain services while incarcerated at Rikers Island.
Educational and Employment History:
According to available records and self-report, Mr.
Lasso stated that he graduated high school and received his diploma in 1975. He described
getting along well with his teachers and peers. During school, he reported obtaining mainly B's
in his classes, as well as being involved in school activities (e.g., bowling team). He denied any
significant issues during his time at school and denied receiving any suspensions or expulsions.
Furthermore, he denied experiences of being bullied or bullying others. After graduating from
high school, he stated that he attended trade school to study photography, and obtained a
certificate of completion within 16 months.
2
In terms of his employment history, Mr. Lasso reported holding his first job at 12 delivering
newspapers. Since then, Mr. Lasso described maintaining several jobs mainly as a gas station
attendant. He mentioned that his most recent employment was selling ice at a gas station, which
he held for eight years, before being deemed ineligible to work as a result of being diagnosed
with a severe mental illness. Following his diagnosis of a severe mental illness, he stated
receiving social security disability insurance (SSDI). He currently reports receiving SSDI
payments of $712 per month.
Trauma History:
Mr. Lasso reported sexual abuse at 12 years old, in which he stated “Guitar
teacher touched my testicles.” He expressed that he did not share this with his parents at the time
this occurred; however, he said that he shared this experience with his mother several years later.
Medical History:
According to available CHS records and self-report, Mr. Lasso’s medical
history is significant for a diagnosis of corneal leukoma central vision in his left eye. He reported
that he is blind in his left eye. Mr. Lasso stated being allergic to haldol and that he will faint if he
takes it. He reported past injuries including receiving stitches on his head and sustaining four
broken ribs. Mr. Lasso also mentioned losing consciousness after a physical altercation,
approximately three years ago, and waking up several hours later in hospital. Additionally, he
reported a broken finger (5th digit) on his left hand.
Substance Use History:
Mr. Lasso reported K2 (synthetic cannabinoid) as his drug of choice,
which he mentioned first using around the age of 59. He mentioned using K2 a “few times a
week”, with his last usage in January 2022. Mr. Lasso reported that he started drinking alcohol
and using cannabis when he was 14 years old. Regarding his alcohol use, he stated that he would
drink alcohol every week when he was younger. He reported last using alcohol two years ago
and noted that he would drink around “6-8” mixed drinks and engage in risky behaviors while
intoxicated. With respect to his cannabis use, he stated using cannabis twice a day with his last
use on the day of the instant offense. Mr. Lasso also reported a history of brief experimentation
using crack cocaine, phencyclidine, and heroin.
When asked whether his substance use has ever affected his employment or interfered with his
relationships, Mr. Lasso stated “No.” He reported his longest period of sobriety being seven
years and that he was able to maintain this length of sobriety because of his active involvement
in programming and treatment groups at the time. Per available CHS records, Mr. Lasso is
reported to have completed a detox program at St. Vincent’s Hospital in 2022. Mr. Lasso also
mentioned being involved with alcoholics anonymous (AA) and narcotics anonymous (NA)
programming, which he reported some benefit from. However, he also mentioned that he did not
complete this programming.
Psychiatric History:
According to available records and Mr. Lasso’s self-report, he reported his
first contact with mental health professionals occuring around the age of 17. Specifically, he
noted that this was close to the time when the “son of Sam '' was at large and he started getting
“paranoid”. Mr. Lasso stated being first hospitalized at Bronx Psychiatric Center in 1978.
Further, he reported hospitalizations at Harlem Valley Psychiatric Center in the early 1980s,
which was followed by additional hospitalizations at Rockland Psychiatric Center and
Creedmoor Psychiatric Center. In total, Mr. Lasso stated that he has been hospitalized around “60
to 70 times”. Per CHS records, Mr. Lasso was also hospitalized at Kirby Psychiatric Center in
3
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2018 for restoration of fitness. More recently, Mr. Lasso mentioned that he was last hospitalized
in January 2022, for a period of 10 days, at St. Vincent’s hospital.
According to available CHS records, dated 4/5/21 to 3/11/21, Mr. Lasso presented as being
internally preoccupied and self-reported non command auditory hallucinations. Additionally, he
has been frequently reported as irritable, disorganized and tangential in speech, as well as
exhibiting low frustration tolerance. More recent records described continued irritability;
however, improvements were noted in Mr. Lasso’s behavioral control. Of note, recent records
dated 3/22/22 to 8/5/22 have consistently noted that Mr. Lasso has not endorsed auditory or
perceptual hallucinations; however, his thought process has continued to be disorganized and his
speech often circumstantial.
Historically, Mr. Lasso has been diagnosed with schizophrenia, schizoaffective disorder bipolar
type, cocaine use disorder, alcohol use disorder, other hallucinogen use disorder, and cannabis
use disorder. Medication trials have included Prolixin (an antipsychotic), Benadryl (an
antihistamine), Depakote (an anticonvulsant), and Depekene (an anticonvulsant). According to
Mr. Degannaro’s self-report, he is currently taking Prolixin and Depekene and has been 100%
compliant, which is consistent with the most recent CHS records dated 8/5/22.
During the current evaluation, Mr. Lasso stated that his mood has been “good”. Further, he
described currently being engaged in mental health treatment at Rikers Island, where he speaks
to a provider every day and engages in group programming when held. Of note, he mentioned
that he likes his providers and particularly enjoys attending the music group. When asked
whether he is currently diagnosed with any mental health condition, he reported being diagnosed
with “schizophrenia”, which was first diagnosed in 1974. Mr. Lasso noted that he would
experience paranoia, hear voices and see things, and have disorganized thinking. Presently, Mr.
Lasso stated that he does not experience paranoia and does not see and hear things anymore. He
reported that it has been “15 to 20 years” since he last heard voices. Mr. Lasso mentioned that his
psychotropic medications help him to organize his thoughts and sleep. He also acknowledged
adverse consequences, such as “thinking funny”, when he has stopped taking his medications in
the past, and reported that he plans to continue taking his medications once released.
Legal History and Instant Offense:
According to his New York State arrest record dated
2/21/22, Mr. Lasso has a total of one felony conviction, 31 misdemeanor convictions, and three
violations. He has a history of one violent felony conviction: Attempted Robbery in the 2
nd
degree in 1999. Mr. Lasso has most commonly been arrested for charges of Burglary in the 3
rd
degree, Petit Larceny, Criminal Possession of Stolen Property, Intent to Obtain Transportation
without Paying, and Disorderly Conduct.
Mr. Lasso is currently charged with Robbery in the 1
st
Degree (PL 160.15(4); Class B Felony),
Robbery in the 3
rd
Degree (PL 160.05; Class D Felony), and Petit Larceny (PL 155.25; Class A
Misdemeanor). According to the criminal complaint, Mr. Lasso is alleged to have attempted to
leave a store without paying for an item of clothing and threaten to shoot a store employee who
attempted to prevent him leaving with the unpaid merchandise. When asked about this arrest, Mr.
Lasso stated that he was smoking marijuana at the time and “needed a couple of dollars.”
MENTAL STATUS
4
Mr. Lasso is a 65-year-old, caucasian male who was interviewed by Dr. Feuer on 10/06/22. Mr.
Lasso’s interview took place over the Department of Correction (DOC) Video Teleconferencing
service. During the video teleconference interview, Mr. Lasso was only visible from the neck up
and he wore beige jail clothing. He appeared his reported age. His hygiene appeared to be
adequate; however, his hair appeared somewhat disheveled. Mr. Lasso was alert and oriented to
person, place, time, and circumstance. He described his mood as “good” which was congruent
with his affect. He presented initially as hurried, wanting to finish the interview quickly;
however, he responded well to redirection from this examiner and appeared more comfortable as
the interview continued. His overall speech was grossly normal in rate and tone but tangential at
times. He denied any current self-injurious or aggressive thoughts. There was no evidence of
delusional thinking; however, his thought process was often circumstantial, as he would often
provide trivial or irrelevant details before circling back and answering the question. He denied
any hallucinations and there was no evidence that he was actively hallucinating. He was
cooperative in his responses. He did not evidence any notable challenges with attention,
concentration, or short-term memory. Expressive and receptive communication was intact.
Overall, his cognitive abilities appeared to be grossly intact.
DIAGNOSTIC IMPRESSION
Based on the results of the current evaluation, as well as collaterally obtained information and
the results of diagnostic testing, the following DSM-5 diagnoses are given at this time:
F20.9 Schizophrenia, multiple episodes, currently in partial remission –
Based on Mr.
Lasso’s reported symptoms and past psychiatric records, he meets criteria for schizophrenia. In
terms of psychotic symptoms, Mr. Lasso has a history of experiencing both auditory and visual
hallucinations and persecutory delusions. Additionally, his symptoms have included disorganized
thinking and paranoia. These symptoms have persisted during periods of abstinence from all
substances, including while in secure forensic psychiatric settings. Although his symptoms may
be exacerbated by substance use, they are not caused by substances. According to available
records, Mr. Lasso has not experienced any hallucinations or delusions, associated with
schizophrenia, since 3/11/22. However, Mr. Lasso has continued to evidence disorganized
thinking.
F19.21 Other (K2) substance use disorder, severe, in early remission, in a controlled
environment -
Based on available records and Mr. Lasso’s reported symptoms, he meets criteria
for other substance use disorder, severe. Mr. Lasso has a history of using K2 in larger amounts
and over a longer period of time than intended, unsuccessful attempts to cut down his use,
cravings to use K2, continued use despite persistent social or interpersonal problems, as well as
continued use despite knowledge of his psychological difficulties which are exacerbated when
using, and a need for increased amounts in order to achieve the desired effect. According to
available records and self-report, Mr. Lasso last used K2 in January 2022.
F12.21 Cannabis use disorder, moderate, in early remission, in a controlled environmen
t -
Based on available records and Mr. Lasso’s reported symptoms, he meets criteria for cannabis
use disorder, moderate. Mr. Lasso has a history of using cannabis, up to several times a day, since
adolescence and has struggled to cut down or control his use. Further, he has experienced strong
urges to use cannabis and has continued to use cannabis despite having social and interpersonal
problems exacerbated by his use. Similarly, he has continued to use despite knowledge of his
psychological difficulties which are exacerbated when using.
5
F10.21 Alcohol use disorder, moderate, in sustained remission, in a controlled environment
-
Based on available records and Mr. Lasso’s history and current symptoms, he meets criteria for
alcohol use disorder, moderate. Mr. Lasso has a history of consuming alcohol in larger amounts
and over a longer period of time than intended, unsuccessful attempts to cut down his use, strong
urges to use alcohol, recurrent alcohol use in physically hazardous situations, and continued use
despite persistent social or interpersonal problems. According to available records and self-
report, Mr. Lasso last used alcohol over two years ago.
VIOLENCE RISK ASSESSMENT
As part of eligibility for diversion, this evaluator assessed Mr. Lasso’s level of risk for violence
and whether his risk can be managed in the community. This violence risk assessment is based
on the interviews conducted with Mr. Lasso as well as a review of the various materials listed
above.
Overview of Violence Risk Assessment Method
For the purpose of this report, violence is defined as actual, attempted, or threatened physical
harm of another person, including intimidation or fear-inducing behavior that is nonconsensual.
Violence risk assessment is the process of evaluating people to characterize the risks that they
will commit violence in the future (e.g., the nature, severity, imminence, frequency, and
likelihood of future violence), as well as the steps that could be taken to minimize these risks.
There are two basic methods of conducting a violence risk assessment supported by empirical
evidence. First, the discretionary approach, sometimes referred to as the Structured Professional
Judgment approach, involves consideration of the totality of circumstances in the case at hand.
This approach may involve reference to professional guidelines and typically involves the
identification of static factors (those that are mostly unchangeable) and dynamic factors (those
that are potentially variable with intervention), as well as factors that are relevant for risk
management. The second method, the non-discretionary approach, sometimes referred to as an
actuarial risk assessment, involves consideration of a limited number of factors that are
combined according to a fixed and specific algorithm. It creates a statistical profile of the person
that may be compared to known groups of recidivistic and non-recidivistic violent offenders. For
the purpose of preparing this report, the discretionary method has been used, conducting a
comprehensive violence risk assessment according to the professional guidelines outlined in
Version 3 of the Historical-Clinical-Risk Management Guide (HCR-20
V3
; Douglas, et al., 2013)
and the Structured Assessment of Protective Factors for violence risk (SAPROF) measure,
respectively. Below are general findings and opinions based on a systematic appraisal and
consideration of the HCR-20
V3
’s and SAPROF’s Historical, Social/Contextual, and Individual
Risk Factors balanced against the Protective Factors domain.
Violence Risk Factors
General Physical Violence Historical Risk Factors
: Mr. Lasso has several relevant risk factors
for violence. He has a history of violence as an adult, including a prior violent felony, and his
most recent arrest, which places him at risk for future violence. Engaging in and threatening
physical violence, may have been reinforced as appropriate strategies to satisfy his need and to
navigate interpersonal conflict. He also has a history of other antisocial behaviors, beginning in
adolescence, including the illegal possession of a substance, as well as acts in adulthood
6
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motivated by financial or material gain, such as petit larceny, burglary, and possession of stolen
property. This has antisocial behavior as a problem-solving strategy. Problems with relationships
are also a risk factor for Mr. Lasso. According to his self-report, he is divorced and has had
several unstable relationships since. His relationship with his daughter is estranged, as indicated
by his reported lack of communication with her for over six years. Further, he appears to be
somewhat socially isolated and reported last communicating with his best friend a year ago. This
instability has led to emotional stress and a lack of exposure to positive interpersonal
relationships, which increases his risk for engaging in violent behaviors.
Current and Anticipated General Physical Violence Future Risk Factors:
Protective Factors (SAPROF):
Mr. Lasso has several protective factors that can help reduce his
risk of violence. He developed and experienced a close bond with both of his parents in
childhood, which serves as a positive influence for prosocial behavior. Mr. Lasso also expresses
a positive attitude toward treatment, in addition to positive life goals such as obtaining
employment, continuing treatment, finding a romantic partner, and making new friends. His
increased positive attitude for treatment and positive life goals can enhance his motivation and
ability to benefit from treatment. He has also been fully compliant with his psychiatric
medication since his recent incarceration and has demonstrated self-control in abstaining from
violent behaviors and substance use. Additionally, Mr. Lasso has managed to sustain positive
relationships with several treatment providers and a commitment to abstain from gambling and
using substances, which have historically been a precursor to violent offending behavior.
Formulation:
At the time of the instant offense, Mr. Lasso had been using cannabis on the day of
his most recent arrest. Mr. Lasso was likely disinhibited, agitated, and psychiatrically
decompensated due to his substance use. Mr. Lasso’s main risk factors include his substance use
and treatment non-compliance. When non-compliant with treatment and using substances, he
presents with an escalation of symptoms including agitation, and impulsivity. Based on the
current evaluation, Mr. Lasso exhibits a high risk for substance relapse and non-violent offending
behavior, as well as a moderate risk for physical violence if left untreated in the community. If
Mr. Lasso were to engage in violence in the future, it is likely that it would be in the context of
psychiatric decompensation due to treatment non-compliance and/or K2 and cannabis
intoxication. This risk would be significantly reduced if Mr. Lasso were to engage in appropriate
treatment described below.
OPINION AND TREATMENT RECOMMENDATIONS
Given the identified clinically-relevant factors, the availability of treatment to address these
factors, and Mr. Lasso’s willingness to participate in such treatment, he is eligible for ATI
through Manhattan CRAN court monitoring with the following treatment plan
:
Treatment
– It is recommended that Mr. Lasso attend a residential Mental Illness Chemical
Addiction (MICA) treatment program that provides intensive daily treatment focused on
substance use as well as coping with mood related symptoms. Residential treatment would
provide Mr. Lasso with structure, monitoring and regimented responsibilities to engage in
treatment for his mental health and substance use disorders. This level of treatment would ensure
that Mr. Lasso abstains from mood-altering substances while gaining support and coping skills to
remain abstinent. He requires access to medication (with monitoring to ensure compliance) as
well as intensive individual and group therapy to treat his mood related symptoms. Mr. Lasso
7
would benefit from a trauma-informed treatment approach that incorporates aspects of Cognitive
Behavioral Therapy (CBT) for Psychosis, specifically targeting unhelpful thought patterns and
developing appropriate coping strategies.
Further, because his substance use is a significant and chronic life-long issue for Mr. Lasso that
intertwines with his mental health symptoms, emphasis should be placed on the role his
substance use has played in his mental health symptoms and life. He would also benefit from in-
depth instruction and assistance in developing and implementing a thorough relapse prevention
plan. In addition, it would be ideal for Mr. Lasso to attend a treatment setting that could help him
to work towards his goal of obtaining employment and building a network of prosocial peers.
Help with these personal goals would likely maximize Mr. Lasso’s engagement and success with
treatment. If the above treatment recommendations are implemented, Mr. Lasso’s prognosis is
moderately good, and his risk for violence could be substantially decreased.
After a period of intensive residential treatment, Mr. Lasso may be suitable for less restrictive
treatment options, although he will likely continue to need some level of monitoring and support
in order to safely transition into the community and will require assistance with housing and
employment. At the point in which Mr. Lasso’s residential treatment providers determine that he
is suitable for a less restrictive setting, a re-evaluation should be conducted in order to determine
the appropriate next steps in his treatment plan.
Monitoring –
Provided that Mr. Lasso is placed in an appropriate intensive residential MICA
program, it would be sufficient for him to meet with a case manager or for the facility to provide
an update every week. He should be tested for substances frequently (once per week) at the
residential treatment facility. Once he eventually moves to a less restrictive setting, Mr. Lasso
should meet with his case manager more frequently to assess his mental status and to be tested
for substances several times per week. Furthermore, if Mr. Lasso’s risk of violence to himself or
others increases due to treatment non-compliance, substance use, or other mental-health related
factors, it is recommended that he be referred for evaluation for inpatient psychiatric
hospitalization.
SUMMARY
Mr. Ted Lasso is a 65-year-old, caucasian American male who stands charged in New York
County Supreme Court with one count of Robbery in the 1
st
Degree (PL 160.15(4), one count of
Robbery in the 3
rd
Degree (PL 160.05), and Petit Larceny (PL 155.25). His criminal history stems
primarily from instability caused by his mental health symptoms, chronic polysubstance use, in
addition to medication noncompliance. These problems have contributed to functional
impairments with his employment, family, and social relationships. He has a history of violence
mostly related to periods of severe substance intoxication. When non-compliant with treatment
and using substances, he presents with an escalation of symptoms including hallucinations,
delusions, paranoia, agitation, and impulsivity, which increases his risk of violent behavior.
Based on the information available, Mr. Lasso meets diagnostic criteria for schizophrenia,
multiple episodes, currently in partial remission; other (K2) substance use disorder, severe, in
early remission, in a controlled environment;
alcohol use disorder, severe, in sustained remission,
in a controlled environment; and cannabis use disorder, moderate, in early remission, in a
controlled environment. Based on the results of the current assessment, Mr. Lasso would benefit
8
from a residential MICA program with a high level of structure, support, and monitoring, as well
as trauma-informed treatment, with an emphasis on CBT for Psychosis that is trauma-informed,
medication management, and frequent toxicology testing. If provided with the intervention
described above, Mr. Lasso’s risk for future violence and offending could be substantially
lowered.
Limitations
The accuracy of risk assessments is limited by the quality of the information on which these
assessments are based. In addition, violence risk is dynamic and can change based on a variety
of factors. Please contact me if new and potentially relevant information comes to light, and I
can advise whether this would lead to any substantive changes in my findings or opinion.
9
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