Showing posts with label James Holmes. Show all posts
Showing posts with label James Holmes. Show all posts

Thursday, July 16, 2015

Mental Illness Policy Org statement on James Holmes Colorado Verdict

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.  

Sunday, July 22, 2012

James Holmes, Mental Illness, Colorado Shootings, Not Guilty By Reason of Insanity

Could James Holmes Be Seriously Mentally Ill?
It is too early to tell, but he could be. There are three reasons people do these things.
  1. Lack of maturity (ex. desire to get attention or get back at someone); 
  2. Political reasons (terrorism);
  3. Their brain was malfunctioning due to mental illness. 
I guess mental illness, and may be wrong, but here's why I think that, based on media reports:
  • James Holmes is 24, the age at which schizophrenia starts. 
  • He is delusional, i.e, believes he is the Joker. 
  • He was "normal" and then became withdrawn. Withdrawal is a common reaction to hallucinations.
  • NY Daily News reported he has lack of affect ("shows no remorse")
  • He is acting crazy spitting on everyone in jail.  
  • The owner of a shooting range reported Mr. Holmes' voice message was "bizarre"
The fact that he was highly educated, and the attack was well planned, does not rule out mental illness. The disease often starts after the education. The Unabomber was also highly educated and planned his attacks well.


If James Holmes had a mental illness that caused the shooting, what could have been done to prevent it?
Probably not much. While there are many (albeit, unused) legal procedures to help people who already have serious mental illness and a history of violence, it is much more difficult to help someone prior to a first episode without violating their rights. (Put another way: the law requires dangerous behavior rather than prevents it). One possible approach might be to make it easier to have someone undergo a 'capacity' or 'competency' hearing. These hearings determine whether someone is rational and can make their own decisions. They are frequently held for people with Alzheimer's, dementia, or developmental disabilities, but rarely for people with mental illness. If someone is found to lack capacity or competency, then someone else can be appointed to make decisions for them, which could include treatment. 


What happens if James Holmes is found Not Guilty By Reason of Insanity for the Colorado Shooting?
(Excerpted from op-ed I wrote a few years back in Wall Street Journal)
If he is found Not Guilty By Reason of Insanity (NGRI) he will be put in locked psychiatric hospital. But theoretically, when sanity is restored, he can be released. As a practical matter, few judges are willing to risk that on their watch, so even when sanity is restored—he will likely be kept committed.


To protect against the possibility of NGRI acquitees going free, some states replaced NGRI with "guilty because of mental illness." Individuals found guilty because of mental illness go to a hospital until their sanity is restored and then to jail to finish out their sentence. This forces individuals who had no culpability for their actions to go to jail at the exact time it's not needed—when they've regained their sanity. For these individuals being mentally ill is the same as being guilty: either way, they go to jail.


Our current system incarcerates people who have no culpability for their actions. It keeps sane people involuntarily committed, and gives potentially violent mentally ill individuals the right to go off violence-preventing medications. That's not justice, it's mayhem.


To correct that, we have proposed that individuals found NGRI be 'sentenced' to treatment for the maximum amount of time they would have received had they been found guilty. This treatment could be in a locked ward if needed or in the community if safe. Treatment would be monitored (much like Parole). The individual could be moved back and forth between inpatient and outpatient treatment as needed with no further court proceedings necessary. This would keep them safe, save money, and keep communities safer.


Learn more
The relationship between untreated serious mental illness and violence
Noncompliance in people with serious mental illness


For more on mental illness and violence visit http://mentalillnesspolicy.org or follow us on Facebook or Twitter.