E-FILED
`IN COUNTY CLERK'S OFFICE
`PIERCE COUNTY, WASHINGTON
`
`January 19 2022 8:30 AM
`
`CONSTANCE R. WHITE
`COUNTY CLERK
`NO: 21-1-02443-1
`
`

`

`Forensic Competency Report
`RE: Zavar K. Nasim
`
`January 18, 2022
`Page 2 of 9
`
`Effort and Reliability: Mr. Nasim refused to participate in the interview for the present
`evaluation. Given the consistency, complexity, and acuity of his clinical presentation, he appears
`to be experiencing genuine symptomsofa severe and persistent mentalillness.
`
`Diagnosis or Current Mental Status: The following diagnostic impressionsare offered:
`e®
`Schizoaffective Disorder, bipolar type
`e Substance Use Disorder (cannabis, alcohol, methamphetamine), per history
`
`Competency: Mr. Nasim currently lacks the capacity to rationally understand the nature of the
`proceedings against him, consult with defense counsel, and the capacity to assist in his own defense
`as a result of mental disease or defect.
`
`Restoration: I respectfully recommend an additional period of competency restoration.
`
`DCR Evaluation: An evaluation by a DCR is recommendedprior to any changein his custodial
`situation.
`
`NATURE OF THE EVALUATION
`
`Notification and Agreement to Participate
`Pursuant to RCW 10.77.060, I, Patricia C. McCormick, Ph.D., was designated as the qualified
`expert to evaluate and report upon the mental condition of Mr. Nasim. On 01/11/22, I introduced
`myself to Mr. Nasim and asked him if he would be willing to participate in a Court-ordered
`competency evaluation. He replied, “No,” declining to participate in the interview. Further
`information regarding ourbrief interaction is describedlater in this report.
`
`Sources of Information
`The following information was reviewed and considered during the completion ofthis evaluation:
`
`Database
`1. Discovery materials provided by the prosecutor:
`2. Attempted Clinical/Forensic interview with Mr. Nasim on 01/11/22, on Ward F-3 at WSH,
`approximately one minute;
`3. Conversation with Mr. Nasim’s defense attorney, James Dahl, Esq., on 01/11/22;
`Consultation with Mr. Nasim’s current treatment team on 01/10/22 and 01/11/22;
`5. Western State Hospital (WSH)records, including:
`a. Declaration in Support of 180 DayPetition for Involuntary Treatment, by Virginia
`Klophaus, Ph.D., and Daniel Ruiz-Paredes, M.D., signed on 01/17/18;
`6. Office of Forensic Mental Health Services (OFMHS)forensic reports:
`a. Community Forensic Competency Evaluation, by Thomas LeCompte, Psy.D.,
`ABPP, OFMHS, 09/28/21, pursuant to case D00051953, Tacoma Municipal Court;
`Inpatient Forensic Competency Evaluation, by Mallory McBride, Ph.D., OFMHS,
`09/23/19, pursuant to case 9ZC000656, Pierce County District Court;
`Inpatient Forensic Competency Evaluation, by Janene Dorio, Psy.D., OFMHS,
`01/18/18, pursuant to case 17-1-01714-2, Pierce County Superior Court;
`
`b.
`
`c.
`
`

`

`Forensic Competency Report
`RE: Zavar K. Nasim
`
`January 18, 2022
`Page 3 of 9
`
`d.
`
`Inpatient Forensic Competency Evaluation report, by Jonathan Sharrette, Ph.D.,
`OFMHS, 09/08/17, pursuant to case 17-1-01714-2, Pierce County Superior Court;
`e. Community Forensic Competency Evaluation, by Les Hutchins PhD., OFMHS,
`08/31/16, pursuant to cases B254255 and 620392092, Lakewood Municipal Court;
`7. Forensic Psychological Report, written by Julia McLawsen, PhD, Independent Evaluator,
`05/18/17, pursuant to case 17-1-01714-2, Pierce County Superior Court,
`8. Washington State Patrol WATCH Report;
`9. Selected portions of the Evaluation of Competency to Stand Trial — Revised (ECST-R).
`
`BASIS AND REASONING FOR OPINIONS
`
`Relevant Clinical History and Collateral Information: The Courtis respectfully referred to Dr.
`LeCompte’s report for a review ofMr. Nasim’s relevant history and collateral information. The
`following information was obtained from WSH treatment records, a brief interaction with Mr.
`Nasim on 01/11/22, and discussions with his current treatment team and defense attorney:
`
`Current Course of Hospitalization
`
`Admission
`Mr. Nasim was admitted to WSH’s Center for Forensic Services on 12/07/21. He was housed on
`Ward F-3, which is a treatment unit within the secure perimeter of WSH designedto assist in the
`psychiatric stabilization and the development of skills to adequately participate in a legaltrial.
`Admitting psychiatrist, Dr. William Ehlers, noted that Mr. Nasim presented with appropriate
`grooming, he was fairly oriented, and he appeared to be “alert to possibly hyper vigilant.” He
`evidenced a “plus plus pleasant” attitude and expressed “undue” familiarity with Dr. Ehlers. The
`psychiatrist indicated Mr. Nasim was “cooperative up to a point,” though he was unwilling or
`unable to expand upon various responses. Mr. Nasim reported that his mood was “dapper,” and
`Dr. Ehlers described the patient’s affect (1.e., outward expression of mood) as euphoric, and his
`behaviors as “energetic” and “elevated.” His thought processes were “somewhatlogical, linear,
`and goal-directed. However, at other times Mr. Nasim’s thought processes were markedlyloose’,
`tangential, and circumstantial’, and certainly over inclusive.” According to Dr. Ehlers, the patient
`was “hyperverbal to the point it was difficult to capture the full quantity of his thought content.”
`His speech was pressured and demonstrated “run together” articulation. Mr. Nasim endorsed
`religious preoccupation, impulsivity, increased energy, and disrupted sleep. Dr. Ehlers denied that
`the patient presented an imminentrisk of dangerto self or others.
`
`At the time ofintake, Dr. Ehlers indicated Mr. Nasim endorsed paranoia and delusional thoughts
`(e.g., reporting that he was the second coming of Christ and could read people’s minds). Mr. Nasim
`endorsed hallucinations and Dr. Ehlers observed the patient occasionally appearing internally
`distracted throughout the interview. Regarding Mr. Nasim’s performance during brief cognitive
`tasks, his short and long-term memorywasintact. When asked to describe a current worldly event,
`
`
`' A thought disturbance demonstrated by speech that is disconnected and fragmented, with the individual jumping
`from one idea to anotherunrelated orindirectly related idea.
`? Circuitous, indirect speech in which the individual digresses to give unnecessary and often irrelevant details before
`arriving at the main point.
`
`

`

`Forensic Competency Report
`RE: Zavar K. Nasim
`
`January 18, 2022
`Page 4 of 9
`
`Mr. Nasim said, “Weare in the aftermath of a long ice age.” Dr. Ehlers indicated the patient’s
`thinking was “rather” concrete, and his attention, concentration, and cognitive processing were
`impaired. The psychiatrist suggested Mr. Nasim’s insight was “limited to good”in that he
`identified being diagnosed with Schizoaffective Disorder. His judgment and problem-solving
`during a hypothetical everyday scenario were impaired and included a sexually inappropriate
`response. Dr. Ehlers concludedthat thetotality of available data suggested Mr. Nasim presented
`with symptoms indicative of Schizoaffective Disorder, “currently manic with psychosis.” He
`highlighted evidenceof delusions, hallucinations, “emotional dysregulation of odd behavior,” and
`“markedly loose and nonlinear” thought processes. He cited Mr. Nasim’s documented substance
`use disorders(e.g., alcohol, marijuana, stimulants) and history of medication noncompliance. He
`prescribed Mr. Nasim Risperdal (i.e., 3mg nightly; antipsychotic) “for psychosis,” and Depakote
`(i.e., 500mg twice daily; anticonvulsant/mood-stabilizer) “for mood.”
`
`Treatment and Medication
`According to WSHrecords, Mr. Nasim’s doses of Risperdal and Depakote increased through mid-
`December 2021
`(to Smg and 2,250mg,
`respectively). The medications were ultimately
`discontinued on 12/27/21, due to Mr. Nasim’s complaints of adverse side-effects (e.g., nausea).
`On 12/27/21, current
`treating psychiatrist, Dr. Meesha Sidhu,
`introduced Zyprexa (Smg;
`antipsychotic) to the patient’s regimen “for psychosis and mood,” the dose of which gradually
`increased. Dr. Sidhu added a more potent antipsychotic, Thorazine (50mg), to Mr. Nasim’s
`regimen on 01/12/22, due to ongoing psychosis (e.g., disorganized thought processes and
`respondingto internal stimuli). On an as needed basis, Mr. Nasim wasalso prescribed Vistaril and
`Benadryl(i.e., antihistamines with calming, sedating effects) for anxiety and agitation, as well as
`Ativan(i.e., benzodiazepine, anti-anxiety), which he has taken intermittently. At the time of the
`present evaluation, Mr. Nasim’s voluntary medication compliance improved in January 2022. On
`that note, Dr. Sidhu informed me during consultation on 01/11/22, that Mr. Nasim was refusing
`medications that were administered in the momings, and his compliance improved once they were
`administered later in the day. WSH records revealed that Mr. Nasim hasnotattended active group
`treatment(e.g., psychology and courtroom knowledge groups), and his willingness to engage in
`treatment meetings has varied. Social Worker [SW], Samantha Kauper, informed me on 01/10/22,
`that Mr. Nasim has beensocially isolative and unwilling to engage with staff. During the occasions
`he did engage, he would not do so “forlong.”
`
`Clinical Presentation
`WSHdocumentation indicated Mr. Nasim has independently completed variousactivities of daily
`living and has made his needs known(e.g., notes by nursing staff, 12/07/21 and 12/09/21; Dr.
`Sidhu, 12/22/21). Mr. Nasim typically remained in his room, at
`times verbally refusing to
`participate in routine medical monitoring, or refusing to leave his room to take medicationsor eat
`meals (nursing notes, 12/15/21, 12/18/21, 12/22/21, 12/23/21, 12/27/21, and 12/29/21). WSHstaff
`described Mr. Nasim’s appearance as disheveled and noteworthy for poor hygiene (Dr. Sidhu’s
`notes, 12/10/21, 12/15/21, 12/21/21, and 12/27/21). He wasalert (nursing note, 12/22/21), though
`his orientation was at times mildly impaired (e.g., Dr. Sidhu’s note, 12/10/21). For example,
`according to a nursing note dated 12/08/21, Mr. Nasim identified himself as “Gregory.” Per Dr.
`Sidhu’s notes dated 12/10/21 and 12/15/21, Mr. Nasim’s memory ranged from being mildly
`impaired to appropriate, his attention/concentration from fair to poor, and his judgment/insight
`
`

`

`Forensic Competency Report
`RE: Zavar K. Nasim
`
`January 18, 2022
`Page 5 of 9
`
`from mildly to severely impaired. On that note, the patient initially provided an unintelligible
`response as to why he was admitted to the hospital (Dr. Sidhu’s note, 12/15/21).
`
`Mr. Nasim wasoccasionally described as calm, pleasant, and cooperative, while at other times he
`appeared to be “manic” (notes by nursing staff, 12/09/21, 12/10/21, and 12/14/21; Dr. Sidhu,
`12/21/21). For example, his behaviors were hyperactive (e.g., dancing at inappropriate times), his
`affect was “expansive” and inappropriately bright, his speech was pressured to rapid, and he
`reported a reduced need for sleep, as well as increased libido/energy (e.g., Dr. Sidhu’s notes,
`12/10/21 and 12/15/21). He denied risk to self and others (e.g., notes by nursing staff, 12/07/21,
`12/08/21, and 12/10/21; Dr. Sidhu, 12/15/21, 12/21/21, and 12/27/21). Mr. Nasim endorsed
`hallucinations and staff observed him respondingto internal stimuli, such as appearing distractible,
`mumbling to himself, or spontaneously laughing at inappropriate times (e.g., notes by nursing
`staff, 12/07/21, 12/08/21, 12/09/21, and 12/10/21; Ms. Kauper, 12/14/21). However, Dr. Sidhu
`documented on 12/15/21, that Mr. Nasim’s reported experiencing hallucinations less frequently.
`Aroundthat time, the psychiatrist increased the patient’s doses of Risperdal and Depakote given
`that Mr. Nasim was expressing delusional thoughts (e.g., stating that he could predict the future)
`and disorganized, circumstantial thought processes (Dr. Sidhu’s notes, 12/10/21 and 12/15/21). As
`noted above, those medications were discontinued on 12/27/21, due to adverse side-effects (notes
`by nursing staff, 12/22/21; Dr. Sidhu, 12/27/21).
`
`Towards the end of December 2021, Mr. Nasim exhibited less hyperactivity, improved mood
`stabilization(e.g., less expansive, thoughat times inappropriately bright), he denied hallucinations,
`and he expressed no delusional thoughts (Dr. Sidhu’s note, 12/21/21). Mr. Nasim wasableto report
`being admitting for mental health treatment (Dr. Sidhu’s note, 12/21/21). His attention and
`concentration improved somewhat. However, his thought processes remained circumstantial. He
`began refusing his medications more frequently, at which point Mr. Nasim wassocially isolative
`and refusing to engage with staff (Dr. Sidhu’s note, 12/27/21). His affect was restricted, he was
`minimally responsive, and he was observed responding to internal stimuli (Dr. Sidhu’s notes,
`12/27/21 and 12/28/21). On 12/28/21, Dr. Sidhu and nursing staff documented that Mr. Nasim was
`placed in seclusionafter attempting to strike or “head-butt” staff when they approached his room.
`He was given an emergency injection of Zyprexa at that point for “psychotic agitation.” During
`that episode, staff described Mr. Nasim asirritable and agitated, with pressured speech and an
`annoyedattitude. He later discussed the event with staff and said, “I was mad forno reason.” The
`following day, Mr. Nasim wasin a verbal altercation with a peer, though he was successfully
`redirected and agreeable to taking medications to improve his mood (nursing note, 12/29/21).
`
`Throughout January 2022, Mr. Nasim wassocially isolative, his affect was irritable or restricted,
`and he refused to meet with treatment staff (notes by Dr. Sidhu, 01/01/22 and 01/05/22; Ms.
`Kauper, 01/10/22). However, Mr. Nasim’s medication compliance improved. Dr. Sidhu
`documented that the patient was observe speaking to himself, though he overall appeared less
`internally preoccupied (01/05/22 note). The psychiatrist adjusted Mr. Nasim’s medication regimen
`“to reduce potential daytime sedation” (01/05/22 note). Ms. Kauper recently described the patient
`as generally polite, though he avoided eye contact and appeared irritable upon staff approach
`(01/04/22 and 01/10/22 notes). Dr. Sidhu informed me on 01/10/22, that although the patient has
`a documented history suggestive of antisocial traits, Mr. Nasim’s socially isolative behavior has
`proven it difficult for the psychiatrist to form “any solid impression on character.” Dr. Sidhu
`
`

`

`Forensic Competency Report
`RE: Zavar K. Nasim
`
`January 18, 2022
`Page 6 of 9
`
`expressed that Mr. Nasim remains psychotic, yet his behaviors have been more appropriate
`comparedto prior courses ofhospitalization (e.g., less aggressive and sexually inappropriate).
`
`MENTAL STATUS EXAM AND CURRENT FUNCTIONING
`
`On 01/11/22, Mr. Nasim was wrapped from headto toe in a blanket and laying in his bed upon my
`approach. I was unable to determine the appropriateness of his appearance, hygiene, or motor
`activity. Mr. Nasim only said, “No,” to participating in the evaluation. He did not presentas a risk
`of danger to himself or others during ourbrief interaction. Given the short nature of our interaction,
`I was unable to explore the nature of his thought content, thought processes, or cognitive
`functioning (e.g., attention, memory,or his ability to demonstrate complex thinking).
`
`CLINICAL SUMMARY AND DIAGNOSTIC FORMULATION
`
`Mr. Nasim is a 31-year-old male who has received inpatient and outpatient psychiatric treatment
`since at least 2012. Listed diagnoses have included Schizoaffective Disorder, Schizophrenia, and
`Substance Use Disorders involving alcohol, cannabis, and methamphetamine.His presentation has
`historically been noteworthy for negative symptoms of psychosis (e.g., neglected hygiene, social
`withdrawal, diminished speech output/emotional expression), as well as positive psychotic
`symptoms (i.e., disorganized thought processes, delusions, hallucinations). Mr. Nasim has
`exhibited symptomsindicative of a thought disorder’ likely secondary to psychosis(e.g., impaired
`cognitive processing, response latency, and poverty of thought*). There appears to be a mood-
`related component
`to his presentation, namely mania (e.g., expansive affect, behavioral
`disinhibition, racing thoughts, pressured speech, and a reduced needfor sleep). At times Mr. Nasim
`has been paranoid,hostile, and threatening, though to a significantly lesser degree throughout the
`current course of hospitalization. Mr. Nasim has historically been prescribed antipsychotics and
`mood-stabilizers; however, his impaired insight and judgment resulted in periods of medication
`noncompliance (and a forced medication order in 2017). His medication adherence has improved
`in recent weeks, though he remains acutely symptomatic (e.g., psychotic)
`
`Mr. Nasim has a documented history of substance use disorders involving cannabis, alcohol, and
`methamphetamine(i.e., a stimulant). Engagingin the use ofillicit or mind-altering chemicals and
`cause or exacerbate psychiatric symptoms. Given the length of time Mr. Nasim has resided in
`secure facility and presumably without access to related substances,it is less likely that his current
`presentation is due to the acute effects of substance intoxication or withdrawal. It is important to
`note that chronic and severe drug use may have a lasting impact on an individual’s psychiatric
`functioning, though the nature and severity of Mr. Nasim’s substance use patternsare less clear.I
`offer substance use disorders at this time based off available historical data.
`
`Based on the available data, the following diagnostic impressions are offered in accordance with
`the Diagnostic and Statistical Manual ofMental Disorders-Fifth Edition (DSM-5):
`
`3 A cognitive disturbance that affects communication, language, or thought content. A thought disorder is commonly
`viewed as a predominant marker of Schizophrenia, but it is also associated with other conditions such as mood
`disorders.
`4 A thought disturbance that may be attributable to Schizophrenia in which there is reduced spontaneity and
`productivity of thought evidenced by vague speech, full of simple or meaningless repetitions, or stereotyped phrases.
`
`

`

`Forensic Competency Report
`RE: Zavar K. Nasim
`
`January 18, 2022
`Page 7 of 9
`
`e
`e
`
`Schizoaffective Disorder, bipolar type
`Substance Use Disorder (cannabis, alcohol, methamphetamine), per history
`
`COMPETENCY TO PROCEED TO TRIAL
`
`This defendant’s competency to stand trial was evaluated against Washington State’s version of
`the Dusky standard; namely, whetheras a result of a mental disease or defect the defendant“[I]acks
`the capacity to understand the nature of the legal proceedings against him orherorto assist in his
`or her own defense”. (RCW 10.77.010 (14)).
`
`The competency opinion is based upon two major considerations: (1) the nature and severity of
`the defendant’s current mental problems and (2) the present impact of any mental disorders on
`those of defendant’s functional capacities that are important for competent performance as a
`defendant in criminal proceedings. Although Mr. Nasim refused to participate in the present
`interview, there appears to be sufficient information to form a forensic opinion. Informationrelated
`to competency wascollected from the aforementioned sources of information.
`
`The prominentdeficits Mr. Nasim has exhibited and wereconsistently noted by forensic evaluators
`since 2016 highlight commandhallucinations, thought disorganization (e.g., circumstantial, loose,
`irrelevant), and delusions. He has also displayed prominent negative symptomsof psychosis (i.e.,
`poverty of thought, response latencies®). Moreover, Mr. Nasim has historically evidenced
`behavioral dysregulation, mood disturbances(e.g., hostility), impaired speech (e.g., pressured),
`and information processing deficits. His clinical presentation has consistently prevented him from
`demonstrating an appropriate degree of factual and rational understanding of legal knowledge,
`most recently in the September 2021 forensic evaluation with Dr. LeCompte.It is unlikely that he
`has acquired a sufficient degree of factual and rational legal knowledgeto apply it to his caseat
`this time. Throughout the current restoration period, Mr. Nasim has continued demonstrating
`symptoms of a mental illness that would likely impair his ability to rationally appreciate his legal
`predicament, consider complex information about his case to reasonably strategize, and
`communicate meaningfully to his attorney and the Court. While he has demonstrated improved
`moodstabilization, Mr. Nasim can beirritable and minimally responsive in social contexts.
`
`Additional Collateral Information: Mr. Nasim’s defense attorney, James Dah}, Esq., informed me
`on 01/11/22, that Mr. Nasim’s presentation has remained consistent over the course of the past few
`months. Namely, he said Mr. Nasim has been unresponsive and unable to engage meaningfully
`with Mr. Dahlto consult andassist in his own defense.
`
`Competency Opinion
`Mr. Nasim presents with active symptomsof a severe and persisting mental illness that impair his
`competency-related abilities. While his mood has improved somewhatand hehas not engaged in
`a pattern of aggressive behaviors, the defendant has recently demonstrated symptomsindicative
`of psychosis (e.g., predominant negative symptoms,
`thought disorganization, responding to
`internal stimuli). Mr. Nasim’s medication compliance has improved in recent weeks, and per
`consultation with his treatment team, he is expected to further improve with continued medication
`
`° Delayed responding.
`
`

`

`Forensic Competency Report
`RE: Zavar K. Nasim
`
`January 18, 2022
`Page 8 of 9
`
`compliance and recent medication adjustments. Mr. Nasim has refused to attend concurrent active
`competency restoration treatment, and there is no evidence suggesting he has acquired an
`appropriate degree of factual and rational legal knowledge to move forward in his pending legal
`matter. It is likely that ongoing psychotic symptoms will impair his ability to rationally assist
`counsel and effectively participate in his own defense. In his current state, the following deficits
`would interfere with the requisite capacities to proceed:
`
`limited
`lack of responsiveness,
`e Prominent Negative symptoms (e.g., social isolation,
`tolerance for conversations) will
`likely interfere with his ability to communicate
`effectively and engage with his attorney and legal proceedings in a productive manner.
`Limited tolerance for conversations may prevent him from meeting the demands of court
`hearings, meeting with his counsel, andtestifying. He may growirritable in social contexts,
`which would impair his ability to interact appropriately during legal proceedings and with
`courtroom participants, including his attorney;
`
`e Disorganized thoughtprocesses will likely impair his ability to discusshis case in a logical
`and goal-directed manner with the Court or his counsel, participate meaningfully in legal
`proceedings, convey relevant information to his attorney for legal decision-making, or
`testify in a meaningful manner;
`
`e Variable attention/concentration,likely attributable to hallucinations, would interfere with
`his ability to track courtroom proceedings in real time to assist in his defense, have a
`rational or realistic appraisal of his current situation, appropriately attend to meetings with
`his counsel, testify effectively, register, retain, and apply higherorderideasto the specifics
`of his case, and he may make statements against his own best interest (considering his
`history of command hallucinations);
`
`e
`
`Impaired insight/judgment will likely prevent him from recognizing the impact ofhis
`mental illness on his current presentation and may possibly lead to resistance to
`remediation efforts.
`
`in my professional opinion, Mr. Nasim lacks the current capacity to rationally
`In sum,
`understand the legal proceedings against him, consult with defense counsel, or participate in
`his defense.
`
`Restoration Opinion
`Should the Court find that Mr. Nasim is not competent to proceed to trial and that he meets the
`criteria for further competency restoration treatment,
`there appears to be a reasonable
`expectation that Mr. Nasim will improve with further pharmacological and psychosocial
`treatment. As such, an additional period of inpatient competency restoration treatmentis
`respectfully recommended. On 01/11/22,
`treating psychiatrist, Dr. Sidhu, expressed his
`confidence that Mr. Nasim’s mental health will improve with medication adjustments. He noted
`that although Mr. Nasim has beensocially isolative and unwilling to engage with treatmentstaff,
`he has appeared less symptomatic in some respects compared to prior courses of hospitalization
`(e.g., less aggression and sexual inappropriateness). Notably, Mr. Nasim’s medication compliance
`
`

`

`Forensic Competency Report
`RE: Zavar K. Nasim
`
`January 18, 2022
`Page 9 of 9
`
`has improved in recent weeks and he has appearedless internally preoccupied. If provided with an
`extended period of inpatient competency restoration treatment and additional opportunities to
`attend concurrent competencyrestoration services offering legal and psychoeducation, it would be
`reasonable to expect that Mr. Nasim’s mental health will improve to the degree of being able to
`demonstrate the requisite competency-related capacities. At this time, he has voluntarily complied
`with his medication regimen, and his adherence has improved in recent weeks. In the event he
`discontinues taking his medications, consideration of a forced medication order may be warranted.
`
`DESIGNATED CRISIS RESPONDER (DCR) REFERRAL
`
`An opinion is required as to whetheror not the defendant should receive an RCW 71.05 civil
`commitment evaluation by a DCR. This opinion is based solely upon the above evaluation
`under RCW 10.77.060. Other reasons mayexist to require a civil commitment evaluation,
`whichfall within the scope of other standards outside the purview of this evaluation.
`
`there is no
`Based upon the available information and results from the current evaluation,
`substantial evidence to indicate Mr. Nasim presents an imminent nsk of dangerto self or others.
`However, he continues exhibiting symptomsof a major mentalillness and likely lacks the current
`capacity to meet his basic needs of health and safety, thus an evaluation by a DCR pursuantto
`RCW 71.05 is recommendedprior to any changein his custodial situation.
`
`Myevaluation of Mr. Nasim’s competency to proceed is complete with the submission ofthis
`report. Please do not hesitate to contact me if you have further questions about this report or
`my conclusions.
`
`Respectfully,
`
`SizeHbonilbd
`
`Patricia C. McCormick, Ph.D.
`Licensed Psychologist
`Inpatient Forensic Evaluation Services
`Office of Forensic Mental Health Services
`Email: patricia.mccormick@dshs.wa.gov
`
`Ce:
`
`Presiding Judge, Pierce County Superior Court
`Glorioso Manigbas Jr., Prosecuting Attorney
`James Dahl, Defense Attomey
`Designated Staff, Pierce County Jail
`DCR,Pierce County
`
`