Should We Execute The Mentally Ill? Scott Panetti, The Death Penalty & Mental Illness

Scott Panetti is a mentally ill, death row inmate in the state of Texas. He has long been diagnosed with schizophrenia and is scheduled to be executed on December 3, 2014. He will be the 10th and perhaps the final Texas inmate to be executed this year.

Mr. Panetti has a long history of serious mental illness. He is profoundly mentally ill and is among the sickest persons to be executed in modern times. Before killing his parents-in-law, he was hospitalized 14 times. Evidence of schizophrenia began in his teen years.

He represented himself at trial and did so while under the control of a hallucinatory figure named “Sarge.” He dressed in a purple cowboy suit and rambled incoherently throughout the trial. He attempted to subpoena hundreds of people, including the Pope and Jesus Christ. His behavior frightened the jurors.

There is no doubt that Mr. Panetti should be held accountable for murdering two people.

If you believe that it is possible for anyone to be mentally ill then there will be no doubt in your mind that Mr. Panetti is mentally ill. Long before murdering his parents-in-law he was hospitalized 14 times. First of all, if you are familiar with the American mental health system you know that it is difficult to get hospitalized even once. Many people who should be hospitalized and whose families and loved ones have tried desperately to get them hospitalized have failed to be hospitalized. A significant number of these people have gone on to murder or commit suicide, or both. When you have achieved a record of 14 hospitalizations, you can be pretty sure that you are mentally ill.

That’s the background and now here’s the question. Should we kill mentally ill people? I suppose you could correctly say there is an even more basic question, which would be, should we give the state the power to execute anyone?

And that’s when it gets complicated. That’s when we talk about the fact that we are the last large democracy in the world that executes its citizens. They don’t do it in Scotland, Ireland, England, Italy, France, Germany, etc., etc.

Those countries are our allies and friends. Many of our families have at some point emigrated from one of those countries. Many of us are very proud of our ancestry. We are Irish-Americans or Italian-Americans, etc. Those countries used to execute their citizens but now they are very much against it. They won’t even release a prisoner to the United States unless we promise not impose the death penalty.

Your relatives and countries of origin, just don’t believe in execution anymore. In fact they are very much against any execution for any reason (it may be wise not to bring up this topic at future family reunions).

It is our traditional “enemies,” those countries around the world who are our political opposites, who continue just as we do to execute its citizens.

If I were to write a thorough analysis of the death penalty, honestly it would take me thousands of pages. It is surely worth writing about but this is not the time or place. I mention the above simply to prove the point and acknowledge the fact that this is an exceedingly difficult topic.

Forget the issue of the death penalty in general.

Let’s keep it simple. Is it right, to execute a mentally ill individual?

Let’s make it even simpler. Let’s move to the lowest man-in-the-street level. Is it right to execute a man who is as nutty as a fruitcake?

Let’s also forget big but meaningful words like “schizophrenia” and “psychotic.” Let’s just talk about it from the perspective of your uncle Bob, who might sum up Mr. Panetti’s condition by simply saying “the guy ain’t all there.”

With a psychotic person, he’s just not “not all there,” he’s not there at all. Really. He is living in a fantasy world and by definition has lost the ability to know what is real and what is not real.

That’s the question. Do we kill mentally ill people? I know it begs the question, should America execute its own citizens, legally guilty of course, but still its own citizens.

We need to think about that. We need to form an opinion and voice an opinion. And that opinion had better be correct, lest you be judged.

I seem to remember reading someplace, someplace really important, advice from an appearingly, supremely knowledgeable source. It came in a list of similar declarative warnings.

It seemed more than a suggestion and more than mere advice. It was stronger than a warning and very clear.

“Thou shall not kill.’

Hey, I’m not pretending to speak for God. I’m just wondering if executing a mentally ill man falls under that admonishment.

Update: Mother Who Heard Voices Drowned Both Sons

A Pennsylvania woman, Laurel Michelle Schlemmer, 40, drowned her three-year-old son in a bathtub. She also attempted to drown her six-year-old son because “crazy voices” told her she would be a better mother to her third child if the other two “weren’t around.”

According to court documents, the mother put her oldest son, age 7, onto the bus before nine in the morning. She returned to the family home, filled up the bathtub and told the younger boys to take off their pajamas and get into the bathtub. She was fully clothed when she got into the tub as the “crazy voices” told her to push the boys into the water. She sat on top of them while they were submerged under the water.

She told detectives that she thought she would be a better mother to the seven-year-old child if the other two weren’t around. She thought that the other two would be “better off in heaven.”

After getting out of the bathtub, she took off her wet clothes, put them and two towels into a trash bag in the garbage. She then lifted the boys out of the bathtub, put them on the bathroom floor and called 911.

She did not attempt to resuscitate the boys because she “did not know how to do it.”

Another Andrea Yates?

This case is fairly similar to Andrea Yates. Andrea Yates was a middle-class Texas severely mentally ill mother who drowned her five children in a bathtub. The drownings began nearly as soon as her husband left for the day.

She took each child and put them face down in the water, one by one. She then immediately called 911 and spoke “unemotionally” to the authorities.

Soon after she called the authorities, Andrea phoned her husband Rusty. “It’s time. I finally did it” was what she told him on the phone.

Andrea gave a 17 minute confession to the police. Her rationale for killing the children was that she realized she was not a good mother to them and “they weren’t developing correctly.” She also did not want her children to be tormented by Satan. Satan had been conveying “bad thoughts” via the television and cameras in her home. She was frightened that Satan would lure her children to him and that perhaps she had some of Satan in her. She thought that Satan was giving her directions about harming her children and about how to drown them.

Andrea believed that drowning them was a way out for her children who would then be up in heaven, safe with God.

She ultimately thought that she was saving her children by drowning them.

Laurel Michelle Schlemmer might also have believed something similar but it’s too soon to know her exact state of mind.

The most telling aspect of these crimes, is that in both cases the mothers who committed these heinous acts of violence immediately reported themselves to the police. There was no effort to hide what they did, a behavior that often signifies severe mental impairment.

Yet another tragedy involving severe mental illness.

UPDATE: The second child has died and Schlemmer has been charged with homicide.

The Pittsburgh Post Gazette has reported that she was found not competent to stand trial and was sent to a state mental hospital for further evaluation. A doctor said that she has major depressive disorder, is psychotic and has suicidal ideations.

An April 4, 2014 article states that a 911 worker was fired for disclosing details of the 911 call from Schlemmer. The 911 call-taker said the mother originally said she thought that her children drowned in the bathtub.

Teen With Schizophrenia Shot and Killed By Police In Front of Family

18-year-old Keith Vidal was shot and killed by a police officer Sunday when authorities responded to a call for help from family members. Keith was in the midst of a schizophrenic episode.

According to early reports, Keith had picked up a small screwdriver and refused to put it down, an action which prompted the family to call police. Initially, two officers arrived on the scene. The following events, which ultimately led to Keith being shot, are not fully clear.

According to Keith’s father, “…all of a sudden, this Southport cop [the third officer to arrive on the scene], walked in the house [and said]: ‘I don’t have time for this. Tase him. Let’s get him out of here.”

The officer used a stun gun on Keith who, “hit the ground [and then] this guy shot him,” Keith’s father reported.

Shots were fired “seconds” after the third officer arrived.

Keith was declared dead soon after being rushed to the hospital.

When Keith’s father demanded to know why his stepson was shot, the officer said “well, I’m protecting my officers.”

Keith’s mother Mary told reporters that she had often tried to get help for her son’s mental illness. Apparently, to no avail.

The current mental health system is in shambles and it’s been this way for some time, especially for people with serious mental illnesses. There are now more people residing in jails and prisons across the United States, than in psychiatric hospitals. The Los Angeles County Jail, for instance, is considered the largest defacto psychiatric facility.

Police shootings of people with mental illnesses is not a new phenomenon. An investigation by the Portland Press Herald and Maine Sunday Telegraph uncovered “that at least half of the estimated 375 to 500 people shot and killed by police each year in this country have mental health problems.”

Their investigation also revealed that in the state of Maine, the Attorney General’s Office, which investigated all of the police shootings, never found one of the shootings to be unjustified.

There are also no federal statistics about police shootings of mentally ill people.

I have worked with many police officers who were called upon to deal with severely mentally ill people. Some felt that it wasn’t their job to deal with “those people” but many others were kind, compassionate and patient with those of whom they were attempting to help.

Studies show that police officers who have undergone crisis intervention training (CIT), are better able to effectively de-escalate a mental health crisis. CIT should be mandatory for all law enforcement officials, at least until they are no longer the front-line responders in mental health emergencies.

Keith’s parents have said that the policeman who shot their son is a cold-blooded murderer.

Keith’s parents said they cannot understand what happened.

“Where is the justice, why did they shoot my son? This is what’s wrong with our mental health system.”

The authorities are investigating the events.

Twitter Reaction

 

 

 

Successful and Schizophrenic

The New York Times features an article by Elyn Saks entitled “Successful and Schizophrenic.” Elyn Saks is a university professor, [amazon_link id=”1401309445″ target=”_blank” container=”” container_class=”” ]an author[/amazon_link], a researcher and the recipient of the MacArthur foundation genius grant. She also has schizophrenia and has clearly experienced a great deal of success in her life. bulb

In the article, she describes the research that she and her colleagues have conducted with 20 highly successful individuals with schizophrenia who manage their delusions and hallucinations. Some utilize cognitive techniques. For instance, one individual would ask himself these questions when he began to experience hallucinations:

“What’s the evidence for that? Or is it just a perception problem?”

One individual would simply “blow off” their derogatory voices.

Another individual felt that it was important to identify his or her triggers for the purpose of preventing a “full blown experience of symptoms.”

Other helpful strategies for minimizing symptoms included: minimizing sensory outputs, exercising, working, getting the proper sleep, developing a healthy diet, avoiding alcohol, and engaging in prayer.

The author is careful not “romanticize” schizophrenia. She recognizes that it is a serious disorder. In her case she also takes medication which has helped her tremendously.

“I don’t want to sound like a Pollyanna about schizophrenia; mental illness imposes real limitations, and it’s important not to romanticize it. We can’t all be Nobel laureates like John Nash of the movie “A Beautiful Mind.” But the seeds of creative thinking may sometimes be found in mental illness, and people underestimate the power of the human brain to adapt and to create.”

Read the rest of Successful and Schizophrenic

James Holmes’ Affect Similar to Andrea Yates?

In court today, officers described the emotionality, or lack thereof, of Mr. Holmes after he had just massacred innocent people. Color

“James Holmes was the picture of calm, “just standing there” in a helmet, gas mask and body armor, staring off into the distance. “He seemed very detached from it all…very, very relaxed.”

Officers thought at first that Holmes was an officer, who had arrived early on the scene but they quickly realized otherwise.

It was also observed that Holmes was sweating profusely, literally dripping with sweat. He smelled badly.

Officer Grizzle said that Holmes “did not display normal emotional responses.”

His eyes were also dilated.

via NBC News

Demeanor Similar To Andrea Yates?

His lack of emotion is abnormal and interesting but we still know very little about Holmes and his mental health state both then and now. We may learn new information as the week progresses.

It does remind me of how Andrea Yates behaved after drowning her five children in the bathtub.

Immediately following their deaths, she called 911 to report what she did. She spoke “unemotionally” to the dispatcher.

Police reported her as being “emotionless” as she told them about having killed her children. Some officers said that:

“…Yates had a flat demeanor and that her reaction was unlike that of other mothers who just lost their children.”

Andrea Yates was seriously mentally ill. Despite having a long history of mental illness, including psychosis, during her trial, she staunchly resisted the efforts of her attorneys to plead insanity. She insisted that she was not insane and believed that she deserved to die. She made statements to that effect to virtually anyone who would listen.

Diana Dial & Delusional Thinking

If you have never interacted with an individual who is delusional, then you might find it difficult to understand what delusions are like. A delusion is the strongly held belief in something despite there being strong evidence to the contrary.Delusions are associated with psychiatric disorders such as schizophrenia, schizoaffective disorder, delusional disorder, bipolar disorder, among several others.

Delusions feel very real to the individual who is experiencing them. An individual who is delusional is unable to recognize that what they are thinking is untrue. They cannot know, they are mentally ill. People do not become delusional on purpose. Delusions happen to people, in most cases because of a mental illness.

Diana Dial

One of the best examples of an individual (on tape) who is clearly delusional is Diana Dial. Ms. Dial shot and killed her roommate because she firmly believed that he was going to poison her and the rest of her family. Despite having a long and documented history of schizophrenia, at her trial she adamantly denied this diagnosis. Under no circumstances did she want to be seen as being mentally ill.

In this video (which I cannot embed), Ms. Dial explains to Dr. Michael Stone her version of events. As you can see in the video, she is clearly delusional. Ms. Dial is not evil. She is mentally ill. Upon the last report on her status (which was years ago) Ms. Dial has not received any mental health treatment while incarcerated.

Have questions about delusions or psychosis? Don’t hesitate to ask.

Clinical Terms In The News, Related to the Colorado Shooting

In light of what many are calling the largest mass shooting in U.S. history, you will likely be hearing many reports about the clinical and psychological status of the shooter. At this time, there have been no reports about his clinical or psychological status but mental health professionals have been speculating about it in the news. Below is a list of clinical terms and information that you may be hearing about or may be wondering about, in relation to the Colorado shooter.

Schizophrenia: Schizophrenia is a severe and debilitating thought disorder that is diagnosed in less than 2% of the United States population. Symptoms of the disorder include: having a break with reality, illogical thoughts and extreme emotional and social dysregulation, among others. The probability of developing schizophrenia is relatively low compared to other mental health disorders.

The perception of individuals with schizophrenia being violent remains strong in our society. The facts do not match that perception. Individuals with schizophrenia are no more dangerous than the average person except under four conditions that increase the likelihood for violence. Those four conditions include:

1. Having a history of violence
2. Actively using drugs and alcohol
3. Off medication and actively psychotic
4. Lack of insight into one’s mental illness

Those conditions may increase the likelihood of violence but they do not guarantee violence. It is difficult (and in fact may not be possible) to accurately predict who is going to be violent and under which conditions.

The National Institute of Mental Health states the following about schizophrenia and violence:

“Most violent crimes are not committed by persons with schizophrenia and most persons with schizophrenia do not commit violent acts.”

Individuals with schizophrenia are more likely to be victims of violence rather than perpetrators of violence.

Schizophrenia is often confused with Dissociative Identity Disorder (DID), which was formerly called multiple personality disorder.

Dissociative Identity Disorder: DID symptoms include: the presence of two or more identities, at least two of these identities recurrently take control of the person’s behavior and having an inability to recall personal information. DID is very rare and is diagnosed in less than 1% of population.

The Bottom Line: Schizophrenia is not DID and multiple personality disorder is now called DID.

Psychosis: Psychosis is a break with reality. An individual who is psychotic might hear voices, see things that are not real or believe that someone is following them. The voices associated with psychosis are generally negative. The voices may be telling an individual to harm themselves or someone else. The voices can be very unpleasant and frightening.

Psychosis is associated with mental health disorders such as schizophrenia, schizoaffective disorder, bipolar disorder, psychotic disorder not otherwise specified (NOS), and several others.

An individual can have a psychotic break and never have another. In clinical terms, that is called Schizophreniform disorder.

Psychopath: According to research by Hare and Newman, psychopaths are:

  • shallow,
  • deceptive,
  • grandiose,
  • dominant,
  • superficial,
  • manipulative,
  • are unable to establish emotional bonds,
  • lack empathy, guilt, and remorse,
  • are social deviants, impulsive and ignore the norms of society.

Many clinicians and researchers believe that psychopaths are untreatable.

Psychopath is a term used interchangeably with antisocial personality disorder (ASPD), sociopathy, and psychopathy but they are not same, at least technically (and according to Hare). Research shows, according to Hare, that most people with ASPD are not psychopathic but most psychopathic individuals meet the current diagnostic criteria for ASPD. Despite Hare’s contention that psychopaths and individuals with ASPD are very different, some researchers contend that both psychopaths and individuals with ASPD are virtually the same.

Antisocial Personality Disorder (ASPD): Antisocial personality disorder is characterized by difficulty interacting with others or lacking the desire to interact with others. Individuals with antisocial personality disorder are typically not shy. On some occasions, they can be charismatic. Ted Bundy, who is considered by many to be a “textbook” case of ASPD, was generally well-liked.

Individuals with ASPD lack empathy, tend to be arrogant, are excessively opinionated, can be charming, and engage in aggressive or criminal acts. There are also characteristically irresponsible, frequently manipulative, impulsive, and have no regard for others.

The aforementioned are some of the terms and phrases that you will likely hear discussed in reference to the Colorado shooter, and in other cases of a similar nature.

Schizophrenia & Violence: What Are The Facts?

I remember speaking with a client with schizophrenia who, for her entire life, had [amazon_link id=”0967718937″ target=”_blank” container=”” container_class=”” ]denied that she had the illness[/amazon_link]. For many years, she would not even allow a conversation between us about schizophrenia. The topic was simply off-limits.

One day, she was talking about viewing a Law & Order television episode in which an individual with schizophrenia had killed someone. That led us to a conversation about schizophrenia and violence. I delicately broached the subject of why she would never admit to having schizophrenia. She stated that she didn’t think she had schizophrenia because she “never killed anyone.”

The perception of individuals with schizophrenia being violent remains strong in our society. The facts do not match that perception. Individuals with schizophrenia are no more dangerous than the average person except under four conditions that increase the likelihood for violence. Those four conditions include:

1. Having a history of violence

2. Actively using drugs and/or alcohol

3. Being off medication and actively psychotic

4. Having a [amazon_link id=”0967718937″ target=”_blank” container=”” container_class=”” ]lack of insight [/amazon_link]into one’s mental illness

Those conditions may increase the likelihood of violence but they do not guarantee violence. It is difficult to accurately predict who is going to be violent and under which conditions.

The National Institute of Mental Health states the following about schizophrenia and violence: “Most violent crimes are not committed by persons with schizophrenia and most persons with schizophrenia do not commit violent acts.”

Individuals with schizophrenia are more likely to be victims of violence rather than perpetrators of violence.

 

 

Find Out What The Criminalization Hypothesis Is

Criminalization Hypothesis

Have you ever heard of the criminalization hypothesis? The basic premise is that individuals with serious mental illnesses (SMI) (i.e. schizophrenia, bipolar disorder, mainly) are disproportionately involved in the criminal justice system because they are committing crimes and being arrested for offenses because of their untreated illness symptoms.

Abramson, more than 30 years ago, was the first to discuss “criminalization.” He believed that individuals with SMI are being routed through the criminal justice system instead of the mental health system.  He observed that trend in the early 1970s.

Defenders

Defenders of the criminalization hypothesis cite studies (among others) such as Linda Teplin’s 1984 Chicago study in which it was found that individuals with a mental illness were arrested at a higher rate than those without a mental illness. The rate of arrests for individuals deemed mentally ill was 46.7 % compared to 27.9 % for individuals not appearing to have a mental illness. Teplin concluded from her study that individuals who appeared to be mentally ill had a higher probability of being arrested than those who did not. In her opinion, “clearly the way we treat our mentally ill is criminal.”

Not Everyone Agrees

Not everyone agrees with the criminalization hypothesis. Scientifically, it is difficult to prove. Within academic circles, it is a debate that may never be resolved.

In a future post, I will discuss alternative theories. What do you think?

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