Thursday, May 31, 2007

Florida Supreme Court Reduces Death Sentence Because of Mental Illness

The Florida Supreme Court reduced a death sentence to life without parole because of the defendant's serious mental illness. The court noted that this was "one of the most documented cases of serious mental illnesses this court has reviewed." In its decision rejecting the trial judge's death sentence for Christopher Offord (pictured), the justices unanimously held that the death penalty was a disproportionate punishment due to Offord's long-standing mental problems. Medical records show that Offord, who was convicted of killing his wife in 2004, suffers from schizophrenia and bipolar disorder and has been in and out of institutions since he was a young boy. The trial judge had imposed a death sentence despite the fact that she found Offord had committed the murder under the influence of extreme mental or emotional disturbance and lacked the capacity to appreciate the criminality of his conduct. The jury had unanimously recommended a death sentence.
(Associated Press, May 24, 2007). See Mental Illness.

Friday, May 18, 2007

Social workers could ease jail crunch

BY LORETTA TACKETT

PAINTSVILLE HERALD EDITOR

The Department of Public Advocacy (DPA) will submit a 2008 budget proposal which includes money to put a social worker in each of its 30 state offices, including Pikeville, hoping to address the revolving door of the justice system by getting more than half of their clients out of jail and into treatment.

Approximately 68 percent of DPA clients suffer from substance dependency and 58 percent are mentally ill, said DPA Commissioner Ernie Lewis, asserting DPA is concerned with lack of treatment options in overcrowded local jails, including the Big Sandy Regional Detention Center (BSRDC).

The Administrative Office of the Courts (AOC) shows the BSRDC, which is located in Paintsville and houses inmates from Johnson, Martin, Magoffin and Lawrence counties, held 181 inmates in a 110-bed facility last year.

DPA Public Information Officer Dawn Jenkins said Friday there were 200 in a 134-bed capacity - increased by a change in space requirements for each inmate by state law due to statewide overcrowding in jails - and one-third were sleeping on the floor.

In a 2006 visit to Pike County Jail, a University of Kentucky researcher found 236 inmates in a 142-bed facility - 89 of whom were state inmates - and one-half were on the floor, according to a special report the DPA called "Realizing justice during difficult times."

Incarceration rates in Kentucky are skyrocketing, says the DPA, with public defenders caseloads growing for the seventh consecutive year.

Over 300 salaried public defenders represented 140,000 cases last year, Lewis said, which was a 4.3 percent growth and the highest number of cases in DPA history.

The Paintsville office, which serves Johnson, Lawrence, Martin, and Magoffin counties, had 1,600 cases for four attorneys.

The problem in Eastern Kentucky has been complicated with the appearance of federally-funded programs like Operation UNITE, which makes drug-related arrests and offers some assistance to prosecution, but not to defense.

The problem prompted the DPA to hold public forums in 2005 out of concern for ineffective counsel and led to assistance from the 2006 General Assembly, decreasing the number of new cases opened per attorney.

The DPA received funding during the last legislative session to hire 36 more attorneys statewide, Lewis said, adding the goal is to get the caseload down to 400 per lawyer, which is still above the national average.

The 2006 General Assembly also funded the Social Worker Pilot Project, putting a social worker in the public defender's offices in Morehead, Owensboro, and Covington, and will place a fourth one in Bowling Green in July.

"The focus is to work with persons with substance abuse, mental illness, or both and treat them so they don't come back into the justice system," said Jenkins, adding Lewis has been meeting and will meet with legislators, judges and defenders in all trial regions before the 2008 General Assembly to seek support for a social worker in all 30 offices across the state.

The goal is to address the root causes of criminal behavior such as chronic alcohol and substance abuse, mental illness, and illiteracy, Jenkins reported

The project would cost about $1.2 million, Lewis said, asserting, "We think the state will actually save money."

"And better yet, save lives," said Public Defender Jay Barrett, who has been serving as trial division director for the DPA.

The DPA reported the Commonwealth saves $47.12 every day a Kentucky inmate is treated rather than jailed, and a program like the social work project resulted in $15 million in savings for Rhode Island.

Asserting the DPA does not have scientific evidence concerning the effectiveness of the Social Worker Pilot Project yet, as researchers at the University of Louisville are working on it, Jenkins said social workers are making referrals to whatever is available, similar to the way drug court works.

"We have to expand treatment," Lewis said, as only 20 percent of the 68 percent with substance abuse problems are getting treatment.

Many are sleeping on the floor while in withdrawal from drugs, a condition about which Lewis said, "You're not going to get better."

"The BSRDC facility is overcapacity most of the time and without mental health and substance abuse treatment," said Paintsville Public Defender Howe Baker. "Many of our clients will continue to return to the criminal justice system unless we can address their root problem."

Sunday, May 13, 2007

Limit to death penalty sought

Bill would protect the mentally ill
Andrea Weigl, Staff Writer

James Floyd Davis was sentenced to death for killing three people during a workplace shooting more than a decade ago at a Buncombe County tool plant. At least one psychiatrist has concluded that Davis was experiencing paranoid delusions and believed he was waging a "holy war" against co-workers conspiring against him.

A bill pending before the legislature would allow Davis, 59, who was diagnosed in 1973 as schizophrenic, to use his delusions at the time of the killings to try to have his death sentence overturned.

State Sen. Eleanor Kinnaird, a Carrboro Democrat, has proposed allowing defendants with severe mental illness to avoid the death penalty if they were too mentally ill to understand their actions at the time of their crimes. The defendant could either ask a judge to rule on the issue before trial or ask a jury to consider it during the trial's sentencing. Those already on death row could file an appeal.

Kinnaird said the bill does not allow these defendants to avoid prosecution or punishment; they could still be charged and face spending the rest of their lives in prison.

But prosecutors oppose the bill, saying the measure is so broad that it could be applied to all murder defendants facing the death penalty.

"Every time, some hired gun comes in and espouses there's mental illness," said Buncombe County District Attorney Ron Moore, whose office prosecuted Davis. "We haven't tried anyone capitally in this state without some kind of diagnosis."

The bill does not say which diagnoses qualify someone as being severely mentally ill. Rather, the bill defines severe mental illness as someone being unable to appreciate the wrongfulness of their conduct, to use rational judgment or to conform their conduct to the law. Each side is likely to present competing testimony from mental health experts, and the question would be decided by a judge or a jury.

Moore said the jury in Davis' trial considered evidence about his mental illness and still sentenced him to death. Moore said a psychiatrist recently found Davis competent enough to fire his lawyers and drop his appeals. He described Davis as "lucid" and "articulate" during recent court hearings.

The rationale behind the bill is similar to successful efforts in recent years to outlaw the death penalty for juveniles and the mentally retarded: a killer's young age, limited mental functioning and severe mental illness make them less culpable for their crimes and not deserving of the death penalty.

"By a certain reasoning, people with certain mental illnesses can be held responsible, but they aren't the worst of the worst because of the illness that they have," said Richard Dieter, executive director of the Death Penalty Information Center, a nonprofit anti-death penalty group based in Washington.

Mental health advocates agree, saying the bill extends the protection already available to those who are mentally retarded to those with severe mental illness.

"These people probably have no real understanding of what occurred," said Julia Leggett, a lobbyist for the Alliance for Disability Advocates.
A few states eyeing it

North Carolina is one of at least three states, including Indiana and Washington, considering such a proposal. Connecticut is the only state that has such a law.

In a poll earlier this spring, 52 percent of 574 North Carolina voters surveyed said they would not support the death penalty for those with severe mental disability. The poll was released by N.C. Policy Watch, a progressive think tank, that hired Public Policy Polling to conduct the survey, which had a margin of error of 4 percentage points.

Last year, the American Bar Association, as well as The American Psychiatric Association and the American Psychological Association, passed identical resolutions about mentally ill defendants and the death penalty. The resolutions said defendants should not be executed if they had severe mental illness at the time of the crime or if their illness prevents them from helping their lawyers handle their appeals, leads them to give up their appeals or makes them unable to understand the purpose of their execution. North Carolina's legislation does not go that far.

But at least one of Davis' lawyers hopes the bill could help Davis and others on death row.

"There is a significant number on death row who are suffering from mental illness," Asheville lawyer Leah Broker said. "I don't think they got fair trials, especially in my client's case. It would give another avenue for review."

She said Davis' trial lawyers didn't present enough evidence about his history of mental illness that she believes could have swayed jurors. Davis' appeal based on those issues was filed in 2000 and has never been heard, she said.

On May 17, 1995, Davis killed co-workers Gerald Allman, Frank Knox and Anthony Balogh and injured Larry Codgill. Davis had been fired two days before the shooting. Knox's widow, Phyllis Knox, declined to comment about the legislation, although she has previously said she opposes the death penalty.

Staff writer Andrea Weigl can be reached at 829-4848 or andrea.weigl@newsobserver.com.

Sunday, May 6, 2007

Hundreds of mentally ill youth prisoners can’t see psychiatrist

Elizabeth Hernandez

May 4, 2007 - 9:37PM

AUSTIN — Young inmates on psychotropic medications at one Texas youth prison have not seen a psychiatrist since January, health providers told lawmakers Friday.

State lawmakers said they were shocked at yet more revelations of problems involving the state’s juvenile corrections agency, this time detailing major gaps in health coverage for incarcerated boys and girls.

Sen. John Whitmire, D-Houston, said health care in the Texas Youth Commission "ain’t worth a damn" and questioned whether the state should continue its contract with the University of Texas Medical Branch. He is co-chairman of a legislative committee charged with investigating the agency.

"It’s so bad, I think we need to start over, like from scratch," Whitmire said. "We got to throw this one out."

At Evins Regional Juvenile Center in Edinburg, mentally ill inmates see a psychiatrist by teleconference only and do not have face-to-face visits, a youth commission official said. At West Texas State School in Pyote, where alleged sexual abuse by administrators grabbed the attention of lawmakers in February, the doctor and psychiatrist have never even met, said Dr. Sheri Talley, who is the doctor at Pyote.

About one-third of 250 people at West Texas State School have psychiatric problems, Talley said.

At Corsicana Residential Treatment Center, there are two part-time psychiatrists for 170 youth, all of whom are diagnosed with serious mental illness and sent there to stabilize before beginning their "socialization" program at other youth commission facilities.

One of the psychiatrists is leaving at the end of May, said Nancy Slott, the agency’s health services administrator.

At Ron Jackson State Juvenile Correctional Complex in Brownwood, children have not seen psychiatrists since January, meaning mentally ill youth are on psychotropic medicine with no oversight, officials said.
There are 460 youth living in the two-prison complex.

Slott said she has hired a contract psychiatrist to go to the school there once a week beginning May 14. He will commute from San Antonio, she said.

Because it is difficult to recruit child psychiatrists to Edinburg, the youth commission lets mentally ill youth there visit with a psychiatrist in Austin by teleconference. He is available eight hours a week, Slott said.

The psychiatric problems are among many the agency’s new leaders are trying to address, said youth commission spokesman Jim Hurley. He did not know of any plans to send a psychiatrist to Brownwood before May 14 but said the agency will do what it takes to get youth proper care.

Teleconferencing for health care, like that done at Evins, is becoming increasingly popular as a way to bring medical care to rural areas, Hurley said.

"Obviously, the best would be a face-to-face meeting, but if we’re having trouble making something available, we’ve got to do something to bring medical care," he said.

The intake unit in Marlin, near Waco, where all youth are processed, is "wholly inadequate" because it is not big enough and does not ensure patients’ confidential conversations with health providers won’t be overheard, said Sandra Ferrara, director of youth services for UTMB.

Whitmire asked why lawmakers didn’t learn of these problems sooner.

Dr. Ben Raimer, UTMB’s vice president and chief executive officer for community health services, said he told the Legislature that UTMB needed more money in years past, and even asked to get out of the contract.

"There is no oversight in the current system," he said.

Elizabeth Amazeen, the facility nurse manager at Giddings State School, where children who commit murder are sent, said in the past year she has seen more mentally ill and more violent youth in the infirmary.

"They are hurting each other; they are hurting the staff," Amazeen said.

"Our nurses are weary. They cannot keep up with the injuries they are seeing."

____

Elizabeth Hernandez covers the state capital for Valley Freedom Newspapers. She is based in Austin and can be reached at (512) 323-0622.

Saturday, May 5, 2007

Mentally ill inmates get state boost

New initiatives and centers open to provide psychiatric treatment.

By ASSOCIATED PRESS

Published May 4, 2007

JACKSONVILLE - A $16.6-million infusion from state leaders and new initiatives will allow the Department of Children and Families to meet state requirements to get mentally ill inmates into hospitals and out of county jails.

Last fall, mental-health advocates and court officials lambasted the state for failing to meet a state law, resulting in hundreds of severely ill inmates being locked up in county jails for months instead of moving them to psychiatric hospitals in 15 days as required by law. Some judges threatened to fine former DCF Secretary Luci Hadi and hold her in contempt.

DCF statistics indicate the situation is improving.

In early January, there were 270 people on the waiting list for mental health facilities for more than 15 days, said Al Zimmerman, a DCF spokesman. By the middle of next week, that number should be zero, Zimmerman said.

DCF officials have contracted with GEO Care, which runs the South Florida Evaluation and Treatment Center in Miami, to oversee new beds at two facilities owned by the state that were turned into treatment centers.

In March, an unused Department of Corrections building in Miami became the South Florida Evaluation and Treatment Center Annex and an empty Department of Juvenile Justice building in Martin County is now Treasure Coast Forensic Treatment Center.

The two new centers have about 400 staff members to care for 275 mentally ill patients.

As part of legislation approved Wednesday and sent to Gov. Charlie Crist, the Legislature is funding 39 new beds, plus keeping open the beds it funded in December.

The legislation sets aside about $4-million to pay for community grants to try to keep people out of jail and $2.5-million for in-jail treatment.
The in-jail treatment programs are operating already in Pinellas and Orange counties, but Zimmerman said officials would like to see it go statewide.

"This bill is a win-win for everyone, " said Sen. Gwen Margolis, D-Bay Harbor Islands. "For those who are mentally ill, it moves them to centers

Thursday, May 3, 2007

Friday My View: Mental health isn't simply a safety issue

By Maggie Labarta
MY VIEW

Kudos to Gov. Charlie Crist for swiftly signing an executive order that establishes the Gubernatorial Task Force for University Campus Safety, which will review all security measures on Florida's college and university campuses.

One of the benefits of this important response to the tragic events at Virginia Tech will be the increased dialogue regarding the treatment of students with mental illness. As this occurs, we should consider a few important points.

The first is that the overwhelming majority of people with mental illness are not violent. In general, those with a mental illness are more likely to be the victims than the perpetrators of violent crime. The tragedy in Blacksburg should not make us afraid of those with mental illness, but it should make us realize that mental illness cannot be ignored without consequences.
Without early and consistent care, the condition of those who suffer from certain illnesses can deteriorate, making their symptoms more severe and increasingly difficulty to treat.

Second, for far too many Floridians, mental illness remains untreated because of a lack of sufficient investment in our state's mental-health system. Florida currently ranks 48th in the country in per-capita spending for mental-health services, 47th in Medicaid spending for child beneficiaries, and 43rd in Medicaid spending for adult beneficiaries.

Florida also ranks second in the number of homeless, first in the number of substantiated reports of child abuse and neglect, second in the number of children in juvenile detention facilities, and third in the number of prison inmates in comparison with other states.

A significant portion of these problems can be traced to the lack of mental-health care. It is an embarrassing and unfortunate testimony to our lack of commitment to care for those with mental illness; we are not adequately funding proven and cost-effective local mental-health programs.

The success of these programs in communities across our state proves time after time that treatment and community supports work and that access to local mental-health care is the key to providing those with mental illnesses with much-needed help at a reasonable cost to taxpayers.

Without adequate investment in the mental-health system through the funding of community-based services, we will by default be investing in hospital inpatient services, emergency-department care, shelters, foster care, juvenile detention facilities, jails and prisons.

Or worse.

Today's college campuses are more vulnerable than ever to problems associated with untreated mental illness simply because more young people than ever with mental illness are in school.

The Americans with Disabilities Act bans the exclusion of students because of mental illness, but is there enough support on campus for ill students suddenly faced with the additional financial, social and academic pressures of college life?

Florida's institutions of higher learning are assessing their capacities to deal with an increasing number of students with mental illness and are working toward needed changes. Undoubtedly, however, some of these students will require services that will be beyond our colleges' and universities' capacities to meet those needs, and they will rely on community-based programs to help.

Our communities with colleges and universities have an excellent history of collaboration on these issues, but often, students and others end up encountering mental-health services through the legal system instead. Just as we wrongly depend on emergency departments to be the front door for physical health care (instead of focusing more on routine and nonemergency care), jails often end up being the front door for mental-health care.

We must reach these people sooner - long before they are referred for treatment by the courts. That is accomplished through the recognition that mental illness can affect anyone and needs early identification.

We must remove the stigma of mental illness, continue efforts to educate the public on the facts about mental health, and encourage people to seek treatment early. Identification works only if there is an adequately funded array of community-based programs that can provide care after screening and early identification.

Establishing a task force focused on campus safety is a needed and important step. But identification and communication is just part of the battle to prevent another tragedy as happened at Virginia Tech.

Our failure to treat mental health is one of the significant health issues in this state. Until we are serious about addressing it, the number of people left untreated until they commit a crime will continue to increase. And that is an unnecessary risk that none of us should be willing to take.

Maggie Labarta is the chairman of the board for the Florida Council for Community Mental Health and the CEO of Meridian Behavioral Healthcare in Gainesville. Contact her at maggie_labarta@mbhci.org.