Vision: I can infer easily that this piece was meant to show someone who is under the disposition of an insanity of some kind, so I would say that this images "vision" was verily executed although not in a subtle way, but I do not think it was meant to be subtle so I shan't retract a star/half-star for it: 5/5
Originality: *disclaimer for section* OK i'm not too well versed in art of this kind, unfortunately, so I went to google to find examples of pictorials along the lines of 'insanity' as well as a few others. My findings where varied some looked like yours, some didn't, some where very low quality, and some where high quality. With my finds I conclude that your drawing is in the mid-way point of originality, so I'll give it: 2.5/5.
Technique: Consulting the above mentioned research, and my own opinion, I think your technique is good. I like it although there are some problems such as the line work isn't great, but that can be attributed to the fact that this started as a sketch that wasn't meant to be fully developed. Another problem is the eye. It is very different from the rest drawing. I do like the (i presume) blood dripping from the body as well as the splattered blood on the forehead. The background also blends nicely with the figure. Overall I'd give it: 4/5
Impact: As I have said in other reviews I usually only critique something if it has impacted me in some way. I like the darker atmosphere of piece, and how smooth the picture looks. As in the picture doesn't have too many colors, and aside from the eye, the style of the art works. 4.5/5
Basically, this is a solid piece of art that has some problems. Mainly, the eyes different style that doesn't quite mix well with the rest of the piece, and some bad line work that isn't too noticeable, but was still mentioned.