Monday, June 30, 2008

The History of Crisis Intervention Teams

The June 2008 issue of Law Enforcement Technology features an interesting article on the history of Crisis Intervention Teams (CIT), pioneered by the Memphis Police Department.

Here are a few excerpts:

"The program builds a team of officers available to respond to calls that partner with families, mental health providers and individuals who are diagnosed with mental diseases. The Crisis Intervention Team, or CIT, preserves the individual's dignity, insures greater safety for both responding officers and the mentally ill person — called consumers — and reassures families."

"NAMI (Memphis) credits CIT with saving lives and preventing injuries, both for consumers and officers," [Major Sam] Cochran [of the Memphis Police Department] wrote in an opinion piece on the department's Web site. "Officer injury data has decreased by seven-fold since the program's inception. University of Tennessee studies have shown that the CIT program has resulted in a decrease in arrests rates for the mentally ill.

"Most importantly, CIT officers give consumers a sense of dignity. This dignity generates a new respect and outlook on the police and the mental health systems."

Read "Diffusing Crisis" in its entirety.

Capital Murder Defendant Found Competent After Fourth Hearing

The San Antonio Express-News reports that the case of Vincent Seard, who has been found incompetent to stand trial as a result of his severe mental illness on three prior occasions, is now ready to proceed ("Slayings suspect ruled OK for trial," June 17, 2008). Serious questions about his mental status remain, however. Seard faces a possible death sentence for the 2003 murders of Terry Ingram and Patricia Kutzer.

Here's the article in full:

"At the fourth competency hearing since he was charged with capital murder in the 2003 beating deaths of two Kerr County residents, Vincent Seard was found mentally fit for trial Tuesday.

But testimony at the three-hour hearing before state District Judge Steve Ables showed schizophrenia and delusional thinking remain issues for the accused, who says he embodies all that is evil and good, looks to numerology to bolster his defense and calls himself 'Vincent Seard Jeffrey, period.'

Ables' ruling that Seard was competent provided little comfort to Cynthia Ingram, whose husband, Terry, and their friend, Patricia Kutzer, were brutally bludgeoned at Kutzer's farm outside Comfort on March 10, 2003.

'It's still going to be forever,' Ingram predicted after watching the hearing. 'It's going to go on and on. I don't think it's going to end.'

Seard, who was arrested in California four days after the killings, is unlikely to face trial before 2009, said District Attorney Bruce Curry.

The defense has previously said an electrical shock Seard suffered may have led to the Houston-area musician's bizarre behavior, including the unprovoked attack at the farm just off Interstate 10.

Defense lawyer Kurt Rudkin put little stock in expert medical testimony that Seard, 44, can meaningfully assist his defense and understands the charges and court proceedings, including the possibility of being sentenced to death.

He said much of his consultation with Seard during five years as his court-appointed counsel has concerned which spirits share his body and how various number patterns may factor into his defense.
Taking the stand Tuesday, Seard spoke slowly and clearly — but often in cryptic terms — about defense strategies, the reasons he left incriminating evidence at the crime scene, and 'Oren,' an 'entity from the sea' that shares his being.

'With clarity now, being as I am whoever I say I am, balancing in the ying and yang ... even to now I am Oren,' he said.

Asked about leaving his dog, photos of himself and his driver's license at Kutzer's home, Seard said, 'The reason was, as was left many articles, I then left evidence to see that whoever was guilty of the crime, charge me with it.'

Rudkin told Ables he heard little evidence Tuesday that differed from a 2006 hearing, the third and last one in which Seard was ruled incompetent.

Curry said Tuesday's hearing was the first in which experts agreed Seard was competent.
Seard's condition has improved because of drugs, but he may relapse into 'frenzies' — as has occurred before — if he halts his medication, testified psychiatrist Richard Coons.

Based on a three-hour interview last week, Coons said he concluded Seard's illness may affect his ability to consult with an attorney 'but not enough to make him incompetent.'

Dr. Michael Jumes, director of psychology at Kerrville State Hospital, said he examined Seard four times, most recently April 2, at North Texas Mental Hospital in Vernon.

'He displayed a factual and rational understanding across the range of questions I posed to him,' Jumes testified.

Questioned by Rudkin whether he thought Coons and Jumes were forthright in their assessments, Seard said, 'Who is to say what is normal?'

Seard's sister, Diane Stills of Houston, hardly recognized the defendant as her loving sibling of bygone days. 'He's not the Vincent I grew up with,' she said. 'Let's put it that way.'

Note: Judge Ables also presided over the capital murder trial of Scott Panetti and allowed him to represent himself.

Monday, June 23, 2008

Coverage of the Indiana v. Edwards Decision

The New York Times has this coverage of last week's U.S. Supreme Court decision in the case of Indiana v. Edwards ("Self-Representation by the Mentally Ill Is Curbed," June 20, 2008):

"A mentally ill defendant who is nonetheless competent to stand trial is not necessarily competent to dispense with a lawyer and represent himself, the Supreme Court ruled on Thursday.

The court said that judges could 'take realistic account of the particular defendant’s mental capacities' and, in the interest of achieving a fair trial, deny the constitutional right to self-representation that criminal defendants ordinarily enjoy.

The 7-to-2 decision overturned a ruling by the Indiana Supreme Court that had found that a schizophrenic man was entitled to a new trial on a charge of attempted murder because the trial judge had improperly denied his request to represent himself.

The defendant, Ahmad Edwards, who was sometimes quite coherent and at other times decidedly not so, had differed with his lawyer over defense strategy. He wanted to argue self-defense, while his lawyer wanted to present a defense based on lack of intent.

Mr. Edwards had fired a gun at a department store security officer after trying to steal a pair of shoes. He was found competent to stand trial after two psychiatric hospitalizations over three years after the shooting.

A landmark Supreme Court decision in 1975, Faretta v. California, established the right to self-representation as a basic constitutional right.

Writing for the majority on Thursday, Justice Stephen G. Breyer said the question in this case was answered neither by the Faretta decision, which did not involve a competency issue, nor by a subsequent decision that permitted a mentally ill defendant to waive the right to counsel and plead guilty.

Conducting a defense at trial without a lawyer’s help requires a higher degree of competence, Justice Breyer said.

Noting that the court has referred to the right to self-representation as an aspect of individual dignity, Justice Breyer said dignity was lacking in the 'spectacle that could well result' from a mentally ill defendant’s efforts, which he said were 'at least as likely to prove humiliating as ennobling.'

Justice Breyer said that rather than setting an all-encompassing definition of competency, the court would leave the decision to individual trial judges, who he said 'will often prove best able to make more fine-tuned mental capacity decisions, tailored to the individual circumstances of a particular defendant.'

Indiana had asked the court simply to overrule the Faretta decision, which Justice Breyer has criticized. But he said 'recent empirical research' indicated that the decision was not, in fact, leading to unfair trials when defendants were mentally competent.

The decision, Indiana v. Edwards, No. 07-208, drew a vigorous dissenting opinion from Justice Antonin Scalia, joined by Justice Clarence Thomas. Justice Scalia said the treatment Mr. Edwards received in being denied to present the defense of his choice 'seems to me the epitome of both actual and apparent unfairness.'

The only reason the court has previously accepted as valid for denying self-representation, Justice Scalia said, was a threat to the orderliness ofthe trial. But Mr. Edwards was 'respectful and compliant' and did not even have the chance to try representing himself, Justice Scalia continued, adding, 'The dignity at issue is the supreme human dignity of being master of one’s fate rather than a ward of the state — the dignity of individual choice.'

Justice Scalia said that 'trial judges will have every incentive to make their lives easier' by appointing lawyers rather than giving mentally ill defendantsa chance to proceed on their own.

'In singling out mentally ill defendants for this treatment,' he said, 'the court’s opinion does not even have the questionable virtue of being politically correct.'"

And here's an excerpt from an analysis provided by Lyle Denniston, with scotusblog ("Faretta survives, with limits," June 19, 2008):

"The Edwards opinion by Breyer, in dealing with mentally ill individuals who voice a desired to be their own defense counsel, provides one clear implication, and one quite unclear prospect.

It is clear, simply from the result, that states may now have one standard of mentally competency for putting a mentally impaired person on trial, and a higher standard that such a person would have to meet in order to be allowed self-representation. Ahmad Edwards had been found competent to be put on trial, but not to represent himself.

What is unclear, though, is what the higher standard is for representing one’s self when mental competency is at issue. The Court expressly rejected a proposal by the state of Indiana that self-representation be denied whenever the accused 'cannot communicate coherently with the court or a jury.' The state had suggested that approach, saying it 'fits Sixth Amendment doctrine, which allows some balancing of interests when defendants attempt self-representation.'

In fact, the state argued, if the Court did not adopt some such standard, that would be a reason to cast Faretta aside.

The Court said no to that approach: 'We are sufficiently uncertain…as to how that particular standard would work in practice to refrain from endorsing it as a federal constitutional standard here. We need not now, and we do not, adopt it.'

To which Scalia replied in dissent: 'Today’s holding is extraordinarily vague. The Court does not accept Indiana’s position that self-representation can be denied ‘where the defendant cannot communicate coherently with the court or a jury.'…It does not even hold that Edwards was properly denied his right to represent himself. It holds only that lack of mental competence can under some circumstances form a basis for denying the right to proceed pro se…We will probably give some meaning to this holding in the future, but the indeterminancy makes a bad holding worse.'

In other words, there will have to be sequels. In the meantime, states can experiment with various formulations of a standard — so long as it is not theone Indiana suggested."

Additional coverage is available in The Washington Post and the Legal Times, and from the Associated Press.

Thursday, June 19, 2008

U.S. Supreme Court Places Limits on Self-Representation

The U.S. Supreme Court has ruled in Indiana v. Edwards that defendants with severe mental illness who are found competent to stand trial do not necessarily have the right to represent themselves. The Court heard arguments in the case earlier this spring.

Here's a quick summary from Associated Press reporter Mark Sherman ("Court puts limits on mentally ill defendants," June 19, 2008):

"The Supreme Court ruled Thursday that criminal defendants with a history of mental illness do not always have the right to represent themselves, even if they have been judged competent to stand trial.

The justices, by a 7-2 vote, said states can give trial judges discretion to prevent someone from acting as his own lawyer if they are concerned that the trial could turn into a farce.

The decision comes in the case of an Indiana man who was convicted of attempted murder and other charges in 2005 for a shooting six years earlier at an Indianapolis department store.

Ahmad Edwards was initially found to be schizophrenic and suffering from delusions and spent most of the five years after the shooting in state psychiatric facilities. But by 2005, he was judged competent to stand trial.

Edwards asked to represent himself. A judge denied the request because he was concerned that Edwards' trial would not be fair. Edwards, represented by a lawyer, was convicted anyway and sentenced to 30 years in prison.

He appealed, and Indiana courts agreed that his right to represent himself had been violated, citing a U.S. high court decision from 1993. The courts overturned his conviction and ordered a new trial.

Thursday's ruling probably will lead to the reinstatement of the conviction.

'The Constitution permits states to insist upon representation by counsel for those competent enough to stand trial ... but who still suffer from severe mental illness to the point where they are not competent to conduct trial proceedings by themselves,' Justice Stephen Breyer wrote in the majority opinion.

Justices Antonin Scalia and Clarence Thomas dissented. 'In my view, the Constitution does not permit a state to substitute its own perception of fairness for the defendant's right to make his own case before the jury,' Scalia said.

The opinion is available at

Earlier coverage of Indiana v. Edwards is available here, here, here, and here.

Wednesday, June 18, 2008

More on Scott Panetti

From the Houston Chronicle ("Austin judge finds inmate sane enough for execution; More appeals are likely in the landmark case," June 17, 2008):

For 15 years, Scott Panetti has been Example No. 1 of the problems that result when mental illness crosses paths with the criminal justice system.

They were evident at his capital murder trial, when he represented himself and dressed up in a purple cowboy suit, making a bad joke of sober proceedings when he subpoenaed JFK and Jesus Christ. And they were just as apparent years later when the state tried to execute Panetti, only to see appeals courts step in and grapple with the question of whether he was too crazy to kill.

Now an Austin federal judge has decided that Panetti, convicted by a Kerr County jury of killing his in-laws in 1992, may not be quite as sick as advertised and likely has tried to manipulate doctors assigned to investigate his mental state.

U.S. District Judge Sam Sparks, who conducted a hearing on Panetti's sanity in February, concluded that he does not deserve the protection of the courts — at least not in his current state.
"If any mentally ill person is competent to be executed for his crime, this record establishes it is Scott Panetti," Sparks concluded in his 62-page opinion.

A year ago, Panetti's lawyers were celebrating a decision by the U.S. Supreme Court that declared Texas' standard for deciding competency for execution was so narrow as to be almost meaningless.
Expanding on its 1986 ruling in Ford v. Wainwright, which made it unlawful to execute the incompetent, the high court said a defendant had to have a "rational understanding" of why he was going to be put to death.

Panetti's lead counsel, Greg Wiercioch, all but said his death row days were numbered.

"Today the Supreme Court recognized that executing Scott Panetti would be a mindless, meaningless and miserable spectacle," Wiercioch said.

His assumption was that any court ordered to review Panetti's case in light of the Supreme Court's ruling — which required that defendants have more than just a technical understanding why they were being put to death — would see how sick he is and spare him the needle.

Malingering suspected

Sparks, however, did nothing of the sort.

While acknowledging that Panetti is seriously mentally ill, Sparks, however, seized on the opinion of three doctors hired by the state who suspected malingering and found behavior inconsistent with previous diagnoses of schizophrenia and schizoaffective disorder.

Sparks was also persuaded by tape recordings of conversations between Panetti and his parents. They indicate he had a good grasp of his legal case, and that he had adjusted his attitude and his level of cooperation with doctors depending on which side was paying them.

To Sparks, Panetti's words suggested a rational appreciation of his predicament.

"It is not seriously disputable that Panetti suffers from paranoid delusions of some type, and these delusions may well have contributed to his murder of Joe and Amanda Alvarado," Sparks wrote. "However, it is equally apparent from his recorded conversations with his parents that these delusions do not prevent him from having both a factual and rational understanding that he committed those murders, was tried and convicted, and is sentenced to die for them."

Wiercioch said Sparks essentially ignored 30 years of medical evidence and relied on a small amount of recorded conversation that did not mean anything when viewed in light of Panetti's system of delusions.

Wiercioch insists Sparks missed the point of the Supreme Court's decision: A condemned inmate's competency has to be considered in light of his broader understanding of the crime, why he committed it and why he is being punished for it.

Careful examination

In its review of the Panetti case, the Supreme Court acknowledged that "rational understanding" is a difficult concept to define. It also pointed out that some offenders might be so callous, unrepentant or lacking in compassion that they might seem out of touch with reality, which does not mean they cannot be executed.

But the high court said that defendants who are seriously mentally ill need to be carefully examined to see that what they believe and understand has some connection to the truth.

"Gross delusions stemming from a severe mental disorder may put an awareness of a link between crime and its punishment in a context so far removed from reality that the punishment can serve no proper purpose," the majority opinion stated. "A prisoner's awareness of the State's rationale for an execution is not the same as a rational understanding of it."

Sparks' opinion took a limited view of what that means. Panetti's illness and belief system are largely irrelevant now if he can talk reasonably about his appeals and understands he is engaged in an adversarial process that could end with his execution, the judge said.

Understanding matters

Under Sparks' interpretation, even the most bizarre delusional system would matter little — say, Panetti believing he killed his in-laws because he had been anointed by God to stop an alien invasion of Earth — because the only matter relevant for execution competency would be a rational understanding of the legal process involved in obtaining it.

"The tapes of Panetti's conversations with his parents establish that Panetti has a fairly sophisticated understanding of his case, up to and including the legal intricacies presented by Ford and the Supreme Court's remand opinion," Sparks wrote.

Sparks also wrote that Panetti's unwillingness to engage mental health experts equally regardless of which side was employing them also worked against the claim that he is too ill to understand what is going on.

"This suggests nothing more exotic than a rational understanding that Panetti's legal defense is an adversarial process and the State is on the other side," the judge stated.

The case will be appealed and ultimately could end up back with the Supreme Court for justices to determine whether Sparks followed the intent of their previous ruling.

Tuesday, June 17, 2008

Washington Post Editorial on Percy Walton

From June 12, 2008:

A Courageous Commutation
Mr. Kaine spares the life of a man on death row.

"Timothy M. Kaine (D), a confidant of Barack Obama's and the first governor outside Illinois to endorse the senator's bid for the Democratic presidential nomination, is routinely mentioned as a vice-presidential prospect. Many politicians in his position might bend or suspend principle to keep such prospects alive. But this week, Mr. Kaine commuted the death sentence of a mentally deficient triple killer to life in prison without parole. Under the circumstances, the decision, which could well provide convenient fodder for Republican attack ads in a national campaign, was courageous as well as fair-minded and fact-based.

As a candidate for governor in 2005, Mr. Kaine, a devout Catholic and lifelong opponent of capital punishment, said he would allow executions to proceed as a function of his office in respect of Virginia law. He has been true to his word, permitting five executions to go forward, more than any state except Texas, Oklahoma and Ohio. But the case of Percy L. Walton rightly gave him pause when he first reviewed it in 2006, and it was Mr. Walton's death sentence that the governor commuted on Monday.

There is no doubt about Mr. Walton's guilt, or the brutality of his crime: In 1996, shortly after his 18th birthday, he shot three people at close range, including an elderly couple, Jessie and Elizabeth Kendrick, in the Southside city of Danville. A year later he pleaded guilty to the three murders.

The question of whether he was or remains competent to face execution has prompted the governor's scrutiny. Confronted with abundant evidence -- from the state Department of Corrections and other sources -- that Mr. Walton is mentally retarded, profoundly confused and only dimly aware of his sentence, the governor twice postponed his execution (originally set for June 2006) to allow further evaluation. Before giving the green light, Mr. Kaine wanted to be satisfied that Mr. Walton met the test laid down by the Supreme Court more than two decades ago: that the condemned man is fit for execution only if he understands that he's been sentenced to death and the reason for that sentence.

At his best, Mr. Walton seemed only vaguely aware of his situation. He told one psychiatrist that he expected to have access to a telephone and a job at Burger King after his execution. Over time, experts who assessed Mr. Walton have disagreed on his mental capacity and ability to grasp the fate that awaited him. So have judges. Ruling on his case in 2006, the U.S. Court of Appeals for the Fourth Circuit, perhaps the nation's most conservative federal court, split 7 to 6 in deciding that he was mentally fit to be executed. Since then, there seems little doubt that his condition has deteriorated. Given the Supreme Court standard, it would have been a travesty of justice for Mr. Kaineto permit the state to execute such a man. In commuting his sentence, Mr. Kaine recognized and applied that standard, acting with guts and decency.

Tuesday, June 10, 2008

NAMI Poll on Perceptions of Schizophrenia

The National Alliance on Mental Illness (NAMI) recently commissioned a poll from Harris Interactive regarding public awareness of and attitudes towards schizophrenia.

Here are some of the findings, pulled from the NAMI report:

Two million Americans are living with schizophrenia (1% of the nation's population age 18 or older). NAMI notes that this is twice the number of people living with HIV/AIDS.

With medication, the symptoms of schizophrenia can often be controlled successfully. About 50% of those diagnosed with the illness can improve significantly or recover completely over time. However, only a third of those living with schizophrenia actually receive treatment, and there is an enormous delay, averaging 8.5 years, between when someone first experiences symptoms and when he/she receives treatment.

People mistake, overemphasize, or underestimate certain symptoms of schizophrenia. The greatest misconception (64%) is that "split or multiple personalities" are symptoms of schizophrenia. Symptoms such as drug abuse (24%), alcohol abuse (23%), insomnia (41%), and disorganized speech (35%) are also not widely recognized.

Violent behavior as a symptom was selected by 60% of the public, which represents a fundamental fault line in how Americans view schizophrenia and other mental illnesses. Ironically, most individuals with schizophrenia are not prone to violence; they typically withdraw from social interaction and simply prefer to be left alone.

The U.S. Surgeon General reported ten years ago that although some research exists to support public concern, "the overall likelihood of violence is low" and the "overall contribution of mental disorders to the total level of violence in society is exceptionally small." The "greatest risk" is from persons dually diagnosed with both a mental illness and a substance abuse disorder. There is also a "small elevation of risk" for persons with severe disorders such as psychosis, "especially if they are noncompliant with their medication."

Other studies support the U.S. Surgeon General's basic assessment and the National Institute of Mental Health (NIMH) has noted that substance abuse "always increases violent behavior, regardless of the presence of schizophrenia." Meanwhile, people with serious mental illnesses are as many as ten times more likely to be victims of violence than the general public.

[Editor's Note: Professor Dorean Marguerite Koenig, a member of the ABA's Task Force on Mental Disability and the Death Penalty and a Professor of Law at the Thomas M. Cooley Law School, notes that schizophrenia is by far the most common mental disorder seen in capital defendants.]

The vast majority of Americans recognize that schizophrenia is an illness (85%) and that with ongoing care, people diagnosed with schizophrenia can lead independent lives (79%).

But only one-fourth (24%) of the general public consider themselves to be familiar with the illness. In a list of 11 common medical conditions that included heart disease, cancer, diabetes, and depression, only Lou Gehrig's disease and multiple sclerosis ranked lower than schizophrenia in familiarity.
For more information and to read the full report, visit

Coverage of Walton Commutation

From the Richmond Times-Dispatch ("Triple murderer spared from execution by Kaine," June 10, 2008):

"Gov. Timothy M. Kaine commuted Percy Levar Walton's death sentences to life without parole yesterday, sparing the triple murderer execution by injection tonight.

Though courts have held that Walton could be executed, Kaine said he granted clemency because Walton was not mentally competent. In 2006, Kaine twice delayed Walton's execution over concerns he was mentally ill.

'Given the extended period of time over which Walton has exhibited this lack of mental competence, I must conclude that a commutation of his sentence . . . is now the only constitutionally appropriate course of action,' Kaine said in a prepared statement.

In 1996, Walton murdered Jessie Kendrick, 80, Elizabeth Kendrick, 81, and Archie D. Moore Jr., 33. All three lived near Walton in Danville. Kaine said there was no doubt Walton was guilty of the crimes, and he did not question the decision to seek the death penalty.

'The victims met a fate they did not deserve, and the families of the victims have suffered greatly from the loss of their loved ones,' Kaine said.

Learning of Kaine's decision, Irene Jurscaga, 87, of Suffolk, sister of Elizabeth Kendrick, said, 'I'm very disappointed.' Earlier yesterday, she said she hoped the clemency request would be turned down.

'He killed three people. He killed my dear sister, my brother-in-law. They were innocent people. This has been torture for us for the last 12 years,' she said. 'When he committed this crime . . . he knew what he was doing.'

Kaine said that while Walton may have been sane when he committed the murders, the U.S. Supreme Court has held that the Constitution 'forbids the execution of those who are unaware of the punishment they are about to suffer and why they are to suffer it.'

Virginia Attorney General Bob McDonnell said he respectfully disagrees with Kaine's decision. 'The United States Supreme Court denied Walton's petition in which he argued that he is incompetent and requested that his execution be stayed,' he said.

McDonnell said nothing prevented Walton from bringing evidence of incompetence before the courts. 'Evidence of an inmate's competency is more effectively evaluated by a judicial officer,' McDonnell said.

Kaine, who opposes capital punishment, has let five executions proceed. This was the first time he commuted a death sentence. Governors L. Douglas Wilder, George Allen, Jim Gilmore and Mark R. Warner commuted a total of seven death sentences since executions were allowed to resume in 1976.

Experts have differed on Walton's condition over the years.

In June 2006, Kaine said Walton's clemency petition presented information that Walton had schizophrenia and that his mental state had deteriorated since 2003, the most recent information the courts had to consider at the time in 2006.

'I was compelled to conclude [in 2006] that Walton was seriously mentally impaired and that he met the Supreme Court's definition of mental incompetence,' he said.

Since then, Kaine said, there has been no improvement. 'One cannot reasonably conclude that Walton is fully aware of the punishment he is about to suffer and why he is to suffer it,' Kaine said.

Nash Bilisoly, one of Walton's lawyers, said, 'I think the governor acted appropriately and compassionately in granting the clemency request.'

He said he asked prison authorities to notify Walton, who on Thursday was moved from death row to the Greensville Correctional Center, where executions are conducted.

The news, Bilisoly said, 'won't make any difference to him. He will not know.'

Gov. Kaine Grants Clemency to Percy Walton

After years of wrangling in the courts regarding Percy Levar Walton's competency to be executed, Virginia Governor Tim Kaine has decided to grant clemency to Walton and commute his sentence to life without the possibility of parole.

Here is the Governor's statement in full:

"I have carefully considered over the past 24 months the question of whether the Commonwealth can carry out the execution of Percy Levar Walton in a constitutionally permissible manner.

"There is no doubt that Walton killed three innocent people over a two-week period in November 1996. The victims met a fate they did not deserve and the families of the victims have suffered greatly from the loss of their loved ones. I have no reason to question the prosecutor's decision to seek the death penalty or the judge's decision that death was an appropriate sentence.

"The courts have emphasized, however, that it is unconstitutional to execute a person who is mentally incompetent. The late U.S. Supreme Court Justice Lewis F. Powell, Jr. wrote in the seminal case of Ford v. Wainwright, 477 U.S. 399 (1986), that the Eighth Amendment of the U.S. Constitution 'forbids the execution of those who are unaware of the punishment they are about to suffer and why they are to suffer it.' He further concluded that the execution of a mentally incompetent inmate would be a 'uniquely cruel penalty' where the inmate could not comprehend that they are about to die and could not 'prepare, mentally and spiritually' for the execution.

"Thus, the question of Walton's mental status is of the utmost importance in assessing whether the Commonwealth may carry out his death sentence. For this reason, the court system has wrestled with the question of whether Walton's mental capacity imposes a bar to his execution. Notwithstanding consistent decisions upholding his conviction, the courts found it necessary to carefully examine whether Walton's death sentence could be carried out consistent with the U.S. Constitution.

"In this regard, a few days before Walton's initial scheduled execution date of May 28, 2003, the U.S. District Court for the Western District of Virginia granted Walton a stay of execution in order to determine Walton's mental competence. In July 2003, following extensive submission of evidence about Walton's mental state from 1997 through 2003, the court ruled that he was competent to be executed. A three-judge panel of appellate judges of the United States Court of Appeals for the Fourth Circuit vacated the lower court ruling, directing a broader inquiry into Walton's mental state. Before that inquiry took place, the entire court reconsidered the panel's decision in an en banc review. The en banc court found Walton competent to be executed by a narrow 7-6 majority.

"In issuing its ruling, the Fourth Circuit properly limited its consideration to psychiatric evaluations and other evidence pertaining to Walton's mental state during the period from 1997 to 2003. By the time I first reviewed this matter, shortly before Walton's scheduled execution in June 2006, three years had passed since the evidence on his mental competence was presented to the court.

"I noted at that time that Walton's clemency petition presented significant evidence that Walton had schizophrenia, that such a mental illness can cause serious deterioration of mental competence, and that Walton's mental state had deteriorated since 2003 such that there was more than a minimal chance that Walton no longer knew why he was to be executed or was even aware of the final punishment he was about to receive. Due to the history of judicial concern about his mental status, I determined that it was important to have current and independent information about Walton's mental condition in order to comply with the law forbidding execution of a mentally incompetent person. Accordingly, I delayed Walton's June 2006 execution date until December 8, 2006, for the purpose of conducting an independent evaluation of his mental condition and competence.

"During that six-month period, I was provided with current and independent information pertaining to Walton's mental state from a number of sources including a thorough review of records maintained by the Department of Corrections, updated evaluations by psychiatrists, and information provided by persons who had interacted with Walton on a regular basis over a period of years.

"After reviewing the information, I was compelled to conclude that Walton was seriously mentally impaired and that he met the Supreme Court's definition of mental incompetence. Because one could not reasonably conclude that Walton was fully aware of the punishment he was about to suffer and why he was to suffer it, I decided that his execution could not proceed at that time.

"At the same time, it was within the realm of possibility - though unlikely - that Walton's mental impairment was not permanent. As a result, I concluded that a commutation of his sentence was not then appropriate. Rather, continued observation of Walton's condition over a more extended period of time was the appropriate course of action. Accordingly, I delayed his execution date by an additional 18 months, to June 10, 2008.

"Over the course of those 18 months, there has been no discernible improvement in Walton's condition and no evidence that his mental impairment is temporary. Walton differs in fundamental ways from other death row offenders. He lives in a self-imposed state of isolation that includes virtually no interest in receiving or understanding information. Walton communicates only infrequently, almost invariably in response to direct questions, and those responses are minimal in nature. He has nothing in his cell other than a mattress, a pillow and a blanket. He shows no interest in contact with the outside world and has no television, radio, magazines, books or stationery. He has no personal effects of any kind. This minimal existence has been in evidence for the past five years.

"In light of this information, I am again compelled to find that one cannot reasonably conclude that Walton is fully aware of the punishment he is about to suffer and why he is to suffer it.

"Given the extended period of time over which Walton has exhibited this lack of mental competence, I must conclude that a commutation of his sentence to life in prison without possibility of parole is now the only constitutionally appropriate course of action.

"Although Walton's mental incompetence alone precludes carrying out an execution that would violate the Constitution, there are other factors that I have considered in granting limited clemency. Since Walton's conviction and sentencing, separate Supreme Court decisions have placed limitations on executions that very nearly fit Walton's circumstances.

"The Court has ruled that the Constitution forbids executing an individual who: commits a capital crime under the age of 18 years old; was insane at the time of the capital crime; or is mentally retarded due to intellectual disabilities evidenced before the age of 18.

"In this instance, Walton committed these murders less than two months past his 18th birthday. While he was not insane at the time of his crimes, there are strong indications that his mental illness started prior to the murders. While he scored a 66 on his most recent IQ test, which is below a standard for mental retardation (70 on an IQ test) set by the Supreme Court of Virginia, he appears to have fallen below that standard for mental retardation only after he turned 18 while the relevant legal standard in the Commonwealth requires that retardation be in evidence prior to that age.

"While no one of these additional factors would justify clemency for Walton standing alone, it is appropriate to employ the sound legal practice of considering and weighing the totality of the facts in determining whether to grant limited clemency to Walton.

"In light of the foregoing conclusions and in accordance with the powers granted to me as Governor under Article V, Section 12 of the Constitution of Virginia, I have granted Walton a commutation of his three death sentences to life imprisonment without the possibility of parole."

"In reaching this decision, I remain mindful of the terrible injustice that Walton perpetrated against Jessie E. Kendrick, Elizabeth W. Kendrick, and Archie D. Moore, Jr. My thoughts and prayers are with the families of these honorable people."

More information on Percy Walton is available here.
The American Bar Association's Recommendation on the Death Penalty and Persons with Mental Disabilities states that "If, after challenges to the validity of the conviction and death sentence have been exhausted and execution has been scheduled, a court finds that a prisoner has a mental disorder or disability that significantly impairs his or her capacity to understand the nature and purpose of the punishment, or to appreciate the reason for its imposition in the prisoner's own case, the sentence of death should be reduced to the sentence imposed in capital cases when execution is not an option."

Monday, June 9, 2008

Research on Rates of Violence Among Those with Severe Mental Illness

Here's an op-ed that appeared today in the Wall Street Journal by E. Fuller Torrey, the founder of the Treatment Advocacy Center (TAC). TAC is a national nonprofit organization dedicated to eliminating barriers to the timely and effective treatment of severe mental illnesses. TAC promotes laws, policies, and practices for the delivery of psychiatric care and supports the development of innovative treatments for and research into the causes of severe and persistent psychiatric illnesses, such as schizophrenia and bipolar disorder.

Compassion, Compulsion and the Mentally Ill

"The debacle of deinstitutionalization continues to worsen with each passing year. In 1955, there were 559,000 individuals in America's state mental hospitals. By 2005, there were only 47,000 state hospital beds left in the country, a number that continues to fall. Numerous studies have documented the tragic effects of releasing hundreds of thousands of seriously mentally ill individuals from state hospitals while failing to ensure that they receive treatment.

The latest, carried out by Jason Matejkowski and colleagues at the University of Pennsylvania, found that individuals with serious mental illnesses are responsible for 10% of all homicides in Indiana. That translates into approximately 1,700 out of 17,034 total homicides in the U.S. in 2006. Over the past 20 years – during which time the public mental-health system has progressively deteriorated – that would mean 38,000 of 388,311 total homicides.

The University of Pennsylvania study examined the records of 723 individuals convicted of homicide between 1990 and 2002 in the Hoosier state. The results were published in the Journal of the American Academy of Psychiatry and the Law.

Examples of such homicides include Joseph Corcoran, diagnosed with paranoid schizophrenia, who shot four people in Fort Wayne because he thought they were talking about him. And Frank Salyers, also diagnosed with paranoid schizophrenia, who killed a policeman in Goshen after his parents tried unsuccessfully to get treatment for him at a local mental-health facility.

Although the Indiana study is the largest research of its kind in the U.S., two earlier but smaller studies reported that seriously mentally ill individuals were responsible for 10% of homicides in Contra Costa County, Calif., and 29% of homicides in Albany County, N.Y.

Most of these homicides were preventable, since the perpetrators in most cases were not being treated. Nontreatment, a past history of violent behavior and substance abuse are strong predictors of potential dangerousness in this population. We have proven options for decreasing such violence, including outpatient commitment. These programs require mentally ill individuals at high risk for violence to continue taking medication as a condition for living in the community.

Kendra's Law, passed in New York state in 1999, established one such program. A 2005 study by the New York State Office of Mental Health showed that physical acts of violence – as well as suicide attempts and arrests – by patients compelled to undergo treatment under Kendra's Law dropped dramatically in just six months; a similar reduction in violent behavior was shown in a North Carolina study.

Despite such data, assisted outpatient treatment is seldom used in the 42 states in which it is available and does not even exist in the other eight states. Even in New York, only a few counties use Kendra's Law widely. Why not? One reason is the reluctance of mental-health professionals to mandate treatment, even for patients with a history of violence and noncompliance with treatment.

Another is the misconception that such programs are expensive. In fact, it is our failure to use such laws that is expensive. Repeated hospital readmissions, incarceration costs, and the costs of homicides and other associated violence take a far greater toll on local, state and federal coffers.

The societal cost of not treating the seriously mentally ill is staggering. They constitute at least one-third of the homeless population. Unable to defend themselves because of their disabilities, they are often exploited and victimized. Approximately 5,000 commit suicide each year – one-sixth of all suicides. An estimated 230,000 are in jails and prisons, 10% of all incarcerations.

According to a 2006 study by the U.S. Justice Department, 56% of state prisoners, 45% of federal prisoners and 64% of local jail inmates suffer from mental illnesses. In fact, there are now more individuals with a serious mental illness in state prisons than in state mental hospitals.

In the end, involuntarily treating people with serious mental illnesses – who, because of their illnesses, are not aware they are sick – does not infringe on their civil rights. The fears of civil libertarians notwithstanding, the paramount civil right of someone who is severely mentally ill should be adequate treatment.

As Supreme Court Justice Anthony Kennedy wrote in 1999: 'It must be remembered that for the person with severe mental illness who has no treatment, the most dreaded of confinements can be the imprisonment inflicted by his own mind, which shuts reality out and subjects him to the torment of voices and images beyond our powers to describe.'"

Dr. Torrey is the author, most recently, of "The Insanity Offense: How America's Failure to Treat the Seriously Mentally Ill Endangers Its Citizens," out this month by W. W. Norton.

Update on Executions

David Mark Hill was executed by the State of South Carolina on June 6, 2008. He had decided to forego any further appeals. According to Amnesty International USA, Hill had a history of mental illness, including several suicide attempts.

The execution of Percy Levar Walton in Virginia is still set for tomorrow, June 10. Jennifer Givens with the Virginia Capital Representation Resource Center and one of Walton's lawyers, said, "There is no new evidence or evaluations that have been conducted recently. I can assure you, however,that Walton is still severely mentally ill." (Richmond Times-Dispatch, June 6, 2008). Governor Tim Kaine has twice delayed Walton's execution in light of evidence of his severe mental illness and concerns about Walton's understanding of the reality of his execution. Kaine is supposedly reviewing Walton's clemency petition but has not yet commented on the case or any action he might take.

Tuesday, June 3, 2008

More on Healthcare for the Homeless-Houston

Here's more information on the pilot program designed by Healthcare for the Homeless-Houston, which aims to provide services to those inmates with severe mental illness immediately upon their release from the Harris County Jail.

From KUHF-Houston Public Radio News:

Health Care For Former Inmates Saves Harris County Money
2 June 2008
By: Capella Tucker

The Harris County Jail system is said to have one of the best mental health programs. But those services stop once inmates are released. Too often those inmates repeat the same patterns that get them right back jail. Capella Tucker reports on a program that looks to literally walk inmates from the jail doors to clinic doors to stop the cycle of re-incarceration.

Click here to listen or read the transcript below.

"Hi, this is George Bement with
Healthcare for the Homeless Houston. I've arranged a special release this morning for Rhanda Gillespy. Okay, I'll be there in about five minutes, thank you."

It's 8 o'clock Saturday morning. Bement walks four blocks to the Harris County Jail.

Rhanda Gillespie has been in and out of the Harris County jails since the mid-1990's.

She's served time for theft, delivery of controlled substances and prostitution. And Gillespy suffers from mental illness. She knows most people expect her to wind up back in jail.

"In fact one of the jailers told me, the lady I worked for, she told me, she says we'll have a job waiting for you when you get back, I said hopefully I find one with better pay."

First Gillespy has to get her feet on the ground, that includes walking back to the clinic with Bement for a doctor's appointment.

"The severely mentally ill people generally are treated in the jail and in fact the jail has a very good mental health unit, but then once they get out there's no linkage of services. Once they are out the door the Harris county sheriff's department no longer has responsibility for their care so they are basically on their own."

Every other time Gillespy has been released it's been at 12:01 a.m., which is the traditional time when inmates are freed.

"The people most unable to be productive in our society are left to fend where I certainly couldn't figure out how to get from jail and before my blood levels of my anti-psychotic are gone get that new medicine. There isn't a place to do it except for clogging the Er's."

Or winding up back in jail. Doctor David Buck founded the Healthcare for the Homeless Houston. The group hopes to make a difference for Gillespy and others like her so they won't wind up behind bars again.

In a pilot project, Buck has found that the level of recidivism drops when inmates are directly connected with services upon being released. He's been following two hundred forty-five patients for the past year.

"When we looked at a comparable group from 2004 and looked at our group, the re-arrest rates from 2004 were sixty percent. The re-arrest of this group from last year was 30 percent."

Buck says that saves Harris County money. Commissioners are expected to vote tomorrow on whether they'll fund the continuation of the program which costs about one hundred thousand dollars a year.

Thanks to Cherie Wyatt, with HHH for sharing this with me.

TN Death Row Inmate Receives Life Sentence

The ACLU Capital Punishment Project reports that Tennessee death row inmate Richard Taylor has received a life sentence, in exchange for pleading guilty to the crime for which he was sentenced to death in 1981. Taylor has a long, documented history of severe mental illness; according to the ACLU, he has been denied psychiatric treatment at various times during his incarceration and was not receiving his anti-psychotic medication at the time of the crime.

Here's the press release from the ACLU:

Mentally Ill Man Receives Life Sentence After 18 Years On Tennessee Death Row (6/3/2008)
Deal Comes Two Months After Death Sentence Reversed By Appeals Court

CONTACT: (212) 549-2582 or 2666;

NASHVILLE — A severely mentally ill man who spent 18 years on death row and whose conviction and death sentence were reversed by a Tennessee appeals court in March was sentenced to life imprisonment today. Richard Taylor, twice forced to stand trial despite his severe mental illness, agreed to the sentence in exchange for pleading guilty to the 1981 murder of a Tennessee prison guard — a crime committed only after prison officials stopped giving Taylor his anti-psychotic medication.

Taylor is represented by the American Civil Liberties Union and Kelly Gleason, an attorney with the Office of the Tennessee Post-Conviction Defender.

"Richard Taylor’s case highlights the fundamental unfairness of capital prosecutions of mentally ill defendants," said Cassandra Stubbs, staff attorney with the ACLU Capital Punishment Project. "Taylor's mental illness infected every step of the case, from the offense through trial. We are extremely pleased that he will not be executed."

Taylor, then 21, was serving a sentence for joy-riding and robbery convictions in 1981 when he attacked a prison guard at the Turney Center correctional facility in Only, Tennessee. Despite the fact that authorities considered him mentally ill and despite the fact that he had previously tried to kill himself by swallowing glass, prison officials stopped giving Taylor his anti-psychotic medication two months before his attack on guard Ronald Moore.

Witnesses of Moore’s stabbing described Taylor at the time as raving, trembling and shaking, with wild eyes and an expression on his face like a wild horse.

"The fact that Richard Taylor was then — and is now — severely mentally ill, at a minimum means that he was not able to fully appreciate his actions," said Stubbs. "Although the death penalty is never an acceptable sentence, even proponents concede it should be used only for the worst of the worst. Surely, individuals like Richard Taylor, who are severely mentally ill, fall outside of that category."

Taylor, convicted and sentenced to death, sat in solitary confinement on Tennessee’s death row between 1984 and 2000, during which time he received no psychiatric services and was tortured by prison guards who beat, starved and taunted him, deliberately trying to make his mental illness worse.

"The treatment of Richard Taylor — including the physical and psychological abuse by guards and the withholding of psychiatric services by the prison — is unconscionable," said Stubbs. "I hope that in the future the Tennessee Department of Corrections will honor its responsibility to provide the psychiatric care for Richard Taylor that he needs."

Taylor was granted a new trial in 2003, but despite continuing to make bizarre and delusional statements, he was allowed to face his two-day capital trial alone — representing himself without even standby counsel to help him. Wearing prison garb and sunglasses, Taylor called no witnesses, introduced no evidence, and presented no defense. The few cross-examination questions he posed during the guilt-innocence phase of his trial were delusional, and he was completely silent during the sentencing phase of the proceedings. The jury that sentenced Taylor to death was never presented with compelling evidence of Taylor's difficult childhood, suicide attempts, psychiatric hospitalizations or severe mental illness.

"Unfortunately, it is all too common for severely mentally ill defendants who suffer grandeur delusions to fire their lawyers and represent themselves at trial, believing that they will out perform their lawyers," said Stubbs. "Richard, like other defendants who fall into this tragic category, was trapped by his own delusions and was incapable of presenting a defense or introduce the very evidence necessary to save his life."

The ACLU’s numerous legal challenges to the 2003 trial and the proceedings leading up to it, including to the judge’s failure to hold a competency hearing during the trial when it was obvious that Taylor was incapable of standing trial and representing himself, were upheld in March when the Tennessee Court of Criminal Appeals reversed his conviction and death sentence.

Additional information about Taylor’s case can be found online at:
An earlier post on Taylor is available here.

Increasing Number of Defendants Found Incompetent to Stand Trial

USA TODAY reports a rise in the number of accused felons who have been found incompetent to stand trial in 10 out of the 12 most populous U.S. states ("Mentally Incompetent Defendants on the Rise"). Interestingly, Texas reported a decline in this number (the article does not provide any explanation for this apparent decline, however). The review cites the lack of access to adequate mental health treatment as a major cause for the increase in other states.

According to the Texas Code of Criminal Procedure (Chapter 46B, Article 46B.003):

“(a) A person is incompetent to stand trial if the person does not have:

1. sufficient present ability to consult with the person’s lawyer with a reasonable degree of rational understanding; or
2. a rational as well as factual understanding of the proceedings against the person.

(b) A defendant is presumed competent to stand trial and shall be found competent to stand trial unless proved incompetent by a preponderance of the evidence.”

Here's the full article from USA TODAY:

"The number of accused felons declared mentally incompetent to stand trial is rising in 10 of the nation's 12 largest states, delaying local prosecutions and swamping state mental health and prison systems, a USA TODAY review finds.

These defendants cost hundreds of millions of dollars to treat and house as local governments tighten their budgets because of a slowing economy.

Legal analysts attribute the increase to a lack of mental health care, judges' increased openness to such claims and legal strategies by defendants to try to avoid harsh punishment.

'It's a huge problem,' says Joshua Marquis, a vice president of the National District Attorneys Association. 'It's equally bad for the accused and the victims' because cases linger.

Criminal defendants who do not understand the legal proceedings against them are generally declared by judges to be incompetent for trial. Most are referred to mental health facilities and treated. The length of treatment varies from an average of three weeks in Virginia to more than nine months in Tennessee before they are deemed fit for trial or mental health experts determine they cannot be successfully treated, the USA TODAY review found.

There is wide variation in how states track thousands of incompetency rulings, and some do not track them at all. Of the 12 most populous states, Texas reported a decline last year and New Jersey did not provide data.

Among states reporting increases:

• Florida: State policy analysts reported in March that incompetent defendants there doubled from 1,061 to 2,123 in the past five years. Florida Supreme Court Chief Justice R. Fred Lewis says that reflects a lack of access to treatment even before the accused enter the criminal justice system. Florida officials spend about $250 million yearly on treatment aimed at restoring mental fitness. The state projects the cost will double in the next seven years.

• Ohio: About 32% of 1,050 state mental hospital patients have been charged with crimes but declared unfit for trial. Most are accused felons, and that number has risen recently, says Howard Sokolov, Ohio's medical director for forensic services.

• California: Mentally incompetent defendants treated by state mental health providers increased in four of the past five years. Accused and convicted offenders now occupy 4,500 of the state's 5,000 mental hospital beds, up from 500 more than a decade ago, says the state Department of Mental Health.

Ken Murray, chairman of the National Association of Criminal Defense Lawyers' mental health committee, says competency claims are gaining acceptance among judges, prosecutors and defense lawyers in part because of growing efforts to identify the wrongfully convicted. 'Some of these people who made false confessions' — and were convicted based on those statements — 'had competence problems to start with,' says Murray, a federal public defender in Phoenix.
Sokolov says incompetency caseloads for Ohio's mental health assessors have risen 22% in the past five years. 'There is an increasing amount of people who are finding it difficult to obtain (mental health) services,' he says, 'and they tend to get in trouble with the law.'"

Monday, June 2, 2008

Execution Set for SC Offender with Severe Mental Illness

The State of South Carolina has scheduled the execution of David Hill, an inmate with severe mental illness who has decided to waive his appeals. Approximately 129 out of the 1,102 executions since 1977 have involved inmates who decided to forego any further appeals of their cases. A number of inmates have done so as a result of their severe mental illness (and many have changed their minds at the last minute).

In this case, David Hill had a history of mental illness before the commission of the crime, including several suicide attempts. He was sentenced to death in 2000 for the murder of three social workers in an office shooting in 1996. Hill is scheduled be executed on June 6, 2008.

Here's more information on the case from Amnesty International USA:

"Josie Curry, Michael Gregory and James Riddle were shot dead by David Hillin the office of the Department of Social Services (DSS) in North Augusta, South Carolina, on September 16, 1996. The next morning police found David Hill lying on railway tracks not far from the DSS building. He had shot himself in the head, but survived, with critical injuries.

David Hill was brought to trial in 2000. A doctor testified that although Hill had sustained frontal lobe damage to his brain when he shot himself, and was suffering from a degree of memory loss, he could understand the charges against him and would be able to follow the proceedings if he paid attention. Several experts testified that David Hill was suffering from serious mental health problems at the time of the crime, and was apparently not taking his medication on the day of the shootings. A psychiatrist who had been treating him in the months before the crime testified that Hill was suffering from three major mental disorders: post-traumatic stress disorder, panic disorder and major depressive disorder. He stated that a number of traumatic events in Hill's life had contributed to this, including his near-drowning when he was a teenager, his guilt over causing a car accident when he was 18 which killed his sister, witnessing an explosion at his workplace, and the stress of his daughter being left paraplegic in a car accident in 1995 (she died in 1998).

David Hill made a number of suicide attempts in the months before the crime. In July 1996, police had been called to his home when he was threatening to kill himself with a shotgun. He was eventually talked out of it by his psychiatrist and taken for treatment for depression. The shootings at the DSS office took place about a week after his three-year-old daughter and his twin two-year-old sons had been taken into DSS custody.

The jury returned a death sentence and Hill's automatic appeal was rejected by the South Carolina Supreme Court in 2004. In May 2007, David Hill wrote to the prosecuting authorities asking them to assist him to 'drop the rest of my appeals and have an execution date set.' The following month, he changed his mind, but in July 2007 again decided to abandon his appeals. A hearing was held before a judge in August 2007 to establish whether Hill was competent to make this decision. A psychiatrist testified that Hill had suffered from severe depression and other mental disorders in the past, but that these were now in remission and he was not currently on medication for any mental illness. She testified that although he had sustained brain damage and neurological impairments as a result of shooting himself in 1996, he had made a good recovery.

The psychiatrist testified that David Hill's decision to drop his appeals appeared to be rational, that he knew the consequences of his decision and even believed that he could win an appeal if he proceeded to challenge his death sentence. Hill had apparently decided to wait until his father, whose health was failing, would no longer be aware of his son's decision to waive his appeals. After the father was taken to hospital and placed on 'do not resuscitate' status, David Hill decided that he could now take the decision to expedite his own death. The psychiatrist also concluded that Hill's religious beliefs as a Mormon had contributed to his decision. Hill himself testified that 'part of my religious beliefs are that if you kill somebody, you shed somebody else's blood, that your blood has to be shed or you have to die in order to be forgiven for that, and that's one of my concerns and then there's some health issues that I'm dealing with that's...bothersome at times...There's not really one big reason. There is just -- several different factors.' The judge found that Hill was competent to waive his appeals, and this was upheld by the state Supreme Court on April 28, 2008."

The American Bar Association Recommendation on the Death Penalty and Persons with Mental Disabilities states that "If a court finds that a prisoner under sentence of death who wishes to forgo or terminate post-conviction proceedings has a mental disorder or disability that significantly impairs his or her capacity to make a rational decision, the court should permit a next friend acting on the prisoner’s behalf to initiate or pursue available remedies to set aside the conviction or death sentence."