Hi,
The concept is good, but I don't think it's being pulled off to it's best ability in this image.
Her left hand is too bright (I'd loose the bracelets as well) and doesn't have the detail that is present in her right hand. There is also something that looks plastic appearing above her left thumb, I'm not sure what it is but I don't think it should be there.
The framing has created some large areas of black top and right that I feel make the image unbalanced.
The light might work, but not in it's current form, I'd expect to see a wall lamp in this position, such as you might see in an asylum; the lamp as it currently is just isn't working although I'm guessing this is appearing more because of the method you used.
Overall I love the black noir grainy feeling of the image but I'd like to see a bit more attention given to the image on another try.
Steve