Piling symptoms upon symptoms...

Well, I had to do another competency evaluation at the jail today. This prisoner kept saying, "Are you from the military? Am I waiting to go to military training" over and over. It got to be ridiculous how obvious it was that he was trying to draw attention to the fact that he is "delusional." He stayed in character the entire forty minutes that we spoke. Because I was skeptical of his story, as the truly mentally ill behave differently than he was behaving (they deny their symptoms and try to draw attention away from them, whereas malingerers will "pile symptom upon symptom"), I asked the guard what he knew about the guy. The guard said that he functions very well in jail, that he used to be in the kitchen work crew, and that he seems to be a"happy-go-lucky" guy most of the time. I think it is really sad that so many psychiatrists and psychologists go to these competency interviews/test sessions, and take everything at face value. Have they ever heard of malingering? Do they know that one of the main red flags for malingering is Antisocial Personality Disorder which the majority of repeat offenders have? Do they realize that people facing 25 years to life in prison would much rather fake crazy so they can go to the state hospital for 3 years and go to programs the rest of their lives? I think my profession is incredibly naive...especially those that visit with the inmate for 10 minutes, buy all of the symptoms at face value, and never gather collateral information from others that know the inmate. Anyhow, I am not sure I have enough information that I can say the guy is competent to stand trial, but I do know that he is malingering and that will be in my report. When he goes to Patton State Hospital for competency restoration, they will read my report and keep their eyes out for whether or not he is faking symptoms.