Rollins must revisit an old case when a child sent to juvenile detention is released after his 18th birthday.
This episode provides examples of:
- Bound and Gagged: Henry does this to two of his victims in the episode, once to a police officer who is then left in the trunk of a police car, and then to Charlotte, (his sister's friend) who is left with her hands tied to a shower head with duct tape over her mouth after he captures his sister for his killing spree.
- The Bus Came Back: This episode continues the story of Henry Mesner and his family, last seen in season 14's "Born Psychopath".
- Also back is Andre De Shields as Keys, a homeless man who does alternate side parking last seen in "Wednesday's Child".
- Call-Back: Multiple references are made to "Born Psychopath".
- Ear Ache: Henry stabs Carisi in the ear with a pencil in court because he was declared fit to stand trial. Apparently, he just barely missed piercing Carisi's eardrum.
- Family Extermination: Henry murders every member of his family except for his little sister Ruby, who was staying with a friend.
- Flashback: During the opening scene at Henry's hearing, multiple flashbacks are shown of his previous appearance.
- Harmful to Minors: Amanda finds out that Henry Messner has been released from prison when her four-year-old daughter tells her she was given a white stuffed dog named Snowball by a strange man at the park. "Snowball" was the name of the neighbor's dog Henry drowned in his previous episode.
- I'll Kill You!: The end of the episode has Rollins visiting Henry after he'd gone after her daughter and stabbed Carisi in the ear. She tells him that if he ever gets out and decides to go after her family again, "that'll be [his] last day on Earth."
- Killed Offscreen: Viola Mesner died in a car accident prior to the episode.
- Obfuscating Insanity: Rollins explicitly states that Henry understands that what he did was wrong, and that she believes that he only attacked Carisi in court to help with his plea of "not guilty by reason of insanity".
- Punk in the Trunk: Henry put one of the cops guarding Ruby in his own squad car after distracting the rest of them by calling in a fake bomb threat.
- Properly Paranoid: Henry’s sister, Ruby believed that her brother hadn’t changed and that he should never have been released, much less in their family’s custody. The mere premise of this episode, proves her worries correct.
- Psychopathic Man Child: Henry. He missed eight years of his childhood while in the mental institution, and he clearly hasn't mentally aged much beyond his ten year old self.
- Self-Made Orphan: Henry murdered his father and step-mother.
- Sequel Episode: To "Born Psychopath".
- Spree Killer: Henry killed three members of his family, and then attacked his former psychiatrist's daughter.
- You Will Be Spared: Henry pitilessly murders his five-year-old half-brother along with their parents and holds a gun to Ruby's head. Although he tells Rollins he wouldn't have hurt Jesse, who he approached at a playground and used as a messenger for Amanda, saying Jesse wasn't on his "list," and only incapacitates Ruby’s friend, her mother, and their police bodyguard rather than killing them. So apparently Even Evil Has Standards, but like, really, really skewed ones.
