Thursday, November 8, 2012

Two cases

(Opposite ends, in a sense, of the spectrum of legal complexity which is psychiatric coercion...)


I'll call my client Billy. He is a college graduate, former stockbroker, English teacher at a foreign university, and a Navy veteran of the Vietnam War.

In 1986 Billy was fired from his job with the Veteran's Administration. Twelve years later he laid in wait at a train terminal for his former supervisor, and fatally shot him several times in the back.

At trial it was found that Billy had believed he was the victim of a conspiracy wherein the government had been reading his mind by electronic means, and that he had been forced to kill his supervisor in order to stop the intolerable government intrusion. He was adjudicated not guilty by reason of insanity (NGRI) and committed to Elgin Mental Health Center for treatment. Prior to the murder and NGRI commitment, Billy had no psychiatric history and no history of substance abuse.

By 2004, Billy had recovered sufficiently that he no longer suffered hallucinations or delusions. He began to refuse psychotropic medications because they made him feel worse and prevented him from thinking clearly. Possibly because he did not accept the orthodox treatment model, he was not granted expanded privileges for several years. However his recovery continued unabated.

I began to advocate for Billy, and the treatment team was soon willing to collaborate. In late 2011, the facility recommended to the court that he be granted supervised off-grounds passes. The psychiatrist in charge never completely stopped hoping he would take psychotropic medications again some day, but she indicated that the drugs were not necessary for him to qualify for these passes.

For his part, Billy promised he would be willing to go back on meds if he ever became symptomatic of psychosis. The obvious point was, he hadn't been symptomatic for many years.

As is usually the case in Cook County, Illinois (largest criminal jurisdiction in the USA), the State's Attorney's Office simply considers it their job to keep anyone like Billy locked up as long as possible, "treated-or-punished-who-cares". Thus, presented with a motion for privileges, their knee-jerk response in this case was to find any possible way to prevent Billy from progressing toward an eventual conditional release.

The SA's first tactic was to request an independent evaluation from the court's own stable of psychiatrists up on the 10th floor at 26th & California, in the hope that such evaluation would be contrary to the Elgin treatment team's request. As luck would have it, the 10th floor didn't like Billy much, and the doctor up there made kind of a big deal about the fact that he's not taking meds. So, that was probably all the court needed to say no to the privileges request.

Billy and I decided that although this was only a privileges request, not a motion for conditional release, sooner or later the prejudice about taking meds would have to dealt with head-on anyway. He has some money, and he was willing to hire a truly independent psych.

Enter, a brilliant mental health professional: Dr. Toby T. Watson, Psy.D.

Dr. Watson testified as an expert on behalf of Billy's privileges motion on November 6th. He was compelling in his arguments that, a) antipsychotic drugs may be helpful at reducing positive symptoms in the very short term, but they increase the likelihood that a person who continues to take them will become chronically ill; b) long-term recovery rates are much higher for unmedicated patients; c) antipsychotics cause a host of debilitating side effects and lead to premature death; d) the new "atypical" antipsychotics are not better than the older drugs and may be worse; and e) being diagnosed with schizophrenia or any other psychiatric disorder does not indicate any real disease: mental illness is, rather, a metaphor.

Basically, the idea that Billy should be held back in his progress through the system for not taking psych drugs was revealed as arbitrary and contrary to the whole purpose of the system itself. The SA's cross-examination of Dr. Watson was quite ineffective.

When the State presents testimony by the 10th floor psych, I'll cross-examine. And I sure am looking forward to it.

(To be continued...)

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