True Case File #1

Lee's comment to my last post made me start thinking back to some of the most outrageous, crazy, or just plain wrong treatments my clients have received in the criminal justice system. Not all situations should be treated as criminal. There are some things that just do not belong.

So perhaps from time to time, I should tell some of these stories of old cases. The first one that springs to mind still sticks in my mind as the best example I've seen of how we mistreat mental illness in this country.

My client suffered from mental illness. His particular illness often manifested in impulsive behavior, including paranoid violent outbursts. He was still pretty young, new to mental illness, and was still working with doctors to find both the medicines and the tools to function with his illness. He lived in a residential treatment center at the time of his "criminal" episode.

He went home to visit his family for a few days at Christmas. While outside the structure of his regular living environment, and with either not enough meds or no nurses making sure he took his meds, he decompensated. He became agitated, angry, and ultimately punched his hand through a window. At this point, his mother called the police because she could not control his behavior and was worried he would hurt himself more severely than the cut hand. The police recognized that this was not a criminal situation but a mental health crisis, so they took my client to the hospital that had the most secure psych ward. The doctors at the psych ward admitted my client. On the admission papers, they noted that his criteria for discharge was to get his violent outbursts under control.

My client was in the psych ward for about 12 hours. During that time, he only saw a doctor briefly at the beginning. He was given medication, but never the proper amount. He in fact noted to a nurse that he was not feeling the effects he should from the sedative. He had been given a pretty low dosage, so it would have been appropriate to give him more, but that never happened. He never quieted down. He was oddly fixated on getting a toothbrush. He wandered through the hall, yelling. All behaviors one sadly can expect to see at the secure psych ward.

Eventually, my client used a mattress and a dresser to barricade himself into his room. Security guards tried to bust in, at which point my client threw dresser drawers at them. One of the walls of his room was damaged. The psych ward called the police, who arrested my client and charged him with aggravated battery and criminal damage to property.

It still infuriates me that a prosecutor, a judge, and 12 jurors viewed this as a proper situation for criminal charges. He was ultimately convicted as charged. My client was not a criminal; he suffered a severe mental illness. He had no more control over his actions than a person in the midst of a seizure would. He certainly did not possess the rationally-formed intent to hurt anyone. He was just scared and confused and trapped inside a personal hell that most of us fortunately cannot imagine.

Even worse than the prosecutor pursuing this as a criminal case, though, is the hospital for asking them to do it. I know that mental health care in this country is woefully underfunded and its needs are woefully misunderstood. But the doctors and nurses who accepted my client into their care took on a duty to him. They said, "We know you're sick and scared and out of control, but we can help. We can stop you from hurting anyone. And we'll keep you here until you are no longer a danger to yourself or anyone else." But after only 12 hours of not much help, they abandoned that duty. Nothing about this case has ever infuriated me more than the fact that the mental health professionals themselves bought into the idea that the manifestations of mental illness should be considered a criminal matter.

It was just flat wrong that this client was ever charged with a crime. He wound up serving several years in prison, where we all have to know he did not receive any meaningful care for his mental illness. And for what? Because he needed help that no one seemed able to give him. He needed proper mental health care. He needed to find the right medications to restore balance to his brain. He needed a doctor, for crying out loud. The last thing he ever should have needed was a lawyer.