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why do you feel he will not be safe at work and do you think not being at work will increase his strain even more with more time on his hands to think about his feelings?
in my opinion, it is likley that as he has verbalised the thoughts openly and has good clinical support it is less likely he will act on them and he has not verbalised any thoughts towards fellow workers
however would be a return to work with his level of drinking  reduce inhibitions for an enactment of feelings and make him a safety risk - did he feel he could curtail this and would his line manager be happy to check for signs of alcohol use before work each day
If this could be managed then perhaps being at work will be a distraction away from the thoughts and aid his recovery but perhaps I have missed something
 but it would be great if you could get to speak to the CPN asap

On Fri, Jan 11, 2013 at 7:41 AM, Tracy Turner <[log in to unmask]> wrote:
Good Morning. I wander if I can have your advice please especially those in mental health. Yesterday saw a gentleman who requested a self referral and wanted HR to be present.
He had signed himself off with stress the day previously. He informed me that he had been experiencing unnatural thoughts towards meat. When I asked him what these thoughts were he replied. I want - wanted to eat human flesh. I asked him if he had ever thought how this would be achieved and he replied. Oh yes there is a jogger who lives near me and I planned to run him over and then take the body and eat it. I knew where to could be stored and everything.
He informed me that he was receiving psychiatric care and that the recovery and crisis team were involved who had informed the police. He was angry that they had been informed as he thought it was unnecessary to do so.
He stated that he has previously suffered with mild depression and anxiety but since September he had various family issues father with dementia and brother with cancer and he was having difficulty handling the stress.
He reports that he still has the thoughts of canabalism but he knows not to act the thoughts out. He has said that his medication is being increased.
He had increased his drinking to 4 strong cans of cider per day. He had one can of cider before attending clinic.
He lives with a lodger and wants to come to work for financial reasons and says staying at home will affect his health more.
He has a meeting with GP today and wants to return to work on Monday. He works in an abattoir.
I with his consent contacted his GP as concerned he was going to be at home without support. I was advised that it would be discussed at todays appointment otherwise for me to contact the Crisis Team. I contacted the crisis team and they advised me they were only asked to do a few tel calls to the man and to discuss with the CPN. I could not locate the CPN. He confirmed that he did not  have thoughts of suicide.
My plan is for him to remain away from work until I have a full mental health history and I am trying to arrange a meeting with his CPN to obtain this. However HR are fully aware of all the details as they were present and they are horrified. Thankfully I am away for the next 2 weeks but when I come back I have important decisions to make. I will have limited use of email but will read any advice on my return so please offer what you can! He has said that he is being honest and test I have not kept him in work and that he has a mortgage to pay. I am concerned I do not know the full facts and that he continues to be a rsk not only to himself but others. I am also concerned that he will deny the thoughts in future in order to return to work. I am a stand alone practitioner with very very apprehensive HR team at the moment!!

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