Jurors could have found James Holmes "innocent," "not guilty by reason of insanity" or "guilty". None work. Mandatory treatment does.
Our hearts go out to James Holmes, his family, his victims and families of the victims. All could have been better served if Colorado allowed James Holmes to plead "Guilty Because of Mental Illness" (GBMI).
Sentencing to Mandated and Monitored Treatment is the Answer
If the cause of the crime was lack of treatment for mental illness, individuals should be found GBMI and sentenced to mandatory long-term mental illness treatment—including medications—so they never become violent again. The sentence to treatment should be as long, or longer, than the maximum sentence that would be imposed had the person been found guilty. If this change were adopted, incarcerating the mentally ill would rarely be needed.
Their treatment could take place in an inpatient setting on a locked ward if that is what is needed to keep society safe. But, if the sentenced patient progresses—and the crime not too serious—their treatment could be continued on an outpatient basis. Over time, it would most likely be both. Under GBMI, the sentenced patient could be moved from inpatient care to outpatient care when doing well and instantly back to inpatient with no further court hearings needed if they started to deteriorate. In either case, the individual would be closely monitored by a case manager to see that they stay on their violence preventing medications. That's the solution that keeps the public safe, avoids wasting resources, and eliminates the dilemma of incarcerating those we should be treating.
Methods for monitoring patients to ensure they take their medications exist and have proven successful. New York's Kendra's Law, for example, allows courts to order treatment and monitoring of dangerous mentally ill individuals. According to a 2005 New York State Office of Mental Health Study, patients under court-ordered treatment had an 83% reduction in arrest and 87% reduction in incarceration compared to the three years prior to participation. A Columbia University study found that "individuals given mandatory outpatient treatment—who were more violent to begin with—were nevertheless four times less likely than members of the control group to perpetrate serious violence after undergoing treatment."
DJ Jaffe is Executive Director of Mental Illness Policy Org.