Firstly, thank you for all your comments and tweets! I have been overwhelmed by the response. It is very real to me now, how BIG this news story really is.

I have decided to write a follow-up post so as to try and answer all your questions as best I can.

I would like to start with a disclaimer of sorts. I have been asked to share my views on the trial, on Oscar’s mental state and on whether he can use Narcissistic Personality Disorder (NPD) as a defence.

I am unable to say.

I have not met OP and have not conducted a single assessment on him so my opinion on his mental state would be completely unsubstantiated. For this reason I am choosing to refrain from making any personal judgements on the case. We are just going to have to wait and see.

I would also like to point out that I have not once mentioned that I believe OP has NPD. My earlier article was merely posing the question based on another news report. I have only chosen to provide you with insight into the diagnostic process

I also want to clear up some misconceptions. The evaluation process is being conducted at the state’s expense. This does not in way mean that the prosecutor has an upper hand. The professionals that have been appointed have a responsibility to act in accordance with their ethical guidelines and would not make decisions based on anything but sound clinical practice. Of course, they are still only human and mistakes can be made but they are going to assess this case with the same objective in mind as any other case. This objective, as I stated on Monday, is to answer the question about reduced criminal responsibility.

Some people asked me why this is the only question they need to answer. The two questions I mentioned are from the Criminal Procudures Act (section 77-79). The team responsible for the evaluation, are only expected to fulfil their duty as per these sections in the Criminal Procedures Act.

It is not the psychiatric team’s responsibility to determine whether OP lied during his testimony or to prove that he is guilty or not. They are merely going to be asked to evaluate his mental state on the night of the shooting to determine whether he can use mental illness to prove diminished criminal responsibility.

So yes, the night of the shooting will most certainly be a topic discussed in interviews as the team have to determine what he was thinking and feeling at the time of the incident. They will ask for his personal account of the events and will probably not base their diagnoses on court records or earlier statements but may refer to them if needed.

If the psychiatric team diagnose OP with an anxiety disorder like Generalized Anxiety Disorder (GAD) then they need to determine whether his anxiety was so heightened on the night of the shooting, that he was unable to determine the wrongfulness of his act. It seems likely that they will also need to explore OP’s trauma history to determine whether there were any post-traumatic symptoms present as well.

I am not able to say whether such a diagnosis would aid the defence’s case or not. I am not a forensic psychologist and do not have the expertise to answer this question or any other question about using a diagnosis as a defence. In this same vain, I am not sure if NPD would qualify for diminished criminal responsibility but I very much doubt it. You would have to look at court records to see if a precedent exists. I suggest contacting a forensic psychologist on this matter.

A lot of people have asked me if I think OP has been lying or can be expected to lie during his psych evaluation. I obviously cannot answer that. One of the symptoms of NPD and ASPD is a tendency for deceitful behaviour. If he exhibits this behaviour, it will be recorded. As I mentioned before, there are tests that can easily pick up if someone is faking a mental illness (Malingering). As someone who commented on my blog mentioned, “because of the way the tests are designed, and the fact that a whole variety of assessment methods are used in combination, competent assessors would be able to pick up if somebody was trying to lie their way through or create a false impression”.

In that way, it may turn out to backfire on the accused, which is why I don’t think that the defence team would try and “coach” OP before the evaluation. Of course I can’t say for sure but I suspect that they are just going to help him stay as calm as possible because if anything, it will be an angry outburst or temper flare up that could really cost him in the end. I am not sure if his psychiatrist would prepare him to respond to the tests in specific ways. I would hope not. I also think that it would take a genius the likes of Mike Ross from Suits to be able to memorize all the items of every test. There is just no way.

If any of the examiners believe OP is lying during testing, it is unlikely for a test to be repeated. Repeat tests are not valid. Some tests can only be retested months apart. Either another test will be administered or they will try and use other methods to obtain the required results. Remember, the formal psychometric testing only forms part of the assessment. In psychiatry and psychology, information is gathered via interviews, observations, psychometric testing and collateral information (interviews with close family members etc.).

In terms of any psychotropic medication he is currently using, i.e. anti-depressants or anti-anxiety meds – I do not think they will ask him to go cold turkey. A lot of people have asked me whether being on these meds would influence the results. I would just like to state that I am not a psychiatrist and not medically trained. I therefore do not have expert knowledge when it comes to psychotropic medication. From what I understand, I do not believe they will ask him to go off his meds. I question how they would substantiate that ethically as they still have his human rights to consider and he is an outpatient and currently on bail. I don’t believe that SSRIs (Selective Serotonin Reuptake Inhibitors) would skew the results much. If anything, his meds would help reduce his anxiety and help him concentrate better. Those kinds of meds do not have the capacity to alter someone’s personality.

And finally, OP is getting special treatment as he is visiting the facility as an outpatient. It is unlikely that this will reduce the amount of time each professional has to assess him. 30 days of ongoing psych interviews a0nd assessments would be exhausting for anyone. He will not, however, have to undergo what other forensic patients have to because he doesn’t have to sleep in the wards. This will reduce the amount of time the nursing staff has to observe him and it will limit his access to other patients, whom he otherwise would have to interact with. I am pretty sure he will be kept away from the other patients as much as possible. This is the only way in which his assessment process will be altered by this special arrangement, from what I can imagine. And I’m sure he is not the first patient to receive outpatient treatment for the 30 days. There should be many cases like this. The wards are very busy and it takes months sometimes to get a bed.

Okay, that is all for now. I hope that you understand that these are simply my opinions and do not in any way reflect those of any other psychologists or other professionals at Weskoppies. I worked there for a year during my internship in 2012 and the views expressed here are based on what I was taught there and not on any practical experience as I never actually worked in the Forensic Unit. The systems may have changed since then so I cannot be 100% sure that my views are an accurate description.