Thursday, February 28, 2008

New Sentencing Hearing for Charles Mines

The Houston Chronicle/Associated Press reports that Charles Mines, who has been on death row since 1989, has received a new sentencing hearing ("Longtime Texas death row inmate wins new sentencing trial," February 27, 2008):

"A death row inmate who killed an 80-year-old woman with a claw hammer nearly two decades ago will get a new sentencing trial because jurors didn't properly consider mental illness when they decided he should be executed, an appeals court has ruled.

Charles Mines Jr., 58, was convicted of killing Vivian Moreno at her home in Waxahachie, south of Dallas. Frances Moreno, 57, one of the murdered woman's 13 children, also was severely beaten in the same attack in May 1988. A relative found the two women on the floor in a bedroom.

The 5th U.S. Circuit Court of Appeals said questions put to jurors considering whether Mines should live or die prevented them from considering his mental condition. The appeals court sent the case back to the state court for a new sentencing.

Evidence at his trial showed Mines had undergone a psychiatric evaluation at a state hospital a week before the slayings. He pleaded not guilty by reason of insanity to a capital murder charge for Vivian Moreno's death and attempted capital murder for her daughter's attack. He was tried on the charges after a state court hearing determined he was competent to stand trial.

A psychiatrist who examined Mines during a five-day observation period a week before the killing determined Mines was not mentally ill and should not be committed, but that he did have a mixed personality disorder with paranoia, passive-aggressive and anti-social features.

Mines' trial in Ellis County was held just weeks before another capital murder case involving Johnny Paul Penry, whose mental illness claims and subsequent appeals changed the way Texas juries are asked to decide mitigating issues in death penalty cases.

'Mines's claim is that because his jury instructions were virtually identical to the ones given in Penry's trial those instructions created the same situation that the Supreme Court found constitutionally unacceptable,' the New Orleans-based 5th Circuit said in its opinion posted late Tuesday.

Evidence showed Mines, a transient, stole food and jewelry from the Moreno home. He was arrested three days later when he was found camping not far from the home. He confessed after police identified his fingerprint on a window sill."
Last summer, the Fifth Circuit Court similarly ordered a new sentencing hearing for Billie Wayne Coble. The Court ruled that the statute in effect in Texas at the time of Coble's conviction and death sentence (1990) had prevented the jury from fully considering the mitigating evidence presented by his trial attorneys regarding his post-traumatic stress and bipolar disorders. His hearing has been scheduled for August 2008 in McLennan County.

Stop Criminalizing the Mentally Ill

That's the title of this week's column by Dr. María Félix-Ortiz ("Society, and judges, should stop criminalizing the mentally ill," San Antonio Express-News, February 26, 2008). Dr. Félix-Ortiz reinforces the fact that people with mental illness are not inherently prone to violence; in reality, they are more likely to be the victims of crime. She also provides suggestions for outpatient treatment and other preventative programs.

"Recent comments made by Judge Tom Rickhoff of Probate Court 2 to KSAT evening news (Feb. 15), suggest a need for educating our criminal justice community about severe mental illness. I was not surprised by his recognition of a problem, but quite disappointed by his proposed solutions.

The judge's comments reminded me of what might happen if you ask a carpenter to fix your sink: He's likely to address the problem with the tool he uses most, his hammer. But that hammer is likely to cause bigger problems for those rusty pipes.

Bipolar disorder is not a crime; it is a disorder of the brain. Few people who are mentally ill ever commit a violent crime; the rate is similar to that found in the general population. If we did an analysis of the number of people who have diabetes who committed violent crimes, we might want to fingerprint every one of these people as soon as they're diagnosed (and close all the ice cream parlors across town).

However, people with mental illness are two and a half times more likely to be victimized (raped, mugged, etc.) than are any of us in the general population. Dr. Virginia Hiday at North Carolina State University-Raleigh also found that court-ordered involuntary outpatient treatment (OPC) for at least six months was associated with dramatically lower incidents of violence among those who were mentally ill and had a history of violence.

Other studies have found intensive case management another effective way of reducing violence and increasing adherence to the treatment plan. Case management involves old-fashioned social work where the mental health professional visits the individual at home to monitor his or her adherence to the treatment plan, help him or her make connections with other services and offer the support that can really keep people healthy.

While somewhat costly, intensive case management and OPC can reduce the more costly expenses of law enforcement, criminal justice and hospitalizations.

If Judge Rickhoff wants some real solutions, why not consult with mental health professionals and advocates, people who have the right tools in their toolbox for the job? We don't need to further criminalize mental illness; we do need more, and more diverse, mental health services and an approach that balances civil/human rights with the community's need for safety.

Contrary to popular opinion, the best mental health professionals can't reliably predict violent behavior; we can identify risk factors, but there is no test, no equation that accounts for all the variables involved in such a prediction. Lo siento, we can't read minds either.

Substance abuse is more strongly associated with violent behavior. We're in sore need of a variety of empirically validated public drug rehab programs, and I'd like to emphasize 'variety.' The programs shouldn't all be 'hammers.' Different people have different needs. Needs vary across age, gender (pregnant women need treatment, too) and sometimes culture.

If we need to find a scapegoat, let's not blame the ill for their illness. Rather, we might ask our legislators why Texas spends only $38 per person on mental health when most states spend about $80 per person, and Washington, D.C., spends more than $400 per person."

Tuesday, February 26, 2008

"Mentally ill unfairly portrayed as violent"

That's the title of an editorial that appeared yesterday in The Boston Globe, by Dr. Ronald Pies, a clinical professor of psychiatry at Tufts University. Dr. Pies cites several studies that illustrate the link (or lack thereof) between mental illness and violent behavior. Here are a few excerpts:

"Writing in the Nov. 16, 2006, New England Journal of Medicine, Dr. Richard A. Friedman of the Weill Cornell Medical College notes that only about 3 to 5 percent of violence in the general population is attributable to those with 'serious mental illness,' conventionally defined as schizophrenia, major depression, or bipolar disorder. The combined lifetime prevalence of these conditions in the US general population is estimated at 19 percent - far larger than their contribution to violence. ..."

"A 1980s study from the National Institute of Mental Health found, using community surveys, that individuals with schizophrenia, major depression, or bipolar disorder were two to three times as likely as those without these illnesses to commit acts of violence. However, to put this in perspective, substance abusers had more than twice the rate of violence as those with these serious mental illnesses.

Moreover, the study found that the vast majority of individuals with serious mental illness were not violent: The lifetime prevalence of violence among people with schizophrenia, major depression, or bipolar disorder was 16 percent, versus 7 percent among people without a mental illness. Those with anxiety disorders had no increased risk of violence.

Even more reassuring is the 1998 MacArthur Violence Risk Assessment Study, led by John Monahan and Henry Steadman, now of Policy Research Associates, which advocates for better mental health services. Unlike the NIMH study, which surveyed people randomly in the community, the MacArthur study evaluated psychiatric patients recently discharged from the hospital. And unlike the NIMH study, which relied solely on self-reports of violence, the MacArthur study used a combination of self-reports, collateral informants, and police and hospital records.

The MacArthur study found that the prevalence of violence among discharged psychiatric patients without a substance abuse disorder was similar to that among community-dwellers who didn't abuse substances. Furthermore, violence by these discharged patients rarely involved vicious attacks on strangers or clinicians. Usually, it resembled violence committed by other community-dwellers, such as hitting a family member inside the home. Lethal violence among the discharged patients was very rare.

In the February 2008 issue of Psychiatric Services, Monahan and Steadman conclude: '. . . for people [with mental illness] who do not abuse alcohol and drugs, there is no reason to anticipate that they present greater risk than their neighbors.'

That said, mental disorders do increase susceptibility to substance abuse, and thus indirectly increase risk of violence. Moreover, as Eric Elbogen of University of North Carolina Chapel Hill School of Medicine wrote me in an e-mail, '. . . a subgroup of people with mental illness likely uses alcohol and drugs to 'self-medicate' psychiatric symptoms.' In my experience, this behavior may reflect the inadequate, fragmented care often provided to those with mental illness who also abuse drugs or alcohol so-called "dual diagnosis" patients.

The image of the violent mentally ill person must also be tempered by research from Linda A. Teplin, of Northwestern University. Teplin finds that those with mental illness are much more likely to be victims than perpetrators of a violent crime. Among psychiatric outpatients, about 8 percent reported committing a violent act, whereas about 27 percent reported being the victim of a violent crime."

Read the full editorial.

Thursday, February 21, 2008

The Role of Medications (or Lack Thereof) in Recent Acts of Violence?

An editorial that appeared earlier this week in the Dallas Morning-News ("Guns aren't only thing to blame in tragedies," February 18, 2008) sheds some light on why those suffering from mental illness might choose to stop taking their medications:

"With clockwork predictability, we zeroed in on the source of the weapons used by the gunman in last week's appalling slaughter in an Illinois campus classroom.

Where did he buy the guns? Why were they so easy to get? Can't we do more to keep guns away from people who are potentially disturbed?

All reasonable questions, albeit politically difficult to answer. Here are some other questions, though, that perhaps should also be asked:

Why did he stop taking his medicine? Wasn't he being monitored? Can't we do more to make people stay on the drugs that keep them sane and stable?

I'm not saying these questions, which go to the heart of privacy and civil liberty, are any easier to resolve than the intractable and shopworn battle over firearms. But somebody, at least, ought to be asking. ..."

"...mental disorders are frequently part of the equation in the murky psychology of crime. For a lot of patients, sticking with the drugs can mean the difference between stability and chaos.

'One of the main goals of our program is to convince them to stay on their meds,' said Dallas County court appellate judge Kristin Wade, who oversees a special program that offers selected minor offenders strict supervision in lieu of jail time. 'I'd say 90 percent of them do not want to.'

The reasons are varied: Some don't like the side effects; some simply don't have the wherewithal to keep up with doctor visits and pharmacy refills. Many people just quit taking their medicine in the perverse belief that, because it makes them feel better, they don't need it any more.

'I always analogize it to antibiotics,' Judge Wade said. 'And then, there's some part of your brain that's in denial about the reality of mental illness.'

Courts can make keeping up with medicine a condition of bond or probation, but there are no guarantees. Some anti-psychotic medicine can be administered by monthly injection, Judge Wade said, which can help patients stay on track.

But, by and large, we expect people to maintain their own health. If they neglect their medicine and get sick – well, that's their lookout, right?

Perhaps. Yet last week, a New York truck driver was charged with manslaughter for running down two people after he suffered a seizure behind the wheel because he didn't take his medication. In that case, there were serious legal consequences for his neglect.

I'm not suggesting that someone could have followed around Steve Kazmierczak to make sure he took his pills, and I'm certainly not intimating that people with diagnosed mental illness don't deserve our compassion.

We need to recognize, though, that many people with severe mental illness need these drugs to function in society. It's more than a minor issue of personal preference to unilaterally decide to stop taking them.

Mr. Kazmierczak's case, perhaps understandably, set off a fresh round of gun-control debate.

If he had stayed on his meds, he might not have gone looking for guns in the first place."

Read the full editorial.

Evidence of Severe Mental Illness Often Not Enough to Prove "Insanity"

Here's another article from the New York Times regarding the case of David Tarloff, a man with severe mental illness who is charged with second-degree murder in the slashing death of Kathryn Faughey, an Upper East Side therapist ("Actions Considered Insane Often Don’t Meet the Standards of New York’s Legal System," February 20, 2008). As in Texas, evidence of severe mental illness is not enough to be considered "insane" under New York law:

"A diagnosis of schizophrenia and repeated commitments to mental institutions might seem like obvious qualifications for an insanity defense — or maybe not.

Experts say the legal standard for insanity is very different from what most laymen and even psychiatrists would consider crazy behavior.

The case of David Tarloff, 39, who is charged with second-degree murder in the slashing death of Kathryn Faughey, an Upper East Side therapist, is the latest to raise questions about when a defendant is too mentally ill to be responsible for his behavior. ...

'The truth is in the State of New York, you can be extremely crazy without being legally insane,' Ronald L. Kuby, a criminal defense lawyer who has handled cases of mentally ill defendants, said Tuesday. 'You can hear voices, you can operate under intermittent delusions, you can see rabbits in the road that aren’t there and still be legally sane.'

What matters to the justice system is whether the defendant is capable of telling the difference between right and wrong, and of understanding the consequences of acts, in spite of mental illness."

The article goes on to describe the legal process for handling cases such as Mr. Tarloff and the consequences for finding a defendant Not Guilty by Reason of Insanity (NGRI):

"The first step in a case like Mr. Tarloff’s is to determine whether he is fit to stand trial, which requires an evaluation of his mental state. Prosecution experts may find that even though he is competent to stand trial, he was insane when police say he committed the crime. And then the district attorney could work out a plea that would send him to a psychiatric institution.

Such a plea can often mean that a defendant will spend more time in a psychiatric facility than if he were found guilty at trial, N. G. Berrill, a psychologist and the executive director of the New York Center for Neuropsychology and Forensic Behavioral Science, said Tuesday.

'It’s not the cakewalk that people fantasize,' Dr. Berrill said.

If Mr. Tarloff went to trial and a jury found him not responsible for his behavior because of mental illness, he would be sent to a mental institution where he would be re-evaluated at least every two years, Dr. Berrill said Tuesday. But, he said, doctors tend to be very conservative about ending treatment."

Read the full article.
According to a 1991 eight-state study funded by the National Institute of Mental Health, the insanity defense was used in less than one percent of the cases in a representative sampling of cases argued before those states’ county courts. The study showed that only 26 percent of those insanity pleas were argued successfully. In approximately 80 percent of the cases where a defendant has been found “not guilty by reason of insanity,” the prosecution and defense have agreed on the appropriateness of the plea before trial. Other studies over the past two decades report similar findings.

In Texas, juries are not informed of the consequences to the defendant if they return a verdict of not guilty by reason of insanity. Legislation to amend the insanity statute in Texas so as to provide this information to juries has been introduced in recent sessions, but has not passed.

New Questions Surround Involuntary Commitment Laws in New York

"The arrest of David M. Tarloff, a man with a long history of mental illness, in the fatal stabbing of a psychologist in Manhattan has revived discussion on the thorny issue of how people with severe mental illnesses can be helped, even when they resist that assistance," according to the New York Times ("Murder Case Focuses New Attention on Mental Illness Treatment," February 19, 2008).

The article goes on to discuss the challenges of involuntary commitment laws in New York (and in most of the country):

"As is standard practice in most of the country, state law in New York allows for people who are in danger of harming themselves or others to be involuntarily committed to a mental institution for evaluation and short-term treatment. A second law, adopted in 2000, allows relatives and others to ask a judge to force patients who have been released from psychiatric hospitals to receive outpatient treatment or to be involuntarily committed. The statute is known as Kendra’s Law, named after Kendra Webdale, who was pushed in front of a subway train by Andrew Goldstein, a schizophrenic patient.

Such laws try to strike a balance between basic civil liberties and public health and safety. But even the best-crafted laws are no substitute for a mental health system that is deeply inadequate in most places in the United States. In 2003, the President’s New Freedom Commission on Mental Health concluded that 'for too many Americans with mental illnesses, the mental health services and supports they need remain fragmented, disconnected and often inadequate, frustrating the opportunity for recovery.' ...

Even under Kendra’s Law, getting a court order to force a mentally ill person to take medication is not easy. According to Michael L. Perlin, director of the Mental Disability Law Program at New York Law School, five criteria have to be met: the person has to be not only mentally ill, but at least 18 years old; unlikely to survive in a community without supervision, demonstrated by a history of noncompliance that has resulted in one or more seriously violent acts over the last 48 months or hospitalization or receipt of mental health services in a correctional facility at least twice in the last 36 months; unlikely to participate voluntarily in treatment; and in need of treatment and likely to benefit from it.”

Read the full article.

Monday, February 18, 2008

New Mental Health Public Defenders in Bexar County

Thanks to Sandrine Ageorges for passing this along, from the San Antonio Express-News ("County hires 4 new public defenders," February 15, 2008):

"Bexar County officials have hired four mental health public defenders. Officials said Anne Mulligan and Kevin McManus will be civil public defenders, representing people at hearings that determine whether they should be committed to the state mental hospital. Julia Garcia and Ellen Pitluk were hired as criminal public defenders, officials said. Garcia and Pitluk will work in the mental health misdemeanor court to be run by County Court 12 Judge Michael Mery."

Travis County established the state's first Mental Health Public Defender's Office, in Austin.

Thursday, February 14, 2008

More on Panetti Competency Hearing

Here are excerpts from an article by Jordan Smith that appeared in the Austin Chronicle ("Legal Battle Over When Prisoner Is Sane Enough for Execution Bounces Back Here," February 15, 2008), regarding last week's hearing on Scott Panetti's competency to be executed:

"The long, sad case of Texas death row inmate Scott Panetti landed back in federal district court last week, where Judge Sam Sparks is tasked with deciding whether Panetti is indeed sane enough to be executed. According to the state, Panetti is quite likely a malingerer who is clearly able to understand the connection between his crime and punishment and, Assistant Attorney General Tina Miranda argued in court on Feb. 6, Panetti's strong religious beliefs clearly evidence this fact: He believes forgiveness for his crime is integral to his salvation – that underlying connection between right and wrong is solid proof Panetti can comprehend his fate, Miranda argued. But Panetti's defenders, including Austin appellate attorney Keith Hampton, argue an ability to understand is not the same as actual comprehension. Panetti's hyperreligiosity is not anchored in any objective reality, they argue. Indeed, Panetti has long claimed the real motive for executing him is to stop him from preaching "the gospel of the Lord King." At stake is not only Panetti's life but also the evolution of a legal standard that could be applied in othercases where a prisoner's competence to face execution is at issue. ..."


"...the Supremes [U.S. Supreme Court] punted the case back to the Austin courtroom of Sparks, giving him the daunting task of wading through the legal morass of the Panetti case in order to divine whether he is sane enough to die – a decision that will become the first step in devising a standard for judging mental eligibility for execution that would ultimately be applied to other similarly situated inmates. (As such, it is inevitable the case will again be appealed, meaning that whatever test Sparks applies in his ruling will have to pass legal muster all the way back up the legal food chain to the high court.)

To Rusk State Hospital psychiatrist David Self, there is no doubt Panetti is too deluded to be considered competent: After evaluating Panetti in November, Self concluded Panetti is 'delusionally preoccupied with religious themes,' which he said is a 'very frequent manifestation' of schizophrenia. Moreover, he found nothing to suggest Panetti is faking his illness – if anything, he said, Panetti at times seemed to be 'faking good,' by trying to present himself as more rational than he actually is. However, Panetti does not comprehend the real reason for his execution, said Self, as he believes he's a player in a spiritual war being fought between the forces of good and evil. Self said Panetti told him that in this fight, the state of Texas has been deluded by the devil: Although the state has come to believe it seeks his execution as punishment for his crime, Panetti believes the state has become a pawn in the devil's game to silence his preaching.

Under questioning by Assistant AG Miranda, Self testified he believes Panetti is incapable of 'a rational understanding' of why he is to be executed. But, Miranda pointed out, Panetti comprehends the cause-and-effect nature of his circumstance and the concept of good and evil –indeed, the notion there is a 'war' between good and evil is not unusual and would not on its face be considered delusional, she noted. 'Is believing in spiritual warfare a fixed false belief?' Miranda asked Self.

'Not by itself,' Self replied. 'No.'"

Read the full article.

Tuesday, February 12, 2008

Addressing Texas' Overpopulated Prisons

Last week at a statewide symposium organized by the Bexar County Commissioner, policymakers and criminal justice experts discussed ideas for addressing Texas' overpopulated prisons (Texas has the second largest-prison population in the country). Several panelists expressed concern about the increased criminalization of non-violent offenders with mental illness, which has resulted in severe overcrowding at local jails. The Bexar County Jail, for example, is 96% full.

Here are excerpts from an article that appeared in the San Antonio Express-News ("Suggestions given for overflowing prisons," February 11, 2008):

"Having reached a critical mass in its prison and jail populations, Texas needs to work harder to divert substance abusers and mentally ill inmates from the system, better equip the wave of those who are released each year and implement alternatives to incarceration for nonviolent offenders, a group of policymakers and criminal justice experts said Thursday.

Although the state's prison and jail systems have long complained of overcrowding, the situation has become dire, as there are not enough prisons or jails to house those who are arrested every day. And even if there were, experts said, the systems are woefully understaffed for the volume. ..."


"In Bexar County, about 25 percent of the jail's population is mentally ill, said Leon Evans, president of the San Antonio-based Center for Health Care Services, a non-profit partnership with University Hospital that tries to divert mentally ill people before they get arrested. The program has been showcased as a model for other counties and states. Evans estimated the group screens about 500 mentally ill people a month who would otherwise have ended up in jail or in emergency rooms because police officers don't know where to take them.

"There's a growing realization that we have a system of incarceration that mainly deals with the mentally ill or with drug offenders," said Tony Fabelo, the symposium's keynote speaker and director of research for the Council of State Government's Justice Center.

Fabelo said incarceration is such a common experience for some people that it's not regarded as a deterrent to committing crime. In Texas, he said, the growth of the prison population has outpaced that of the state: Between 1980 and 2005, the state jail population jumped 61 percent and the prison population by 310 percent. Meanwhile, the state's overall population grew 61.3 percent.
Nearly two-thirds of felons are re-arrested within three years of their release, said John Byrd, a criminal justice professor at the University of Texas at San Antonio. In Bexar County Jail, Adkisson said, about 81 percent of the inmates have been there before.

Policymakers and elected leaders must make it easier, under certain circumstances, for offenders to post bail, the panelists said, and use better pre-trial services to reduce the number of those awaiting trial. ..."

Read the full article.

Monday, February 11, 2008

Competency Hearing for Scott Panetti

Last week Federal District Judge Sam Sparks presided over a hearing to determine whether Scott Panetti is competent to be executed. In June 2007, the U.S. Supreme Court blocked Panetti's execution, ruling that the Fifth Circuit Court of Criminal Appeals had used "an improperly restrictive test" in determining Panetti's competency. The Court also found that Panetti had not received a full and comprehensive competency hearing.

Here are excerpts from an article about the hearing that appeared in the Austin American-Statesman ("Judge must decide whether death row inmate's delusions prevent his execution," February 5, 2007):

"Convicted of killing his in-laws in 1992, Panetti believes satanic forces are seeking his execution to keep him from preaching the Gospel, his defense lawyers have testified.

The U.S. Supreme Court, according to the majority decision, ruled that the constitutional ban against cruel and unusual punishment means that inmates must understand why they are being put to death. The ruling did not provide aprecise standard for assessing Panetti's claims.

A psychiatrist from the Rusk State Hospital testified today that Panetti is schizophrenic. Dr. David Self said he interviewed Panetti for five hours in November and asked him if he knew why he was on death row. 'He said to preach the gospel of Jesus Christ,' Self said.

The doctor said he did not think Panetti was faking mental illness because of Panetti's frequent hospitalizations before the killings. Panetti showed signs on mental illness during his interview, Self said, including showing emotions that were more intense than normal, Self said. 'His anger would flare and his happiness was just too great,' Self said.

Sparks said at the beginning of the hearing that he feels that no matter what decision he makes, the case will be appealed and land back in his court. He said he also has to determine what would happen if Panetti was declared incompetent. 'Does that mean he can't be punished at all,?' Sparks said.

It was not know when the judge would reach a decision. The hearing is scheduled to last until at least Thursday. ..."

Read the full article.

Earlier coverage of the Panetti case is available here and here.

Thursday, February 7, 2008

Mental Illness and Violence

The February 2008 issue of Psychiatric Services focuses on mental illness and violence. It includes such articles as "Perpetration of Violence, Violent Victimization, and Severe Mental Illness: Balancing Public Health Concerns," "Jail Incarceration, Homelessness, and Mental Health: A National Study," and "Risk of Violence by Psychiatric Patients: Beyond the "Actuarial Versus Clinical" Assessment Debate."

According to editor Howard Goldman, M.D., PhD., the issue "addresses behavioral extremes perpetrated by people with a mental disorder but more often perpetrated against them—by individuals and by society. ..."

Here's more from Dr. Goldman:

"Our field often focuses on the tension between personal liberty and societal protection. It is imperative that we get the balance right. The articles, brief reports, and commentaries in this issue address this set of concerns—the risk of violence and victimization, the proper role for seclusion and restraint and patients' preferences in regard to these practices, and rates of incarceration and homelessness and efforts to prevent these outcomes. At every turn there is the chance that we will underreact and there will be harm—or more likely, that we will overreact and a different kind of harm will result. I believe that we have an obligation to use extreme measures in the rarest of instances, when there is no alternative. When we exploit the dangers associated with mental illness to advance policy, we risk the harm of exploiting the individuals themselves."

"Psychiatric Services" is a publication of the American Psychiatric Association. You can read abstracts for the contents of this issue at

Independent Investigation of Death Row Inmate's Suicide

Fort Bend Now reports that the Office of the Inspector General will be conducting an investigation into the suicide of mentally ill death row inmate William Robinson ("Office Of Inspector General To Review Prison Suicide," February 7, 2008). Robinson, 49, was found hanging by a bed sheet on February 1, 2008 in the Jester IV Unit, a mental health unit of the Texas Department of Criminal Justice.

"Such an investigation is conducted any time a prisoner dies in custody, TDCJ spokesman Jason Clark said.

'Anytime there is a death of an offender, the Office of Inspector General is notified,' Clark said. 'The OIG is a separate entity and they conduct a thorough investigation.'

Clark stressed that there are no indications that the case was anything other than a suicide and that the OIG investigation is routine.

Robinson, 49, was found hanging by a bed sheet early yesterday morning in his single-man cell at the Jester 4 unit in eastern Fort Bend County. Robinson was being held in Jester 4, a mental health unit within the prison system, for evaluation following what the prison system described as 'mutilation' incidents. ..."

"Prison system spokesperson Michelle Lyons said that Robinson had been confined in the Jester unit since last September. While Lyons was not able to discuss the nature of Robinson’s emotional disorder due to privacy restrictions, Lyons did confirm that he had previously been treated at the unit 'on several occasions.'

Robinson was awaiting death by lethal injection for the 1985 robbery and murder of 26-year-old Steven Creasey in the Montrose area of Houston."

Read the full article.

More information is available here.

Wednesday, February 6, 2008

A Holistic Approach to Offenders with Mental Illness

Here's an op-ed from Judge Nancy Hohengarten that appeared in the Austin American-Statesman ("A way to ensure justice for all", February 5, 2008):

"Traditionally, family members of criminal defendants do not discuss cases with the prosecution, but when the defendant is mentally ill, family input is appropriate.

A family member who understands the nature of a defendant's mental illness, behavior and circumstances is a valuable resource to the criminal justice system. Protection of the community requires that the mentally ill receive treatment to prevent recidivism. A mentally ill defendant who does not receive appropriate treatment will often be re-arrested, thrown back in jail and yet another person will have been a victim. In the misdemeanor courts' mental health docket, Travis County Attorney David Escamilla allows his mental health prosecutor to listen to family members because it leads to better decision-making on criminal cases.

The role of a prosecutor, after all, is to seek justice. On a case-by-case basis, it means that the punishment should be appropriate for the offense and the offender. This, of course, requires the prosecutor to show leadership on community problems — like mentalillness — that can lead to crime.

My experience with family members trying to keep a loved one mentally healthy and out of jail is that they are exhausted, frustrated and heartbroken.

Their experience provides valuable guidance to criminal justice professionals so that the justice system appropriately addresses andmonitors mentally ill defendants.

One longtime Austin business owner whose son had damaged her property asked me to put her son on probation so that he could be ordered to take his medication. He did very well and was discharged early.

Another woman asked me to find treatment for her son because the stress was killing her. Unfortunately, her mentally ill son couldn't stop using cocaine while he waited the two months for residential treatment on probation. Now he's spending a month in jail because the wait for such treatment is shorter when you're locked up.

Family members aren't asking for leniency; rather, they want their loved ones mentally healthy so they won't break the law and end up in jail. Thus their interests coincide with the interests of criminal justice.

Prosecutors, judges and defense attorneys need to listen to these families. It is our responsibility to provide protection for thecommunity and fairness and justice for all."

Hohengarten presides over Travis County Court at Law 5. She is a member of the Mayor's Mental Health Task Force Monitoring Committeeand the Austin Travis County Mental Health Jail Diversion Committee.

Read the editorial online.

Tuesday, February 5, 2008

Another Suicide on Texas' Death Row

Allan Turner at the Houston Chronicle reports that another death row inmate in Texas has committed suicide ("Mentally ill killer found hanging in cell," Feb. 4, 2008). William Robinson, who was under psychiatric care for an unspecificied mental illness, had been on death row since 1985.

Here's the article:

"A psychologically troubled inmate sentenced to die for a 1985 Houston robbery-murder has become the second Harris County killer to commit suicide in state prison in a four day period, Texas prison officials said today.

William Robinson, 49, condemned for his role in the June 11, 1985 murder of Steve Creasey, 26, at a Montrose apartment complex, was found hanging from a bed sheet in his Jester 4 Unit cell at 5 a.m. Friday.

A prison spokeswoman said Robinson had been transferred from death row to the Fort Bend County prison, reserved for psychiatric care, in September.

Just three days earlier, Jesus Flores, sentenced to die for the May 22, 2001 murder of Harris County sheriff's Deputy Joseph Dennis, bled to death in his death row cell after cutting his throat with a razor blade.

Robinson's death brings to nine the number of condemned killers who have taken their own lives since the Texas death penalty was reinstated in 1974.

Lyons said psychiatric patients are checked by guards at 15-minute intervals; death row prisoners are checked every 30 minutes.

Robinson was alive but unresponsive when found in his single-occupancy cell, Lyons said. He was taken to a Richmond hospital, where doctors determined he was brain dead. Life support was discontinued at the request of his family. He died at 6:19 p.m.

Lyons said privacy regulations precluded her from revealing Robinson's psychiatric diagnosis, but noted that he had been treated at the mental health facility on several occasions.

Prisons inspector general John Moriarty, who investigates such deaths, could not immediately be reached for comment."

The article is available at

Monday, February 4, 2008

Caring for Mentally Ill in Jails, Emergency Rooms

The Austin-American Statesman (February 3, 2008) reports that since November, at least 125 depressed, suicidal, or violent people have been sent to emergency rooms in Austin, rather than the state hospital:

"Previously, most of those people would have gone to the state hospital, said Dr. Jim Van Norman, medical director for the Austin Travis County Mental Health Mental Retardation Center.

Now, some spend up to 14 days in emergency rooms waiting for a bed in a psychiatric facility. Others are treated and released from emergency rooms without any mental health care."

Late last year, for financial reasons, Austin mental health officials drastically cut the number of patients they send to the Austin State Hospital, a public facility for people with mental illness.

The Statesman chronicles the case of Daniel Whitehead, a man who has bipolar disorder and schizophrenia and who spent months in jail waiting to be sent to a psychiatric hospital. His case starkly illustrates the vicious cycle of incarceration and hospitalization in which many people with mental illness now find themselves:

"On Sept. 30, the 32-year-old Austin man — who said he was using crack, was not taking his psychiatric drugs and thought federal agents were out to get him — was arrested and jailed, accused of forging a $231 check at a sporting goods store to buy socks, sunglasses and a jacket.

He couldn't afford to pay the $10,000 bail, said Whitehead's wife, Lisa Valentine. And by the time Whitehead had a psychiatric evaluation a month later, his mental health had deteriorated so severely that he was unable to assist in his defense, said Amber Vazquez Bode, Whitehead's lawyer.

Whitehead was deemed incompetent to stand trial, and a judge ordered him sent to a psychiatric hospital. But because of a backlog of more than 40 inmates awaiting similar transfers, Whitehead spent more than three months in the Travis County Correctional Complex in Del Valle.

He is now at the Austin State Hospital."

Austin does not have a medical hospital with a psychiatric emergency room:

"Doctors, medical professionals and mental health advocates have had multiple meetings about the problem, but no solution has emerged. Some people want to see psychiatric hubs staffed with mental health professionals established in three local hospitals. Some want the state to give the MHMR center more psychiatrc beds. Others think a stand-alone emergency psychiatric hospital for the uninsured is the best solution.

For now, the MHMR center is applying for a $6 million state grant that would fund mobile mental health teams to work at several local emergency rooms. But whether the agency will get that money remains unclear."

Read the full article at:

Friday, February 1, 2008

Florida Inmate's Death Sentence Reduced to Life

According to the Pensacola News Journal (January 31, 2008), the Florida Supreme Court has reduced the death sentence of Ryan Thomas Green, who was convicted and sentenced to death in January 2006 for the death of 59-year-old James Hallman, a retired Pensacola police sergeant:

"[The] Court overruled the trial judge's sentence because Green suffered from schizophrenia and was unable to fully appreciate the consequences of his actions, according to the opinion released Thursday.

Green now will serve life in state prison without parole for the crime. He also is serving 2 consecutive life prison terms without parole for theattempted murder and robbery with a firearm of house painter Christopher Phipps. ...

'Green testified that God motivated him to kill Hallman,' the court wrote. 'He felt God put him there, on that day, to kill Hallman because Hallmanwas the Antichrist.'

Former Circuit Judge John Kuder, who retired the day after Green'ssentencing, noted that in the years leading up to the shootings, Green was in a 'psychological, emotional and anti-social free fall into an abyss' and 'fully immersed in a drowning pool of mental illness.'"