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Humane treatment 

Mental health needs to be approached differently in the judicial system

My December commentary dealt with fatalities from law enforcement shootings in the U.S., half of those being mentally ill. Fortunately, law enforcement in San Luis Obispo County is carried out with an enlightened temperament of mind.

Last November, SLO County Sheriff’s Office personnel responded to a report of an assault with a deadly weapon in rural Paso Robles. On arrival, Sheriff’s deputies found the body of a man who had died from gunshot wounds. The suspected murderer, owner of the house, fired one shot at the deputies before barricading herself upstairs. For safety reasons, the deputies went outside the house. During the next nine hours, they patiently, but unsuccessfully, attempted to contact the suspect. Finally, they deployed tear gas in the home. The suspect responded by firing multiple gunshots at the deputies. 

Around midnight, she surrendered unharmed. This is just one example of how our local law enforcement personnel perform their duties with high professional standards. Many thanks to Sheriff Ian Parkinson and his team and also to the police departments in the county.

This is the third and final commentary on mental illness issues. The focus will be on how the judicial system deals with mental illness cases. The U.S. judicial system is antiquated and inept in handling cases involving mentally ill. It has failed to incorporate research-based advancements in neuropsychiatry, neurophysiology and neuropsychology. Some judicial decisions defy the logic and are diametrically opposed to current scientific knowledge.

Joseph, a 10-year-old boy, confessed to police that he had killed his neo-Nazi father who was a drug addict, had physically abused him and his stepmother repeatedly, and had threatened to burn down the home with them inside. According to the court records, Joseph has low intelligence, suffers from attention deficit disorder, and had been exposed to many illicit drugs used by his mother during pregnancy. The issue was whether Joseph validly waived his Miranda rights—the legal right to remain silent—when he confessed to police. The court ruled that a 10-year-old can knowingly waive the legal right to remain silent. The appellate court upheld the lower court decision. The California Supreme Court refused to review the case, thereby de facto agreeing with the other two courts.

I have a question for the judges of the three courts: “What were you smoking, your honor?”

How can the concept of a voluntary, knowing, and intelligent Miranda waiver can be meaningfully applied to a 10-year-old child, especially one with low intelligence, attention deficit disorder, and exposure to narcotics that his pregnant mother had used? The whole life of this child has been nothing but a continuum of pain, torture, fear, and misery.

“Children, because their brains are still developing, are not just small adults,” states Dr. Steven Hyman, a Harvard expert on psychiatry and former director of the National Institute of Mental Health.

In 2013, new guidelines were issued to child psychologists in the U.K. changing the age range they work with from 0-to-18 to 0-to-25. This change was a direct result of advances in neuroscience, which show that a young person’s cognitive development continues into this later stage and that their emotional maturity, self-image, and judgement will be affected until the prefrontal cortex of the brain has fully developed. According to child psychologist Laverne Antrobus of London’s Tavistock Clinic, “Neuroscience has made these massive advances where we now don’t think that things just stop at a certain age, that actually there’s evidence of brain development well into early 20s.”

Our judicial system’s obsolescence in dealing with mental illness cases becomes especially evident from its processing of cases that involve serious mental illness, e.g., schizophrenia, bipolar disorder, and chronic depression. For example, schizophrenia is a brain disease often causing failure to recognize what is real. Symptoms include believing that what other people are saying is not true (delusion); hearing, seeing, tasting, feeling, or smelling things that others do not experience (hallucinations); confused thinking; deficit of normal emotional responses (apathy); having little emotion or inappropriate feelings in certain situations. Latest research indicates that the major cause of schizophrenia is genetic: 2.4 million Americans have this affliction.

Individuals suffering from schizophrenia have considerably higher rates of drug use and their combined effect often results in violent behavior. Since it is the combination of both schizophrenia and drug use, it is difficult if not impossible to attribute a violent act to only one of the two factors. However, last year prosecutors convinced a local jury that the accused, Mark Andrews, killed his neighbor in 2013 primarily because he was under the influence of drugs, and the fact that he suffered from schizophrenia had little bearing on the tragic event. If one accepts this rationale (as the jury did), i.e., that drug-use alone would make one commit a murder, then we would expect thousands of murders being committed in the county every year because, undoubtedly, there are thousands of drug users in the county not suffering from schizophrenia.

Andrews pleaded not guilty by reason of insanity. He had his first psychotic episode in 1993, more than 20 years before he was charged with murder. That year, he threatened his mother with a scalpel during a manic episode. Then he called the police and said, “This is Mark Andrews, and I need some help. I’m going to commit murder if you don’t come and help me now.”

He had been committed to mental health hospitals eight times. Andrews believed that he was a werewolf and that his neighbor and family friend, Colleen Barga-Milbury was a vampire; God had commanded him to kill the vampire and rid the world of this evil.

The legal test of insanity in California, and 25 other states, is called M’Naughten test of 1843 (yes, 1843). There are inherent differences in philosophy between psychiatrists/psychologists and the legal/judicial systems. In the U.S., the ultimate legal judgment of a defendant’s sanity is determined by the jury and not by psychiatrists, psychologists, and other mental health professionals knowledgeable in the latest advances in neuroscience.

It should come as no surprise that the jury, composed of non-experts in mental illness, ruled that Mark Andrews was “legally sane” (using M’Naughten test) when he killed Barga-Milbury. Andrews received a sentence of 50 years to life.

There was no animosity between Andrews and Barga-Milbury. In fact, Barga-Milbury was a family friend. This leads to the question: What was the motive for murder? It may seem incredible, but the prosecution does not have to prove a motive for murder in California.

No sensible person would suggest that Joseph and Andrews should be set free. The enlightened and humane approach calls for court-mandated treatment in a mental health hospital, instead of imprisonment where their condition is bound to get worse. Treatment is the practice in many Western European countries including Norway, Sweden, Denmark, and Finland, to name a few. 

Zaf Iqbal contributes a commentary to New Times the first week of every month. He is past associate dean and professor emeritus of accounting at Cal Poly’s Orfalea College of Business. Zaf volunteers with several nonprofit organizations, including Wilshire Hospice, Good Neighbor Program, and Mentoring Program for At Risk Youth at the Pacific Beach High School. He is Partner for the Future at the Southern Poverty Law Center, and past president of the San Luis Obispo Democratic Club. Send comments to zafiqbalslo@gmail.com.

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