Mental health & the death penalty

Mental health & the death penalty

Defining Severe Mental Illness

Although the essential characteristics of severe mental illness have been recorded and dissected in the annals of social and medical science for centuries, defining mental illness is a complex business, and the science of mental illness is an evolving field with many significant advances in recent decades.

Most mental illnesses cannot be identified psychologically, i.e., with blood tests or brain scans (though some associations are now being made between structural brain abnormalities and mental disabilities).  Instead, mental health professionals consider a host of observable criteria when rendering their opinions.

According to the Diagnostic and Statistical Manual of Mental Disorders, which is the manual used most often in diagnosing mental illness, a mental disorder is defined as:

                                   A clinically significant behavioral or psychological

                                   Syndrome or pattern that occurs in an individual and

                                   That is associated with present distress (e.g., painful symptoms)

                                   Or disability (i.e., impairment in one or more important areas of

                                   Functioning) or with a significant increased risk of suffering death, pain,

                                   Disability or an important loss of freedom…Whatever it’s original

                                   Cause, it must currently be considered a manifestation of a behavioral,

                                   Psychological or biological dysfunction in the individual.

The Diagnostic and Statistical Manual of Mental Disorders, previously in its fourth revised edition (hereinafter referred to as DSM-IV-TR), organizes psychiatric diagnosis into five areas:

Axis I    Clinical disorders, including major mental disorders, as well as developmental and

             Learning disorders.

Axis II    Underlying pervasive or personality conditions, as well as mental retardation.

Axis III   Medical conditions which may be relevant to the understanding and treatment of

               Disorder.

Axis IV    Psychological and environmental factors contributing to the disorder.

Axis V     Global Assessment of Functioning (on a scale from 100 to 0).

The DSM-IV-TR’s multi-axial systems attempt s to yield a more complete and holistic picture

Of the patient, rather than just a simple diagnosis may not have the same etiology (cause) or require the same treatment.  Indeed, it is for this reason that the DSM-IV-TR contains no information on treatment or cause.

Combine Axis I disorders include depression, anxiety disorders, bipolar disorder, attention deficit disorder.

These changes, though not yet widespread, have come in  response to an appreciation of the fact that mentally ill offenders, by virtue of their impairments, deserve special consideration when assessing culpability and determining an appropriate punishment.

MENTAL HEALTH & THE DEATH PENALTY

Guy Tobias LeGrande was sentenced to death in l996 in Stanly County, North Carolina, for the murder of Ellen Munford.  LeGrande fired his court appointed attorneys and was permitted to represent himself at trial.  The judge appointed “standby counsel” who sat in the courtroom, but were not allowed to do anything without LeGrande’s permission.

Standby counsel filed a motion suggesting that LeGrande was severely mentally ill and not competent to represent himself, but they were not allowed to be heard.  They wanted, but were not allowed , to tell the court that LeGrande believed that he was receiving signals from Oprah Winfrey and Dan Rather over the television; that he suffered from delusions of grandeur and extreme mood swings; and that he believed he would receive a large monetary settlement after his acquittal.  The judge asked LeGrande, who was wearing a Superman t-shirt, if he wanted him to disregard the motion; LeGrande’s response was to tear the document in half.  The judge allowed the trial to proceed.

At one point in the trail, the judge was moved to comment on LeGrande’s increasing agitation and urged him to take time to calm himself.  LeGrande’s testimony and arguments culminated in incoherent ramblings and the jury recommended a sentence of death.

After the North Carolina Supreme Court affirmed the conviction and death sentence, LeGrande continued to represent himself, and refused to properly preserve his legal issues in state court because he did not trust the state of North Carolina and believed he would prevail in federal court.

After his death sentence, experts evaluated LeGrande and concluded that he suffers psychosis; specifically, a delusional disorder with grandiose and persecutory delusions.  His delusions make it impossible for him to participate in a meaningful way in the defense of his life, and his lawyers for several years.  In prior conversations with his counsel, he has said that he can see other people’s thoughts and true desires.  He also obsessively discusses the prospects for settling his multi-million dollar lawsuits against various government agencies.  In one conversation, LeGrande insisted he could see a “circle of smoke” around his lawyer’s head.

LeGrande is a prolific letter writer.  Most of his letters focus on the pending settlement of his multi-billion dollar lawsuit against the State of North Carolina, while others detail such fantastical events as anvils falling from the skies.

After LeGrande filed scores of frivolous documents in court on his own, a federal judge finally appointed two lawyers to represent him.  But the lawyers had little to present in federal court, since courts will not hear issues that are not first raised properly on state court.  LeGrande was scheduled to be executed in December 2006, but the execution has been stayed several rimes and is still on hold pending an additional mental health evaluation/  His status is in doubt, mostly because LeGrande continues to obstruct the efforts of his attorneys and mental health experts, making an accurate and reliable evaluation virtually impossible.

The execution of Charles Singleton in Arkansas last January 6th marked another shameful episode in the saga of capital punishment in the United States.  The case was not remarkable because Mr. Singleton was an African American defendant sentenced to die by an all-white jury.  All-white juries are a commonplace feature of America’s death penalty system.  Even in New York, one of four men on death row (Nicholas McCoy) is a black man condemned to die by an all-white jury.  Rather, what catapulted Mr. Singleton’s case into national news was the fact that his schizophrenia had worsened to such a degree that he no longer understood what it meant to be executed.  It doesn’t take much to be judged competent for execution:  you just have to understand what an execution is and why it’s being done to you.  But, Mr. Singleton was completely out of it, living in a delusional world.  He didn’t meet the law’s minimal standard of competence, meaning that the state of Arkansas could not legally execute him.

But the keepers of the justice system in Arkansas found a way around this problem.  They proposed giving psychotropic medication to Mr. Singleton to quell his delusions.  Mr. Singleton could be made to understand his circumstances, the state reasoned, he’d meet the legal standard for competence and then the execution could proceed.

Of course, the defendant’s lawyer objected.  Isn’t medicine supposed to heal people?  Isn’t it absurd to heal people for the sole purpose of killing them?  On the other hand, without medication, Singleton’s mental illness left him besieged with hellish delusions.  The state insisted that he be forcibly medicated, not from any kindness, but to make him eligible for execution.

This issue was litigated to the eighth circuit federal court in Missouri.  Often we look to the federal court system for sanity in the law.  However, a panel of federal court judges ruled that the state of Arkansas interest in carrying out the death sentence outweighed Mr. Singleton’s interest in avoiding what it termed “the negative side effects of the medication.” The US Supreme Court declined to hear the case on appeal, thus paving the way for Mr. Singleton to receive the psychiatric treatment that led to his execution by lethal injection.

(If only the prison system were as strongly motivated to provide effective treatment to the estimated 16% of state prisons inmates suffering from serious mental illness!)

Works Cited:

New Yorkers against the Death Penalty.com

Donna Taylor

 

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