Monday, May 08, 2006


TAC Newsletter 5/6/06


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May 6, 2006





4. MENTALLY ILL JAM JAILS - Lakeland Ledger, April 30, 2006


1. U.S. NEWSWIRE, May 1, 2006

[Editor's Note: We are pleased to announce that the Treatment Advocacy Center has received a presidential commendation from the American Psychiatric Association. Mary Zdanowicz, our Executive Director, will accept the award later this month at the APA's Annual Meeting.]


To: National Desk, Health Reporter

Contact: Alicia Aebersold of the Treatment Advocacy Center

ARLINGTON, Va., May 1 /U.S. Newswire/ -- The Treatment Advocacy Center has won the American Psychiatric Association's Presidential Commendation for "sustained extraordinary advocacy on behalf of the most vulnerable mentally ill patients who lack the insight to seek and continue effective care and benefit from assisted outpatient treatment."

The Treatment Advocacy Center (TAC) is a national nonprofit organization dedicated to eliminating legal and clinical barriers to timely and humane treatment for people with severe brain disorders who are not receiving appropriate medical care. TAC educates legislators and the media on the benefits of assisted outpatient treatment (AOT) to improve outdated treatment laws that keep people from getting the help they need. Since TAC opened its doors in 1998, this small organization has been involved in changes in treatment laws in 17 states.

"One of the great tragedies of modern psychiatry is the large number of individuals with mental illnesses who are incarcerated or homeless," said APA President Steve Sharfstein, M.D. "This is the inevitable consequence of our reluctance to use caring, coercive approaches, such as assisted outpatient treatment. The Treatment Advocacy Center has been the catalyst for many positive changes in our laws and a shift in our perception of the importance of intervention. Their unique advocacy is restoring the important balance between individual freedom and caring coercion."

Assisted outpatient treatment allows courts to order people who meet specific criteria to receive outpatient mental health treatment. AOT helps those who are the most ill and often unable to make informed treatment decisions for themselves. Results from states that use AOT show marked reductions in the incidents and duration of hospitalization, homelessness, arrests and incarcerations, victimization, and violent episodes. AOT also increases treatment compliance, promotes long-term voluntary compliance, and improves quality of life.

"Until we find the causes and definitive treatments for schizophrenia and bipolar disorder, we have an obligation to those who are suffering to try to improve their lives," said TAC president E. Fuller Torrey, M.D. "Except for biological chance, any one of us might today be there, living on the streets or in jail. TAC is the only organization willing to take on this fight, and I am very proud to be part of it."

TAC Executive Director Mary T. Zdanowicz will accept the award at the 2006 APA Annual Meeting in Toronto later this month. Past winners include Rosalyn Carter and U.S. Senator Pete Domenici and Nancy Domenici.


The Treatment Advocacy Center ( is a national nonprofit organization dedicated to eliminating barriers to timely and humane treatment for millions of Americans with severe mental illnesses. TAC is funded by individual donations and does not accept funding from pharmaceutical companies.


2. USA TODAY, May 4, 2006

[Editor's Note: Pete Earley has been bringing a lot of attention to people with severe mental illnesses who are incarcerated and the difficulty of getting treatment for and preventing such people from entering the criminal justice system. Pete and his riveting new book, Crazy: A Father's Search Through America's Mental Health Madness, have been featured in magazines and radio programs throughout the country. This week Mr. Earley brought his message to the more than 2,000,000 readers of our nation's largest newspaper.

Crazy: A Father's Search Through America's Mental Health Madness, it is available on If you buy Mr. Earley's work, or any other, from Amazon, TAC gets a percentage of the money you spend if you enter the Amazon website through this special link: ]


By Pete Earley

"Dad, how would you feel if someone you loved killed himself?"

My college-age son, Mike, has stopped taking medication for the mental illness that was diagnosed a year ago, and he is having a relapse. He and I are speeding to an emergency room. Hang on son, I think. The doctors will help you.

But after waiting four hours, a doctor appears and tells me it's illegal to treat Mike. He is not sick enough. He is not in "imminent danger," and because Mike now thinks "pills are poison," the doctor cannot forcibly medicate him under Virginia law. I'm told to bring him back if he tries to kill himself or someone else.

No parent should watch what I see next. Mike sinks further into a mental abyss. Forty-eight hours later, he breaks into a stranger's house to take a bubble bath. The homeowners are away, but Mike is arrested and charged with two felonies. I've been a journalist 30 years and thought I knew a lot about jails, courtrooms and mental illness. But I was always on the outside looking in.

I was so outraged about what happened to my son that I spent the next three years investigating America's mental health system.

I went to Florida, to separate myself from Mike's case, and spent time in the Miami-Dade County jail. I followed psychotic prisoners through the courts, rode with cops, interviewed judges, attorneys, psychiatrists, mental health advocates, parents and persons like my son.

System In Disarray

I discovered our system is in a shambles. Jails and prisons have become our new asylums.

Deinstitutionalization - the haphazard closing of state mental hospitals and dumping of patients into the streets during the '70s and '80s - began the migration from hospital wards to jail cells.

In 1955, about 559,000 Americans were patients in state hospitals. If you took the patient-per-capita ratio then and extrapolated it out to today, you'd expect to find 930,000 patients in those facilities. But there are fewer than 60,000.

Where are the others? About 300,000 are in jails and prisons. An additional 500,000 are on probation. According to the Department of Justice, 16% of inmates in state correctional facilities say they have a mental condition or have spent a night in treatment. The largest public mental facility in the USA is the Los Angeles County jail.

Lawsuits filed to protect patients from abuse in horrific state hospitals created legal barriers that are now preventing parents and other loved ones from intervening until it is too late, just as they did in Mike's case. A shameful lack of community services, including treatment programs and housing, also are to blame.

In Miami, I saw homeless men with chronic schizophrenia arrested for trespassing, jailed, released Untreated And Arrested Again Days Later. They Are Stuck In A Vicious Revolving Door.

No One Is Immune

Mental illnesses are chemical imbalances that affect how nerve cells in the brain send and receive messages. They can strike anyone. Nothing in our family's history hinted that a debilitating disorder loomed ahead. And Mike did nothing to bring this sickness on himself.

Sadly, we are making jails a core part of our mental health care network. Jail officials are building separate facilities for psychotic prisoners. In effect, we are reconstructing the dreaded "warehouse" asylums from our past inside our jails.

Jails are not safe places for a person with a mental illness, and the sick shouldn't have to become criminals to get help. Most can get better. Treatment works in 80% of cases - if it is available.

Incredibly, we are continuing to shut down psychiatric wards in favor of jails. My state, Virginia, has lost 84% of its psychiatric hospital beds since 1955. Why are we choosing cells over beds? The cost of a psychiatric bed exceeds $500 per day. The cost of a Virginia jail is $89 per day.

My son is back on his medication. But now he faces the stigma of having a mental illness and a criminal record. That's wrong. Few of us worry we'll wake up with a mental illness. But what if the phone rings and it's someone telling you about your sister, your daughter, your mother - your son?

I've been on the inside looking out now. It is frightening.

Pete Earley's book, Crazy: A Father's Search Through America's Mental Health Madness, was published this month.


3. NOSPEEDBUMPS.COM, April 17, 2006

[Editor's Notes: The internet gives a public voice to just about anyone who wants one. One no longer has to be a reporter, broadcaster, national figure or renowned expert to make your opinion available to the populace. And the advent of blogging has made reaching out even easier. is Dan Morgan's blog, his voice to the world. On his blog, you can learn that Dan is a married computer systems engineer with two daughters who plays the guitar (although not well) and likes lobster and beer. In the April 17 entry on his blog, Dan also shows that he has compassion as well as common sense.]


By Dan Morgan

When I was in New York City a couple of weeks ago, there was a lady dressed only in plastic trash bags begging for money on a street corner. The bags were very torn up. The upper part of body exposed a lot of skin, it seemed that the bags would fall away at any moment. She stayed leaned forward at about 45 degrees for some reason.

She was obviously mentally ill. It made me wonder if the right thing was done when in the 1960s and 1970s state mental institutions were closed down. You think of the movie One Flew Over the Cuckoos Nest, and you think: We don't want to give mental health officials the right to institutionalize people or force treatments on them. Remember Jack Nicholson's forced lobotomy?

But the real world of today is far, far from the fictional world of One Flew Over the Cuckoos Nest.

Tonight on NPR's show Fresh Air, there was an interview with Pete Earley, a former Washington Post reporter whose son is mentally ill. To hear how messed up our mental health system is, listen to his story of trying to get treatment for his son. (This is incredible, you really should listen to it.)

If you have a schizophrenic family member, who refuses their medicine, it is extremely hard to get any help from the state.

Incredibly, often the best way for families to get treatment for someone that is mentally ill, and refuses their medicine, is for the ill person to end up in prison for committing some crime. Otherwise, you are powerless in trying to get them to take their medicine.

Later on the show, psychiatric Dr. E. Fuller Torrey advocates turning back the clock just a bit and forcing people, who are obviously very mentally ill, to take medication. This requires using the "out-patient commitment statutes" that most states have. Unfortunately, these are very hard to use because of excessive legal safeguards.

But why force them to take their medicine? Dr. Torrey s explained that schizophrenia and bipolar disorder effect the mind so that most sick people have no awareness that they are ill. He said it is similar to Alzheimer's in that regard. He said that they will really believe things like they have regular conversations with the president and that the CIA beams messages to them.

Dr. Torrey said the positive thing is that now we know that the vast majority of these people do not need institutionalization. They can be treated on an out-patient basis, typically needing an injection just every two weeks. He says that they are far better off than in being in state institutions. Modern medicines to treat schizophrenia and bipolar disorder have come a long way.

But unfortunately, when the commitment order expires, often patients will think that they are better. They will stop taking there medicine for awhile and then, without them realizing it, they are back in a delusional state but unaware it.

Have we done the mentally ill any favors letting them go untreated in the name of civil rights? Dr. Torrey said that 28% of the mentally ill homeless in LA get most of their food out of garbage cans. About 20% of people in prison are mentally ill. (Deranged people eventually get in some kind of trouble.)

But when they take their medicine, most do just fine. But you have to force many of them to take it. Dr. Torrey says you don't have to hold them down or anything. Most will come for treatments just knowing that the alternative is jail. Also, most people getting the treatments are much happier. They become rational again. And they are less victimized by crime since they can watch out for themselves better.

It seems pretty clear to me that Dr. Torrey and Pete Earley are right. The pendulum has swung way too far in the direction of just letting deranged people roam the streets in a pathetic state. It is not right to let people, in the name of freedom, be utterly neglected. And it is not fair to burden families with this by taking away channels to force treatment if a family member refuses it because they have gone insane.

And it is not healthy for society to have mentally ill citizens neglected, filthy, vulnerable to crime, and living on the streets eating out of garbage cans.

The bottom line is that we need to start committing people again and forcing them to get treatment. Between a judge, a panel of experts, and family members - the courts should be able to have a mechanism to quickly get an out-patient commitment for someone in a delusional state. And the laws need to be changed to allow this process to work quickly, like over a weekend.

If you think otherwise, listen to Pete Earley's story above on how the hospital refused to treat his son because his son believed that the medicine was poison. Just take him home the doctor at the hospital told him, there was nothing that he could do.

Of course lots of safeguards are needed. But the system and procedures for dealing with the mentally ill needs a major overhaul. I imagine that the ACLU will fight reforms every step of the way. But good reforms are never easy, there are always the defenders of the status quo.

It is time to end the fantasy that severely mentally ill people will somehow find a way to get better, or be happier, simply because we ignore them.


4. LAKELAND LEDGER (FL), April 30, 2006

[Editor's Note: The headline of this piece is an apt summary of the deplorable situation in Polk County, Florida: "Mentally Ill Jam Jails." If you investigate, chances are that you will find out that it's not too different in your county.]


Hospitals Full

Inmates Locked in Place

By Robin Williams Adams, The Ledger


Which Polk County institution houses the most people with mental illnesses? Look no further than the Polk County Jail, where nearly 1 in 5 inmates gets psychotropic drugs.

The number of inmates taking those drugs generally ranges from 17 percent to 19 percent of the total jail population.

In March, the average daily number of inmates in Polk's jails was 2,610, which means 444 to 496 inmates were medicated for illnesses such as schizophrenia or bipolar disorder.

And don't think those are all the inmates who have mental illnesses. Others are undiagnosed or refuse medication.

"Our jail is the biggest mental-health facility in Polk County," Polk Sheriff Grady Judd said. "Our jails and prisons collectively are the biggest mental-health facilities in the state." That's a crisis, in Florida and nationwide. Jails have become asylums for thousands of inmates with mental illnesses whose problems and needs far exceed what jails can provide.

Among the problems in Polk County:

. Although inmates are screened for mental illnesses when they're booked into the jail, the evaluation falls far short of what they would get in a true mental-health facility.

. Most mentally ill inmates are put in regular jail populations, exacerbating problems caused by overcrowding. The Special Needs Unit at the Central County Jail, for inmates whose mental illnesses are seen as putting them at greater-than-average risk, has fewer than 50 beds for men and women. More are needed.

. Detention deputies, except those in special units, typically don't get advanced training in handling people who have mental illnesses.

. Little money is available to improve the jail or set up alternative treatments, and Florida lawmakers have shown little inclination to pay for reforms.

"Many of the problems (of people with mental illnesses) have been dumped on a criminal justice system that is ill equipped to deal with it and, frankly, should not be dealing with it," said Risdon Slate, chairman of the Florida Southern College criminology department.

Judd and other sheriffs say it's a role they don't want, didn't expect and would gladly assign elsewhere if they could.

But other resources are scarce. Interviews with Slate, Judd and others identified changes that need to be made:

. More law enforcement officers who have crisis intervention team training to better equip them to deal with people who have mental illness.

. A broader range of housing, including additional facilities more secure than the assisted-living facilities now used for many who have mental illnesses.

. More beds at state psychiatric hospitals where inmates go for evaluation or if they are incompetent to stand trial. A bottleneck now keeps some waiting for months in the local jail.

. More programs to divert people with mental illness away from jail and more money to let community mental health centers expand those alternatives.

What Can Result

James Lee Griffin, who died March 19 after altercations at Polk County's Central County Jail, is a worst-case scenario.

Griffin was arrested in Lake Wales on March 18, a Saturday, after a disturbance at a restaurant.

He said he had bipolar disorder, a mental illness, but that he wasn't receiving medication for it. That's on the arresting officer's information sheet, which a detention deputy signed when Griffin arrived at 7:20 that morning.

The information sheet said Griffin wasn't displaying unusual, bizarre or violent behavior and didn't appear suicidal.

Griffin, 21, never made it to the Special Needs Unit, although he was scheduled for a mental-health evaluation the following Monday, March 20.

Griffin was put into an isolation cell after he became disruptive. He kicked the window of the cell on March 19, shattering it, Judd said, and had to be subdued.

That included being shocked with an electronic riot shield. Investigations of his death continue, the Sheriff's Office said.

In a best-case scenario, Griffin would have been taken to a mental health center, rather than to jail, and received a full evaluation from mental health experts. They would have made a determination as to whether he posed a danger to himself or others.

Without more comprehensive community care and other alternatives to imprisonment, jails will continue having an excess number of inmates with mental illnesses, law enforcement and mental health advocates agree.

Fallout From Hospital Closings

Burgeoning jail populations aren't what mental-health advocates had in mind when "deinstitutionalization" began removing mentally ill patients from state hospitals in the late 1950s.

But jails and courts nationwide soon saw the fallout. Communities were ill prepared for the influx of released patients and the extent of services they needed.

Many people with mental illness end up recycling through the justice system. While some belong behind bars, Judd said, he agrees with mental-health advocates that the number is too high.

"I can show you a percentage in the Polk County Jail who are not intentional criminals," Judd said. "They are just really, really mentally ill."

He described a patient who paced his cell almost constantly, sleeping for 15 minutes at a time, then getting up to pace again.

Another time, he said, he saw one of his detention deputies pulling off a rubber glove and saying about a new prisoner: "I finally got him to urinate in the toilet instead of in the bed or on the floor." There are patients who aren't faking their illness, Judd said, but there are others "who are mean as snakes or crooks and they use mental-health issues as a shield."

The National Alliance for the Mentally Ill recently gave Florida a C-minus grade on health care for the seriously mentally ill. The state has a crisis, NAMI said, with 23 percent of inmates in county and city jails thought to have a mental condition.

"By necessity, the criminal justice community has become one of the most visible mental health advocacy communities in Florida," NAMI said.

NAMI and Partners in Crisis, a statewide group of law enforcement and mental health advocates, urge legislators to allocate more money for mental-health care, including help with housing and job skills, and to streamline the process of getting treatment.

"We've been grossly underfunded since the 1950s," said Circuit Judge Charles Curry, who helped form the local Partners in Crisis chapter.

He said it's crucial that mentally ill inmates be dealt with in a separate setting.

"Mentally ill people don't belong in jails and jails are poorly equipped to deal with mentally ill people," Curry said.

Judd, who works with Partners in Crisis, also wants alternatives.

"We need an environment where they're housed so we can ensure they take their medicines, where we can protect them from society and society from them," he said.

Begging For Beds

In the Polk County Jail, no one describes the general population, where most mentally ill inmates go, as therapeutic.

"We do our best to treat them humanely, but when you're in a dorm of 130 people it's survival of the fittest," Judd said.

Although patients can get medicine, the jail isn't set up for other mental-health therapy.

"Our job is to get them on medication and stabilize them," said Derek Zimmerman, mental health liaison at the jail.

The Special Needs Unit has an extra level of protection for up to 30 men and 16 women. But safety carries a price -- spending most of each day in a cell rather than mingling with others.

Jimmy, 35, said he doesn't say he is bipolar when he is in jail because he doesn't want to go in that unit. The Lakeland man, who asked that his last name not be used, was at his mother's home when he was interviewed.

Others, however, said they feel safer in the Special Needs Unit.

When jail expansion is completed, it won't be a problem to add more Special Needs Unit beds, Judd said. Two pods adjoining that unit could be used for inmates with mental illness.

But expansion won't be complete for about three years, he said, and space isn't there now.

Another factor contributing to limited SNU space is insufficient beds in the state's psychiatric hospitals. Inmates in the SNU include some in limbo as they wait for hospital beds. Two who were interviewed had waited more than three months.

Under state law, inmates referred for commitment to a state hospital should be transferred within 15 days, said Michele Saunders, executive director of Florida Partners in Crisis.

Reality is different.

In early April, men waited an average of eight weeks and women waited nine weeks statewide.

Gov. Jeb Bush's proposed 2006-2007 budget included $6.8 million for 84 new state hospital beds and $5.4 million for increased hospital drug costs.

But mental health advocates were disappointed Bush didn't seek money to boost community alternatives. His proposal didn't earmark extra money for community mental health.

Hunt For Housing

Affordable housing is a major concern for many whose mental illnesses aren't controlled enough to let them work. The problem becomes worse for those on disability who end up in jail.

Their government disability benefits stop when they're in jail, said John Ruffin, program manager for Peace River Center's forensic (criminal justice) program.

It takes six weeks to six months to get benefits started again for people in jail more than 30 days but less than a year. For those in jail more than a year, he said, reinstatement can take up to a year.

But keeping them in the county jail for one day short of a year, which makes getting back on disability easier, conflicts with one of Judd's strategies to reduce jail overcrowding.

Judd said he encourages judges to sentence inmates for longer than a year so they serve time with the Department of Corrections' state prisons rather than in Polk County's overcrowded jail.

Peace River Center and Winter Haven Hospital Behavioral Health -- the two community mental health programs -- can help with medicine during the time released inmates wait for disability payments to resume.

But the supply of housing is limited, causing mental health caseworkers to search desperately for places to put people.

"That's a dream for a lot of us, to have forensic housing exclusively for these people," Ruffin said. "So often they have special needs."

Zimmerman, the jail mental health liaison, said Polk County needs more locked facilities such as step-down programs and Peace River's short-term residential unit.

Pete Earley, author of "Crazy: A Father's Search Through America's Mental Health Madness," advocates reinstituting or expanding state hospital systems, along with other alternatives, to provide somewhere outside the jails for some people who have severe mental illnesses.

Earley, whose son is diagnosed with and treated for bipolar disorder, includes in his book an account of the psychiatric ward of the Miami-Dade County Jail.

That jail has "by default become the largest psychiatric institution in Florida," according to the 11th Judicial Criminal Mental Health Project Jail Diversion Project, but "it cannot provide the necessary and appropriate treatment that is required for successful rehabilitation and recovery."

Some Changes Are Coming

There are bright spots:

. Crisis intervention team training in some counties, including Polk, improves relationships between CIT-trained officers and people with mental illnesses.

. Some counties, although Polk isn't among them, have mental health courts. Judges, prosecutors and defense lawyers collaborate to find the best solutions for people with mental illnesses who commit crimes.

But much more is needed.

"Crisis intervention training is a piece in the puzzle, but it's not a panacea in and of itself," said Slate, the FSC criminology professor. "You can have all the diversion you want, but, if the person is out causing trouble in 22 hours, what have you gained?"

Crisis intervention team training, which came to Polk County recently, makes officers more aware of how mental illnesses can affect behavior.

Changes in how law enforcement approaches someone with a mental illness can make a difference in how the encounter ends.

The person may go to a crisis unit rather than jail after an altercation, for example. A simple charge of trespassing can stay at that level instead of escalating to a more serious charge of battering a law enforcement official.

Mental health experts and law enforcement officers agree a jail will always be a poor setting to address the needs of the mentally ill.

"Wouldn't it be nice if they didn't come to jail in the first place?" Judd asked.


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 periodic hardcopy newsletter, please forward your mailing address to

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)

Wednesday, May 03, 2006


TAC Newsletter 4/21/06


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April 21, 2006



2. SUPREME COURT TAKES UP INSANITY DEFENSE - San Francisco Chronicle, April 19, 2006

3. SUPREME COURT COULD REDEFINE LEGAL INSANITY- Salt Lake City Tribune, April 16, 2006

4. MENTAL HEALTH BILL CONSIDERED - The Albuquerque Tribune, April 15, 2006

5. CHÁVEZ STEPS UP TO HELP MENTALLY ILL - Albuquerque Journal, April 16, 2006

6. MENTALLY ILL FALLING THROUGH CRACKS - Lawrence Journal-World, April 9, 2006



This week we sent out a special notice about the April 18 edition of Fresh Air, National Public Radio's popular interview show that has an estimated 4.5 million listeners around the country. The hour-long show featured author Pete Earley, whose experiences with trying to get treatment for his son and his new book based on them have galvanized the conversation about the need for treatment and how we treat those who end up incarcerated because of mental illnesses. The second half of the show is an in-depth interview with TAC President E. Fuller Torrey, who delivers perhaps his most compelling and insightful explanation of the barriers to the treatment of those who most acutely suffer from severe psychiatric disorders.

If you have not yet, we urge you to listen to these amazing interviews.

Mr. Earley's is at:

Dr. Torrey's is available at:

Mr. Earley's book, Crazy: A Father's Search Through America's Mental Health Madness, was released yesterday - and joins the newly released fifth edition of Dr. Torrey's wildly popular Surviving Schizophrenia in bookstores. Whether buying one of these books or any other, you can help TAC get a percentage of the money you spend at by entering the Amazon website through this special link:



[Editor's Note: The United States Supreme Court is directly taking on the insanity defense for the first time in decades; oral arguments in the case, Clark v. Arizona, were on Wednesday.

It is almost impossible to forecast how significant will be the court's ultimate ruling, but the questions of law before the court offer the nine justices an opportunity to wholly redefine the established constitutional protections of people charged with crimes because of actions stemming from the symptoms of a severe mental illness.

In this case, we saw the opportunity to educate the members of the high court. The Treatment Advocacy Center submitted an amicus, or "friend of the court," brief focusing on anosognosia. That the effects of illnesses like schizophrenia can impair or even completely disable a person's capacity to perceive that he or she is sick is critical to the consideration of whether or not that person should be held accountable for illness-impelled acts. Knowledge gained about anosognosia in Clark v. Arizona, moreover, should aid the Supreme Court justices in deliberations of future cases concerning those who most suffer from severe mental illnesses.

We are indebted to the extraordinary lawyers from the Princeton office of Dechert LLP for their pro bono work on the Treatment Advocacy Center's brief to the Supreme Court.

You can read the full brief on our website at ]


By Gina Holland, Associated Press

Supreme Court justices rarely talk about Martians. But on Wednesday, extraterrestrials were at the heart of a case brought by a schizophrenic teenager who says he killed an Arizona police officer because he thought the lawman was a space alien.

Until now, the high court has avoided challenges to insanity defense laws, even as states around the country toughened their laws following John Hinckley's acquittal by reason of insanity in the 1981 shooting of President Reagan.

It was a surprise when justices agreed to review Eric Michael Clark's case, and they seemed uninterested Wednesday in broadly addressing the constitutional rights of psychotic criminal defendants whose lawyers want them sentenced to psychiatric facilities instead of prisons.

Court members, however, did repeatedly refer to the unusual facts of Clark's case, signaling that they are likely to rule very narrowly. He was a popular football star until he became convinced that aliens had taken over his town, Flagstaff, Ariz., as a "platinum city" and that his own parents were aliens.

Justices David H. Souter and Stephen Breyer both mentioned Martians.

Justices John Paul Stevens questioned whether someone who thought he was on a mission to kill space aliens could receive the death penalty for killing a person instead.

When Arizona lawyer Randall Howe said that the slain officer was wearing a uniform and driving a police cruiser, Justice Ruth Bader Ginsburg said that Clark's lawyer "wants to introduce (evidence) on the other side, `I had delusions, I thought I killed an alien.'"

The Supreme Court has never said mentally ill accused criminals have the right to an insanity defense, and four states do not allow for that: Idaho, Kansas, Montana and Utah.

The remaining states have a variety of standards for proving insanity, and Clark's lawyer argued that Arizona's is almost impossible to meet, violating the constitutional rights of mentally ill defendants.

Texas has a similar law and the court's ruling in Clark's appeal could affect Andrea Yates, the Houston mother who drowned her five children in the bathtub and goes on trial in June.

"The state has the right to define insanity as it sees fit," Howe told the justices.

Under Arizona's law, a defendant "may be found guilty except insane" if lawyers prove the defendant was so mentally ill that he did not know what he did was wrong. Many other states also consider a second factor, if a defendant understood the nature of his acts.

Clark shot Flagstaff police officer Jeff Moritz on June 21, 2000, after the officer pulled over the 17-year-old as he drove around his neighborhood in a truck playing loud rap music. Moritz, 30, was the only police officer ever killed in the line of duty in the mountain community north of Phoenix.

Clark's lawyer, David Goldberg, told justices that his client "was drowning out the voices in his head" with the loud music.

Clark had a trial before a judge in which he was found guilty of first-degree murder and sentenced to life in prison. Part of his appeal turns on whether the judge should have considered Clark's mental illness in weighing whether he intentionally killed the officer.

Justices agreed to hear the case late last year, in the final weeks before the retirement of Arizona native Justice Sandra Day O'Connor. O'Connor was in the courtroom and watched part of the argument.

Most of the questions justices asked Wednesday were technical, and the court might rule in a way that will affect only Clark's case.

Arizona Attorney General Terry Goddard said afterward that he was relieved by the tone of the questions.

"Our concern was they were going to put all the insanity issues on the table," he said.

Deborah Denno, a Fordham Law School professor, said insanity cases are difficult for courts because they involve imprecise matters of science.

"They don't want to get their hands dirty with this psychological evidence," Denno said. `They're going to have to confront this at some time."

Clark's parents were at the court.

"This is beyond our son. The outcome of this case could be far-reaching," said his mother, Terry Clark.

The case is Clark v. Arizona, 05-5966.


3. SALT LAKE CITY TRIBUNE, April 16, 2006

[Editor's Note: A ruling by the Supreme Court can critically impact the whole nation, but each case is about a set of facts, directly about particular people. Clark v. Arizona is about Eric Clark, and what the symptoms of his illness caused him to do.]


Arizona Case: The Lawyer of a Convicted Cop Killer Says State Law is Overly Restrictive Toward The Mentally Ill

By Pauline Arrillaga

FLAGSTAFF, Ariz. - The phone roused Terry Clark from sleep. ''Flagstaff Police Department,'' a voice announced, asking to speak with Mr. Clark. Terry nudged Dave and handed over the receiver. ''My son's truck?'' she heard her husband say. ''Gentry?''

Gentry was the oldest of their three children. Had he been in a wreck? Terry crawled from bed and headed for the front door to see if her son's Toyota pickup was in the drive. She stepped out onto the porch, then stopped dead in her tracks.

In the dim glow of dawn, she could see that Gentry's truck was gone. Where it should have been, men in helmets stood clutching guns aimed at Terry's head. ''Get against the garage!'' one shouted.
At first, investigators told Terry only that a policeman had been shot.

She would hear a name, Officer Jeff Moritz, and discover he was called to their neighborhood after residents reported a pickup circling, blaring loud music. The policeman had pulled the truck over and called in the license plate, then radioed dispatch once more: ''999. I've been hit. 999. I've been hit.''

The pickup - her son's pickup - sat abandoned next to the sidewalk where, Terry soon learned, the police officer had died.

She realized then that her son was the prime suspect. Not Gentry, who had been at home in bed.
Her middle son. Eric.

The one who had been a star football player and a good student with dreams.

The one who just two months earlier called his own mother and father aliens.

Suspect's profile: The victim of the June 21, 2000, shooting was the only police officer ever killed in the line of duty in this mountain community north of Phoenix. He was a caring cop who cut firewood for the handicapped, a husband and father with one young son and a second on the way.

The accused was a 17-year-old high school senior who had a history of marijuana use and had been arrested two months earlier for drunken driving and drug possession after police found two dozen hits of LSD in his car.

A portrait emerged of a drug-crazed teen. But as the facts slowly surfaced, so did a different picture of Eric Michael Clark - that of a decent boy who had descended into a world of delusion, the terrifying existence that is schizophrenia.

It took three years for Eric Clark to be found competent to stand trial and participate in his defense. When the case proceeded, his lawyers pushed for a verdict of ''guilty except insane,'' meaning incarceration in a psychiatric facility. Instead, a judge found him guilty of first-degree, intentional murder and sentenced him to life in prison.

On Wednesday, the U.S. Supreme Court is to take up the case of Clark v. Arizona and the issue of just how difficult states can make it for criminal defendants to prove insanity.

It's the first time the court has dealt with a direct constitutional challenge to the insanity defense since lawmakers around the country imposed new restrictions following John Hinckley's acquittal by reason of insanity in the 1981 shooting of President Reagan.

The issue is determining under what circumstances absolution of a criminal act is warranted.

Increasing symptoms: Terry Clark wonders, now, when it all started.

Did it begin with Eric's fear of drinking tap water? It was December 1998, and a house fire forced the family to live temporarily in an apartment. Eric, then 16, worried about lead poisoning and would only drink bottled water.

Was that the first clue?

Always low-key, Eric then began to grow moody - exploding one minute, sobbing the next.
Was that illness or teen angst?

Terry, a school nurse, had seen her share of troubled kids. She wondered if Eric was on something, but she'd had him drug-tested before, and the results were negative. Was it depression? Anger management? The pieces didn't fit into one neat puzzle, and Eric's behavior grew more bizarre.

On June 21, 1999, Terry and Dave had their son admitted to a mental health center. He'd abandoned his car in a road, called a police officer rude and then reeled on his father, using the f-word. At the center, Eric tested positive for marijuana. But doctors thought his behavior perhaps stemmed from pre-schizophrenia. With no mental illness on either side of the family, Terry pushed that idea aside.
The family attended counseling sessions,

and Eric seemed to improve. He promised Terry he'd quit using drugs and continue seeing a therapist. She had him discharged after only three days.

''He's getting better,'' Terry convinced herself.

He got worse.

That fall, Eric quit school. He became obsessed with Y2K and charged $1,700 worth of survival gear on his dad's debit card. When Jan. 1, 2000, came and went, Eric was thrilled and went back to school.
''He's getting better,'' Terry thought again - until Eric started mentioning ''them.''

''They're after me,'' he'd tell his mother.

That April, in the midst of conversation, Eric referred to his mother and father as aliens. ''If you'd go get some tools,'' he told them matter-of-factly, ''I'd show you.'' Terry was relieved when, that same month, Eric was arrested on drunken driving and drug charges; she thought that would lead to help. But authorities decided to postpone prosecution until Eric turned 18 later in the year.

On June 19, 2000, Eric called his mother an alien again.

''How would you like to be me,'' he said, ''and never know who your real mother is?''

The next day, Eric seemed better, and he, Terry and Dave went to a movie together. Afterward, Eric asked if he could stay to watch another film. He hugged his folks, and said goodbye.

Unknown motive: Investigators surmise that sometime after 1:30 a.m. on June 21, 2000, Eric made his way home, sneaked into his brother Gentry's bedroom, took his keys and left in Gentry's truck.

What happened after that, and why, no one can know for certain; Eric's never talked about it.
Both sides, and their mental health experts, agreed that Eric suffered from paranoid schizophrenia and was mentally ill.
But legal insanity is another matter; Arizona law spells out its qualified use as a defense.

''A person may be found guilty except insane if, at the time of the commission of the criminal act, the person was afflicted with a mental disease or defect of such severity that the person did not know the criminal act was wrong,'' the law states.

The prosecutor, Assistant Attorney General David Powell, argued Eric did know. One witness testified that weeks before the shooting, Eric mouthed off about his disdain for cops and wanting to shoot them. Powell's theory was Eric lured Moritz to the scene by playing loud music until residents reported him.
''He wanted to kill an officer that day,'' Powell said at trial. ''And he did.''

Defense lawyers insisted Eric's psychosis was so severe he was incapable of hatching such a plan. They noted that after the shooting, Eric called his parents from jail and explained that Flagstaff was a ''platinum city'' inhabited by 50,000 aliens. He told them: ''The only thing that will stop aliens are bullets.''

In his appeal to the U.S. Supreme Court, defense lawyer David Goldberg asserts that Arizona law is so restrictive that it violates a mentally ill defendant's right to a fair trial. For one, he says, Arizona law prohibited the trial court from considering Eric's mental illness in weighing whether he intentionally killed a police officer.

The Supreme Court could establish a more specific definition of legal insanity or allow for broader discretion in determining when evidence of mental illness may be considered at trial.

Its decision could also mean a retrial for Eric, something the Moritz family would see as unjust.

''To say, gee if you're mentally ill you can be forgiven for murdering somebody, you're giving a license to kill to millions of people,'' says the victim's father, Dan Moritz.



[Editor's Note: A bill to bring assisted outpatient treatment to New Mexico passed committee after committee and was unanimously approved by the House of Representatives during the state's fleeting 30-day session this year, only to run out of time on the Senate floor.

Albuquerque Mayor Martin Chavez, a major proponent of that bill and a champion of people with severe mental illnesses, is not willing to wait until next year's session - he is endeavoring to establish AOT in his city now via municipal ordinance!

Note: A unique "home rule" provision in the New Mexico Constitution makes it possible for Albuquerque to create city-level AOT without authorization from state law.]


City Council To Hear Arguments On Proposal To Order Outpatient Treatment

By Erik Siemers, Tribune Reporter

For some, it's a tool aimed at a small portion of the mentally ill whose illness keeps them from realizing they need help.

For others, it infringes on civil rights and threatens to diminish Albuquerque's already diminishing mental health resources.

The City Council on Monday will wade through both arguments about the proposed Assisted Outpatient Treatment Ordinance, a version of what's referred to commonly as Kendra's Law.

"Obviously, it touches a nerve," said City Council President Martin Heinrich, who has yet to take a position on the proposal. "I've got a lot to learn."

The ordinance, carried by Councilor Michael Cadigan on behalf of Mayor Martin Chavez, would allow certain relatives, health care officials and law enforcement to petition the state District Court to order a mentally ill person to receive assisted outpatient treatment.

The mentally ill who could be affected by the ordinance include those who had been hospitalized or jailed twice within 36 months, had been violent within 48 months, or who are unlikely to participate voluntarily in a treatment plan.

Treatment would be physician-recommended and could include medication, substance-abuse treatment or group therapy. The individual would receive treatment no longer than six months.

The bill is expected to appear for a council vote within 45 days, Cadigan said.

The efforts follow the lead of New York, which in 1999 passed the first Kendra's Law, named after Kendra Webdale, a woman killed after being pushed in front of a New York City subway by a man who failed to take prescribed mental illness medication.

New Mexico is one of eight states that doesn't have a version of Kendra's Law, Chavez said. A statewide effort earlier this year that passed in the state House of Representatives failed on the Senate floor when time ran out.

"This is designed to serve the severely mentally ill. That means those who typically cannot recognize their illnesses and who are rapidly in a declining spiral toward being a threat to themselves and others," said Sherry Pabich, a board member of National Alliance on Mental Illness's Albuquerque affiliate.

Critics, including the American Civil Liberties Union, believe Kendra's Law threatens personal freedoms.
"In our mind it is, in fact, a law to allow forced sedation masquerading as a therapeutically friendly outpatient treatment law," said Peter Simonson, executive director of the ACLU of New Mexico.

Among the ACLU's concerns about the law: It could make the mentally ill subject to not-so-well-intentioned family members and the as-yet unknown cost for the required treatments, particularly if the person is uninsured or has insurance that doesn't cover the court-mandated treatment.

An equally pressing question echoed by a chorus of critics is one of mental health resources.

The University of New Mexico Hospital announced last month it would close its intensive outpatient program for the mentally ill, which served around 200 patients.

And Lovelace Sandia Health System next month is expected to stop providing outpatient behavioral health care. Lovelace's move affects nearly 7,000 patients.

Patrick Tyrrell, executive director of the state chapter of the National Association of Social Workers, believes there should be a rallying cry for more resources "rather than putting it into a knee-jerk type of response."

Said ACLU's Simonson, "What this law threatens to do is take resources away from legitimate voluntary treatment and channel it into this radical forced-sedation law."

Chavez acknowledged that mental health resources are limited in Albuquerque. But he said they're limited everywhere.

"You can make the same argument for anything. We shouldn't have tougher DWI laws because we don't have enough programmatic assistance?" Chavez said.

Pabich argues that the law would not tap existing mental health resources because it would affect a small portion of the mentally ill population.

Her organization estimates that, statewide, about 75 people would be affected a year, most of whom would likely come from Albuquerque.

Chavez points to two high-profile incidents where city police officers were shot by mentally ill assailants.
In 2003, Sgt. Carol Oleksak was shot in the head in Nob Hill by Duc Minh Pham, a mentally ill man who wrested her gun away. Pham was later shot to death by other officers as he fled.

John Hyde, a diagnosed schizophrenic, is accused of killing five people on Aug. 18, including Albuquerque Police Department Officers Michael King and Richard Smith. Police said Hyde had stopped taking his medication.

"I don't know how many Albuquerqueans went to the funerals of King and Smith," Chavez said. "I don't want to do that anymore."

Simonson worries that the bill is "a political move on the part of the mayor because of the John Hyde situation."

Cadigan realizes it's common to hold up Hyde and Pham as examples.

"None of us really knows enough about their medical history to determine whether this would have been in place would it have categorically avoided this problem," Cadigan said. "There's only so much you can do. You can never guarantee crime is never going to happen. But you want to have the tools in place to do what you can."


5. ALBUQUERQUE JOURNAL, April 16, 2006

[Editor's Note: Supporting Mayor Chavez's quest for AOT is the Albuquerque Journal, one of the state's most influential newspapers.]



Kendra's Law in New York forces people with mental illness to take medication if a court decides they are potentially violent otherwise.

A similar statewide proposal passed the House unanimously this year but died in the Senate. Rather than wait another year for state action to help patients caught in a downward spiral, Mayor Martin Chávez and Councilor Michael Cadigan advocate an Albuquerque version of Kendra's Law.

"We're not waiting. The consequences are too severe," Chávez says. "When the state fails to act, I am still charged with protecting the public in Albuquerque."

Under current state law, a person with mental illness must deteriorate to the point of being dangerous before treatment can be ordered.

Too often that is too late- for the patient, for his or her family, for police who by default are the underqualified first-line crisis counselors and for bystanders in the wrong place at the wrong time.

But intrusive measures that come too soon are a clear civil liberties concern. The proposed ordinance has safeguards, however. A relative, a social worker or a police officer would have to petition the court. Then a judge would have to rule that a person needed mandatory care and approve an enforceable treatment program. Treatment could be as simple as taking medication or as complicated as supervising living arrangements. Not complying could result in involuntary commitment.

Before the courts start ordering treatment, "we need to put resources into providing community-based support" for the mentally ill, says Nancy Koenigsberg, legal director for the statewide Protection & Advocacy program.

That's a pointless chicken-and-egg argument for families of the mentally ill, who say they can't wait for a new program or building. Their loved one is in crisis now. Perhaps once judges start ordering treatment, the state and the health-care community will finally find the wherewithal to assure its availability.

Unwilling to join in the hand-wringing as another Albuquerquean commits suicide by cop or kills a police officer on a mental-health pickup, and unwilling to join in the whining that there aren't enough treatment facilities so it's best to do nothing, Chávez has stepped up to help those who aren't able to help themselves.



[Editor's Note: Whoever coined the phrase "revolving door" to describe deplorable and endless cycling between streets, jails, and brief hospitalizations must have had someone like Robert "Simon" Gilmore in mind.]


Those Who Refuse Treatment And Break The Law End Up In Jail

By Dave Ranney

Robert "Simon" Gilmore is in jail. Again.

He's been arrested eight times in the past three weeks. The last time - April 3 - he asked the judge to leave him in jail for 90 days.

"He said if they let him out, he'd just get arrested again," city prosecutor Jerry Little said. "So the judge set his bond at $500. He's still in jail."

Gilmore, who will soon turn 50, is the homeless man who's often seen sitting or sleeping on the sidewalk in front of either Weaver's department store or The Replay Lounge downtown.

He's known for wearing white socks on his hands and, when it's cold, wrapping himself in a thrift-shop blanket. Legally blind and intensely private, he rarely says more than a few words to strangers.

Family members say Gilmore has been diagnosed as paranoid schizophrenic.

Mental health advocates and law enforcement authorities say he has become a prime example of how the mentally ill, especially those who refuse treatment, are falling through ever-widening cracks in the social service network.

Since moving to Lawrence in the early 1980s, Gilmore has been arrested more than 50 times, usually for wandering on private property, urinating in public, disobeying a police officer or obstructing traffic.

Lawrence Police officers arrested Robert "Simon" Gilmore at Seventh and New Hampshire streets.

"He can't see very well, so he tends to walk in the street," Little said.

Gilmore's latest troubles stem from a new city ordinance that prohibits camping on a downtown public right-of-way. Sleeping on the sidewalk in considered camping.

City commissioners passed the ordinance in response to downtown merchants' complaints of people sleeping in doorways, sidewalks and alleys.

The ordinance was not aimed specifically at Gilmore, Mayor Mike Amyx said.

"The ordinance is very fair," Amyx said. "It concerns all kinds of folks, not just him."

'The Only Place'

Little said jail wasn't the best place for Gilmore. But for someone who's mentally ill and who insists on breaking the law, it's the only place.

"We're at a loss as to what to do with him," Little said. "He's very independent."

Gilmore has refused help from Bert Nash Community Mental Health Center.

Recent efforts to have him committed to Osawatomie State Hospital have been denied, Little said.

To have Gilmore committed, Little would have to prove that Gilmore is a danger to himself or others and incapable of making reasoned decisions.

"I could probably get one - 'danger to himself or others' - but I can't get both," Little said, noting that in the past, Gilmore's mental illness hasn't been considered severe enough to hinder his decision making.

Under the law, Gilmore has the right to choose to be mentally ill.

"I'd be glad to work with any agency in town that thinks it can work with Mr. Gilmore," Little said.

Bert Nash stands ready to help, but Gilmore has rejected the mental health agency's overtures.

"I cannot comment on this or any other individual's circumstances," said Dave Johnson, Bert Nash executive director. "But I will say that people have the right to refuse services. You don't lose your rights because you're mentally ill.

"But when that's the case," he said, "we don't have a solution."

Gilmore's troubles are fast becoming a burden on jail staff, Douglas County Undersheriff Kenny Massey said.

Lawrence Police officers arrested Robert "Simon" Gilmore at Seventh and New Hampshire streets, after fielding several calls about him walking in the streets, in this Dec. 30, 2005, file photo. Gilmore was taken to the Douglas County Jail, but was quickly back out on the streets. Gilmore is frequently arrested - eight times in the past three weeks - and taken to the jail, which can do nothing to treat his mental illness.

"He can be very demanding," said Massey, who is in charge of jail operations. "He becomes upset, he trashes his cell, he makes a lot of noise."

Gilmore's being in jail serves no long-term purpose, Massey said.

"We manage him," he said. "We don't treat him."


John Tucker, 41, has battled schizophrenia most of his adult life.

"I've been in treatment," he said. "I deal with it now."

Tucker, who lives in Lawrence and is active in the Douglas County chapter of National Alliance on Mental Illness, said he sympathized with Gilmore. Tucker said he, too, has felt "overwhelmed" by his illness and unable to find "virtue" in his life.

Still, he said, people who are mentally ill have an obligation to themselves and to society to seek treatment.

"If (Gilmore) chooses not to do that, then that decision should be made for him," Tucker said. "That may mean having to go to Osawatomie State Hospital and being kept there until he's ready to get better."

He added, "Jail isn't the answer."


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