The PAIR Program

ENEWS - TREATMENT ADVOCACY CENTER

TREATMENT ADVOCACY CENTER
Visit our web site www.psychlaws.org
January 20, 2006

******************************

SEATTLE POST-INTELLIGENCER, January 12, 2006

[Editor’s Note: How profoundly can the symptoms of a mental illness engulf a
person’s perceptions and rationality? – powerfully enough to make a mother take
the life of a beloved child. That point has been repeatedly reinforced in a
string of similar tragedies over the last few years, most notoriously the deaths
of Andrea Yates’ five children.

By presenting Lori Farmer ten years after her horrific event, this piece offers
a viewpoint unavailable to us in examining those more recent tragedies. She is
understandably imbued with melancholy, but she is also functional, stable and
decidedly non-violent. Her recovery leaves little doubt that her son’s life was
taken not by her but by the effects of her illness.]


TAMING A DEFIANT MIND

Lori Farmer's Recovery From Mental Illness Opens Window On Insanity Defense

By Tracy Johnson, Seattle Post-Intelligencer Reporter


Lori Farmer paces around with her guitar on open-mike night at the sandwich
shop, a colorful place filled with other eager performers who don't know about
her past.

The song she will sing mentions him, but not what happened. Not how.

She settles down at a table, sips her coffee and skims the topic, anyway.
Delving too deep, she still cries.

"I'm afraid people will persecute me. They'll say: 'Look at her. Do you know
what she did?' "

Her friend Brian Rogers tells her again. He tells her often:

"You're not the same person now."

Farmer says she knows. She was sick. The voices weren't real. God would never
urge her to hurt someone -- least of all her 4-year-old son, who loved Batman
and used to run around in a cape that his grandma made from an old skirt.

Zane was buried in his pretend cape 10 years ago. Farmer killed him.

She believed, with a rigid certainty she can still barely express, that she was
saving him. She tried to die with him. Instead, a Pierce County judge ruled her
criminally insane.

She has struggled to get hold of a defiant mind and is trying to rebuild a life.


Finding 'A Quality Life'

Farmer's story is a rare look at what happens to people who are found not guilty
by reason of insanity, sent to one of the state's two psychiatric hospitals and,
because of privacy laws, are often forgotten by the general public.

Yet of the 27 people who killed someone in Washington and were found insane
between 1995 and May 2005, 13 have already earned some degree of freedom,
according to a Seattle P-I analysis of court records, mental-health evaluations
and interviews with prosecutors and defense lawyers across the state.

Nine of them, including Farmer, have moved back into communities.

They include Bruce Rowan, a Port Angeles doctor found insane for killing his
wife with a baseball bat and an ax, and John Hallinan, who climbed into the
bathtub at a Federal Way motel six years ago and drowned his 3-year-old son.

In their cases, mental-health professionals generally found -- and judges agreed
-- that proper medication, treatment and a strong understanding of their
disorders make it unlikely they will commit another crime.

Most of the nine, like Farmer, who lives in a Lakewood group home, remain under
supervision and probably will for the rest of their lives.

Four more people, like Marc Gerson, who torched his family's Redmond home six
years ago because he thought demons told him to, have earned their way to
Western State's community program. The unlocked ward helps patients make the
transition to freedom.

The rest of the 27, like Dan Van Ho, who stabbed to death a retired Seattle
firefighter in a random attack outside the Kingdome in 1997, are still
considered unstable enough that they require 24-hour security.

Some, including Farmer, 42, may always hear voices or have delusions. The goal
of treatment, according to community program manager Dick Tomko, is to help them
find support outside the hospital's walls and "enjoy some form of a quality
life."


Early Signs Of Trouble

Years ago, Farmer's parents misread the early hints of mental illness as signs
of their daughter being a teenager.

She always thought people were looking at her and whispering behind her back.
She often seethed with anger. Her father, Deane Farmer, remembers how she
sometimes planted herself on the couch and glared at him, inexplicably fuming.

Then one day, she began screaming that demons were coming out of the bathroom
mirror at her. She started seeing "shadow people" and feeling evil spirits
brushing against her skin, crawling lightly on her arms.

She began talking about things that didn't make sense to her family. That an
unseen camera had been clicking pictures of her every move. That Jon Anderson,
lead singer of the rock group Yes, was her father in a previous life. That he
had brought her to Earth in a spaceship.

She started drinking and smoking pot. She tried to hurt herself. Her mother,
Elva Farmer, recalls finding blood-soaked tissues and questioning her daughter,
who eventually admitted she'd made cuts across her wrists.

"If I tried to talk to her about it, she'd just pick a fight about something
else," Elva said.

They knew little about mental illness and recall that it was "pretty much kicked
under the carpet" back then, she said. They sometimes wondered if Lori's odd
behavior was a ploy; it often came when she didn't get what she wanted.

Eventually, they helped her move into an apartment and supported her
financially.

"I have to confess," her mother recalled, "it was a lot easier to pay her rent
than to live with her."


Multiple Suicide Attempts

Farmer knew something was wrong. Other people didn't spend full days sobbing.
She would go to church but otherwise isolate herself in her Tacoma apartment.
She didn't have any friends. She'd sit alone and play her guitar.

Some days she felt almost normal. Some days she couldn't pull herself out of
bed.

"I felt like somebody hit my soul with a Mack truck," she recalled.

She heard angry voices, sometimes God, sometimes Satan, and started using harder
drugs such as methamphetamine. She was trying to get through the day any way she
could, thinking, "If I die, I die."

One night she cut her wrists so deeply that she almost did.

A doctor first prescribed an anti-depressant after one of her suicide attempts,
but she wouldn't always take it. She got counseling, too, but it didn't help.
Her parents say she had a way of "masquerading" -- pretending she was fine.

They wanted her to get help but couldn't force an adult who didn't want it. They
weren't allowed to see her medical records, so she was able to keep them in the
dark.

Her father recalled simply, "We didn't know what to do."


Tough Defense To Prove

Many lawyers consider insanity a defense of last resort.

Juries seldom find people insane in murder cases. It appears to have happened
just once in the past decade in Washington, in the case of Rowan, the Port
Angeles doctor. And judges, as in Farmer's case, rarely do either.

At least 3,342 people were charged with homicide in Washington between January
1994 and December 2004. Less than 1 percent of them were ruled insane.

Proving someone is not guilty by reason of insanity is tough. It's not enough
that the person is mentally ill, hears strange voices or has a long, documented
psychiatric history.

Under state law, it means a mental "disease or defect" made the person either
unable to "perceive the nature and quality" of the crime or to distinguish
between right and wrong at that time.

The "not guilty" part can be a wrenching concept for victims' relatives to
accept: that legally, no one is responsible.

"I think most of the time it's met with great skepticism because murder is a
deliberate act of one human against another," said Jenny Wieland, director of
Families and Friends of Violent Crime Victims, a Washington-based victims'
advocacy group.

But mental health advocates say delusions can obliterate a person's perception
of what is real and what is right.

They say sending such people to prison -- blaming them for their disorder
instead of treating it -- doesn't bring justice for anyone.

"There's a legitimate public interest to make sure there's no recurrence," said
Ron Honberg of the National Alliance on Mental Illness.

"Maximum-security prisons are environments that are pretty much guaranteed to
make symptoms of mental illness worse."


A Boy Called Bucky

Farmer keeps a small photo album full of pictures of Zane, who had shiny brown
hair and got a kick out of putting his hands over his eyes and hollering,
"Somebody turned out the lights!"

As she sat on a picnic bench on an outing with her Western State therapist, Kris
Harkness, her memories of Zane tumbled out. She smoked a menthol as she talked
about him with a proud smile and sad eyes.

She used to call him Bucky, and he could almost always sweet-talk her into
buying him a new toy. Once Farmer told him he had too many and should give some
to the Salvation Army. He thought about it and brought it up the next day.

"Mom, don't give all my toys to the mations!" he told her, a bizarre word that
still makes her laugh.

His father was a man Farmer had met on the psychiatric ward at a Pierce County
hospital, where she ended up after a suicide attempt in 1989, but she didn't
stay with him for long.

Farmer acknowledges now that she often wasn't a good mom. She was sick, and like
many mentally ill people, was trying to feel well by using drugs. Some mornings
Zane found her too depressed to drag herself out of bed.

"He'd say, 'Take your medication, Momma,' " Farmer recalled. "He knew."

She had been prescribed several anti-depressant and anti-psychotic drugs over
the years, but they made her feel weak and anxious and gain weight. She'd feel
drained and ugly and quit taking them, then skid toward paranoia.

Once she saw construction workers outside her apartment and became convinced
that they were nailing boards over the doors to trap her inside.

She became preoccupied with the Antichrist, the Mark of the Beast at the
Apocalypse, concepts she'd learned about in church. She worried constantly about
kidnappers and sex predators, certain that one was going to snatch Zane.

As she fought with her fears, her parents recalled, she tried to put everything
she had into taking care of Zane. That was clear to Elva Farmer even as she
cleaned out Lori's apartment after her grandson was gone.

"When I went to his little dresser, all his things were folded so neatly. His
socks were all rolled up," Elva recalled. "Everything of Lori's was just a
mess."


A Reeling Mind, A Gunshot

Farmer was expecting her parents for dinner on June 13, 1995.

Zane was playing outside while she stood at the stove, trying to make spaghetti
sauce. She couldn't concentrate. She recalls hearing the voice of God: This is
it, he told her. Suddenly, she had to get Zane.

Her mind was racing with all that was real to her: Jon Anderson, the musician,
the man who brought her to Earth in a spaceship in another life, was now the
Antichrist in this one. He was coming. The Apocalypse was at hand.

Her neighbors were in on it. Zane would be given the Mark of the Beast, and the
Antichrist would take him away. She had to make sure she and Zane went to
heaven. Together.

The meat for the spaghetti sauce burned.

Farmer hurried outside and led Zane in by the hand. He was hungry. He headed for
the pantry and rummaged around for a snack. Farmer got the gun she'd bought to
protect them some earlier time when her mind had churned out illusory reasons
for alarm.

She remembers reaching one hand to her little boy's face.

"I said, 'Zane, I love you,' " she recalled, eyes filling with the tears that
nearly always come. "And I covered his eyes so he couldn't see."

She shot him in the chest. She remembers leaning his small body over gently on
the pantry floor.

"I thought I was saving him," she said. "I believed it with all my heart."

She sprawled next to him on the floor and curled the gun around, resting the
barrel against her own chest. Fired once. Tried again.

Wounded, bleeding, she fought with the weapon. It was jammed. She felt warm; the
pain wouldn't rush in until later.

The next hours collapsed into each other. Her parents came over, knocked
repeatedly and left. Night fell. Farmer fumbled around for some knives, carved
open her wrists and lay down on her bed.

Zane was on his way to heaven. She had to catch up.


No Dispute Of Her Insanity

Farmer was inconsolable, rocking, crying. Doctors at two other hospitals had
treated the bullet wound in her chest and her sliced arms after her parents went
to her apartment and discovered what she had done.

Now sitting at Western State Hospital, she was almost unrecognizable.

"When I first saw her, I never thought she'd get well again," her mother said.
"There wasn't much to say. We just sat and cried. She said, 'I tried to save
him.' I tried to tell her, 'Well, you're still here. The end of the world hasn't
happened.' "

Farmer was charged with murder. A psychologist asked by the court to evaluate
her concluded she was legally insane when she killed her son: that while she
understood what she was doing, she couldn't tell right from wrong.

Pierce County prosecutors knew it would be difficult to prove otherwise and, in
a rare decision, agreed Farmer should be found insane, according to Jerry
Costello, chief criminal deputy prosecutor.

For many months, Farmer would "sob for extended periods throughout the day" and
had "auditory and visual hallucinations, especially of angels and other
spiritual figures," according to a hospital report.

Her parents tried to learn what they could about Farmer's mental problems, which
they found, only after Zane's death, included schizoaffective disorder --
essentially schizophrenia with shades of depression.

Hospital staff watched her carefully, wary that she might try again to kill
herself. She so urgently wanted to be with Zane.

"She said, 'I just want to die.' She said that for a good four or five years,' "
Elva Farmer recalled. "It was hideous. Just heartbreaking."


Treatment, Not Punishment

If she had been found guilty, Farmer might still be behind bars. A second-degree
murder conviction can mean 10 to 18 years in prison or longer.

To mental-health advocates, the time isn't the point. The goal isn't punishment;
it's helping people learn to manage their illness, which often takes much longer
than the sentence would have been.

"You're not sent to the state hospital to 'do time'; you're sent there to get
treatment," said Deborah Dorfman, director of legal advocacy for Washington
Protection and Advocacy System, which works to protect the rights of people with
disabilities including mental illness.

"It's not like they're discharging people right and left," she said. "Getting a
conditional release (from a psychiatric hospital) is not easy. It's not taken
lightly."

Still, some worry that the hospital staff members who recommend release -- or
the judges who agree to it -- might make mistakes in deciding whether someone
still poses a risk.

Many victims' relatives want to see mentally ill offenders locked up for more
time simply "because they committed a crime, and there's got to be
accountability," said Wieland of the victims' advocacy group.

Zane's father, Tom Dickerson, said that although he's been diagnosed with
paranoid schizophrenia himself, his understanding of mental illness doesn't calm
his anger about what Farmer did.

"I think she should have went to prison," said Dickerson, 35, who is behind bars
in Idaho for failing to register as a sex offender after a 1990 rape conviction.
"She lost a son, and I know she really loved him, but he was all I had."


Refusing Her Responsibility

As doctors searched for the right balance of anti-psychotic and anti-depressant
medications, Elva Farmer remembers, Lori became fidgety. In the first year after
the shooting, she talked more but would unconsciously stamp her feet on the
floor. She couldn't sleep.

And for a long time, Lori tried to blame others for Zane's death.

God shouldn't have let it happen, she'd tell people. The devil shouldn't have
tricked her. Her psychiatrists must have prescribed the wrong medications. Her
mother should have seen it coming.

"It was so much pain," Farmer recalled. "I had to have somewhere for it to go."

Hospital staff were gently trying to help her understand that her own actions,
while she was psychotic, led to Zane's death.

"This is a very difficult process for any patient to come to grips with," they
wrote in 1996, "as there is so much guilt."


Getting Better Was Worse

In their twice-yearly reports, hospital staff said Farmer was impulsive.

She broke rules. She traded food with a patient who was supposed to be on a
special diet. She got caught smoking in various places on the ward, lighting
cigarettes with a hairdryer.

Once, as patients were filing down a stairwell, she spontaneously yelled, "Run,
everybody, run!"

Every time she'd start to improve, earning a new level of responsibility under
the hospital's motivational system, she'd backslide.

"I think it was self-punishment," Elva Farmer said. "Her son was dead, and she
didn't think she deserved anything because of it."

Medications have a way of generating more anguish long before bringing hope.
They can expose reality.

Farmer remembers slowly realizing the Antichrist hadn't been coming for her and
Zane that day. Her mind had created this delusion. This lie. And still, Zane was
gone.

It tore at her all the time.

She hurt so many people. Her parents, who adored their grandson. His playmates.
Zane was their first friend who died and the reason they had to learn, so young,
what that meant.

"I had to face what I did," Farmer said. "It wasn't like I spilled a gallon of
milk. I mean, Zane died."

"There was a time, as she began to get better mentally, that the better she got,
the worse it was," her mother remembered. "She'd cry and cry."


'Guilty But Mentally Ill'

People have been found not guilty by reason of insanity for centuries, though
the idea has always brought controversy.

In 1982, when John Hinckley Jr. was found insane after shooting President Reagan
in an apparent attempt to impress actress Jodie Foster, many states took steps
to make it harder for mentally ill people to be acquitted.

Several states did away with the insanity defense altogether. Others gave juries
another option: a "guilty but insane" or "guilty but mentally ill" verdict. The
idea is that people will get treatment, then spend the rest of their sentence
behind bars.

Families and Friends of Violent Crime Victims plans to propose a similar law in
Washington state this year.

"The benefits would be for the victims, really," said Ida Ballasiotes, vice
chairwoman of the group's board and a former state representative. "At least
there's a little sense of closure."

The group's proposal will likely echo legislation once put forward by former
state lawmaker Jeri Costa, who now heads the state's Indeterminate Sentence
Review Board. It would let juries find people "guilty and mentally ill."

"Whether they knew what they were doing at the time or not, they killed
somebody," Costa said. "The No. 1 issue here is that there's no accountability."

Mental-heath advocates argue that such an approach has a fundamental flaw: It
means locking up people for acts prompted by illnesses that aren't their fault.

The National Alliance on Mental Illness opposes such laws because "they are used
to punish rather than treat persons with brain disorders who have committed
crimes as a consequence of their brain disorders."

Critics also contend it's just a regular guilty verdict in disguise -- with a
feel-good provision about treatment that people won't likely get because there
won't be resources to provide it.

"I think it's just something to mislead the jury," said Seattle lawyer David
Allen, who defended Rowan seven years ago. "And I don't think there's a problem
anyway, because very few juries ever acquit."


Accepting Her Illness

In her tiny room at the hospital, Farmer intermittently hung pictures of Jon
Anderson and Jesus, then ripped them down. Sometimes the images were reassuring
to see; sometimes she felt like they were saying bad things to her.

Hospital staff said her spirits could soar or crash depending on whether she
believed, at any particular time, that she and Anderson would be together in
another life.

She went to daily group therapy, where patients talked about why they needed to
be hospitalized and how to prevent relapse. She attended sessions about the
importance of medications, the side effects and the need to steer clear of
street drugs.

By 2002, she began asking more questions about her illness and had "shown desire
to understand her behavior," according to a hospital report.

She admitted the voice of Jesus had been keeping her up at night. She realized
that hiding her symptoms hadn't persuaded anyone to free her and wasn't helping
her get better.

Staff saw signs that she was beginning to accept her illness and what it would
mean for her life. She talked about a future that involved making supportive new
friends, taking medication and probably never living alone.

In early 2004, hospital staff decided she was ready -- a Pierce County Superior
Court judge agreed -- to move to the community program.

There, she was gradually allowed to leave the hospital grounds -- at first for
an hour, eventually for weekend furloughs when she'd sometimes go camping with
her parents -- as she worked toward freedom.


Low Rate Of Reoffending

Some of the people who have committed crimes and live in Western State
Hospital's locked ward don't want help. They resent supervision. They don't
believe they are sick or try to pretend they aren't.

"Some people continue to blame other people or don't want to deal with the
seriousness of their crime," said Tomko, the community program manager. "Those
are the people who don't get out."

Yet patients don't have to show they are somehow "cured" to be released; it's a
matter of whether they are considered at risk of breaking the law again. They
must also show they can keep their symptoms in check.

Whether someone should move to the unlocked community program or into society is
up to the hospital's risk-review board, which also considers the patient's
attitude toward treatment, plan for the future and support outside the hospital.

People who are treated at places such as Western State Hospital are much less
likely to commit another crime than those who land in prison, according to Bruce
Gage, supervising psychiatrist for the hospital's Center for Forensic Services.

He said most people released from prison will break the law within three years,
while the recidivism rate for people found insane and treated at a specialized
psychiatric program is less than 5 percent.


Dealing With The Voices

Farmer now wants to understand as much as she can about the mental disorder she
used to pretend wasn't there. She wants to retain control of it.

"She's very genuine; very honest," said her therapist, Harkness, whom Farmer
calls her guardian angel. "She'll tell you when she has symptoms. She wants
help."

Despite her medication, the voices are still there occasionally. They don't
command her to do anything, which hospital staff would find more troubling.

She sometimes hears Jesus, God or even Anderson, whom she still believes was her
father in a previous life but now realizes isn't the Antichrist. They say
negative things, that they're going to punish her, make her fat, make her hair
fall out.

Jesus tells her, "Woe to you."

Sometimes she ignores the voices. Sometimes they grow too loud.

Then Farmer gets what she calls "a reality check" to help make sure these
hallucinations never again whirl out of control. She'll ask her mom, Harkness or
whoever is around: Could the voices be real?

Harkness sometimes tells Farmer to try to shut the voices out. They are her
illness. Her mom explains that God and Jesus are loving. They wouldn't want to
punish her.

Farmer said she thinks about it for a while, follows the logic, "and then I
start reasoning right."


Support Makes A Difference

At the end of August, Farmer moved off the campus of Western State and into a
group home, which has about 20 other residents and staff who work there full
time.

Harkness continues to see her at least weekly to talk about her symptoms,
budgeting her limited Social Security money -- most of it goes to the group home
-- or whatever else comes up.

At some point, Farmer plans to look for a job, maybe in a mailroom somewhere,
with very limited hours to curb potential stress.

Every Wednesday, she goes to a group session about substance abuse at Greater
Lakes Mental Healthcare, where she has a case manager and someone who prescribes
her medication.

She likes to relax at her parents' cheery rambler in Sumner. Her mom and dad
have given her constant support over the years, according to hospital reports --
often a powerful part of a patient's recovery.

Her mother said she misses her grandson but has never felt like she couldn't
forgive her daughter.

"We lost one to this illness," she said. "There's no point in losing two."

Farmer often talks about how she'll always have to take medications and will
never again drink alcohol or do street drugs. If she does, or if her mental
illness otherwise grows worse, Western State staff can bring her right back to
the hospital.

A Pierce County judge also reviews hospital reports about Farmer, sent at least
twice a year, to consider how she's doing and whether there's any reason she
shouldn't remain free.

Farmer said she now wants to keep other mentally ill people from ending up in
her situation. To keep taking their medication. To realize that they can't
simply ignore what's going on in their heads.

She has seen her own illness at its worst and must live with the consequences.

"I want to see me make it, and I'm going to," she said. "I don't want to hurt
anybody. I don't want to hurt myself. I want to have a peaceful, successful life
now."


Her Radiant Star

Farmer waits for her turn to sing at the Antique Sandwich Co. in Tacoma. She's
wearing a new outfit and an elaborate necklace jeweled with colored stones.

She shows off the brown felt hat she's brought with her. Should she wear it or
not? She asks a few people. She puts it on. She takes it off. She declares, "I'm
not nervous at all."

On stage, she begins strumming her guitar, her thick silver rings flashing, her
short, sapphire-painted fingernails finding the chords. She's playing "Radiant
Star," a song she's written about Jesus being there during her toughest times.

I got drunk at the bar; I slept in my car, she begins, her voice deep and
strong. But you were my radiant star.

She closes her eyes, moving to the music. My son died one day; in heaven he
plays. But you are my radiant star.

Sometimes she sings "Zane's Song." That one's harder.

Maybe she'll play it next time.

******************************

Treatment Advocacy Center E-NEWS is a publication of the Treatment Advocacy
Center.

This E-NEWS is provided as a public service by the Treatment Advocacy Center.
There is no fee. If you would also like to receive a free subscription to the
Catalyst, our quarterly hardcopy newsletter, please forward your mailing address
to info@psychlaws.org.

The Center does not accept donations from pharmaceutical companies. Support
from individuals who share our mission, however, is essential to our ability to
effectively help our most vulnerable citizens. The Treatment Advocacy Center is
a 501(c)(3) not-for-profit organization. All contributions are tax-deductible
to the extent allowed by law. Donations to the Treatment Advocacy Center should
be sent to:

Treatment Advocacy Center
200 North Glebe Road, Suite 730
Arlington, VA 22203
703-294-6001 (main no.)
703-294-6010 (fax)