what are the ramifications of prision versus state hospital? politically, practically?

I don't know that my opinion is going to be very popular, but I think anyone with a mental problem who kills another person needs to be locked up in prison for the remainder of his/her life. If you want to put them on a mental unit in a prison, fine by me.

I don't think it's fair to those who have not hurt other people to be thrown in with those who have. That's one of my biggest beefs about psych hospitals in general - they mix people who have committed crimes in with those who haven't done anything wrong. I don't care if the guy murdered his psychiatrist because of mental illness or not, he took a life and needs to be incarcerated with others like him for the rest of his.

State hospitals (at least the one I've been inside as a visitor)have a prisoner ward/floor.

So you do not give any quarter?
What if you forget your meds or cannot get them refilled for a week and go out of your mind....and you hurt someone.
Lock you up with others who hurt people?

Now admittedly, it did not say he was on or off meds, but seriously think about it. Yes, he needs to be off the streets. But he needs serious mental health care, not criminal prosecution. He has no idea the implications of what he has done and his motivations were (conjecture) probably spontaneous not "intent".
Differentiate between mentally ill and criminal a bit better please, you are offensive. In fact, go buy a dictionary and look up paranoid schizophrenia and then tell me that this person should be with criminals.
bah.
and so lisa....what do you suffer from? or are you just one of those lurking healthy critic/skeptics?
admittedly, although I read this blog ravenously I tend to ignore everyone but Phil, having first read his thoughts on a myspace forum, you seem to not actually "get" it.
People like this are WHY they have a state mental hospital with a ward for the criminally mental ill offenders.

educate don't ignorate. (yes I made that word up as far as I know lol)

Knowledge Junkie

never mind the conditions that may have created a person insane enough to commit the (an insane)act of murder. It was that damn mental illness that did the murder. If only we had a cure...

Murders should be punished. What sort of punishment murders are given based on various mitigating circumstances is a question for the criminal justice system. As someone else wrote, putting a murderer or accused murderer in a psychiatric hospital with people who have not been either currently accused or convicted of crimes, is horribly wrong. Most states do not separate out the held awaiting trial folks from the held for potential to commit crime folks (i.e. committed).

The idea that lack of medication can excuse someone from guilt is so dangerous and wrong. Most people with psych labels, by TAC's estimate, 90%, never commit any crimes regardless of their medical or treatment status.

Therapy cannot not remove guilt, regardless of what anyone says. If we want people to undergo therapy or forced meds in prison, while I object, it is a punishment for a crime. This touches on the entire problem with psychiatry...

Knowledge junkie, I'm not asking you to agree with me. Although it would be nice if you could remain civil & disagree without name calling. I'm not interested in taxpayer $ paying for people who have committed violent crimes to sit in "group" all day processing their feelings - might as well just take a fistfull of cash and flush it straight down the toilet.

Stephay, when I was writing I has started thinking about sex offenders & how they just stick those in with the rest of the mentally ill. Turns my stomach. Hopefully you are right & they would at least put someone who hacked to death another person in a different unit - although I would prefer it be on a separate campus altogether. I don't want my family member having to share a facility with other patients who have murdered people. Doesn't seem very fair to her.

The system in the state institution I witnessed wasn't completely "together" re: the entry of ppl who eventually ended up being processed to the prison floor. As a matter of fact the sexual predator that attempted to assault my daughter there was transferred the following Monday after the doctor came back from the weekend. It was a dangerous set up for all patients.

This was a hard core institution though, trust me it's not a 'hospital'. It's a warehouse for anyone who arrives there, no matter the reason.

the lie of brain chemical imbalance as an explination of mental illness, leading to magical medication, leading to physical brain changes and addiction,

The damages done by psychiatric medication to the persons consciousness/decision making ability does not exist medically, but in reality it does exist.
The crimes a person so altered can commit under the influence gets chalked up to mental illness and the chemical merry-go-round goes on.

My previous post here of a "cure" was a dark joke.

It is sad if a person commits a violent crime while forced or coerced into taking drugs that permanently alter their brain chemistry, drugs developed to make the person taking them mentally and physically incapable of self control. Involuntary intoxication is a legal defense. If it applies here, I hope this guy's lawyers use it.

It's sort of like the college kid who goes to a frat party and gets served a tall delicious glass of "fruit punch" with no way to tell it's laced with grain alcohol, and then, because one of the side effects of alcohol intoxication is a false sense of confidence and another is lack of physical coordination, is involved in a vehicular homicide on the way home. The kid really isn't responsible for his actions.

This is different from saying that someone who has auditory hallucinations or is convinced by some pshrink that they have such is excused from responsibility for killing because of these hallucinations. Again, even by the most hysterical measure, the bogus TAC stats, the vast majority of murders do not have auditory hallucinations and the vast majority of those accused of having such don't kill.

I don't know enough about this case to say anything.
However I would like to stress that psychotropics do induce violent behaviour and I have experience it during Effexor withdrawal.
I have tried to kill myself twice and other two time I only thought about it.
I was pretty violent and had put myself on many quarrels and I behaved as not according with my nature.
I have even punch a windshield and kicked the neighbor's door with my foot for the sound was too loud and other strange behaviors.
I never did those things in my entire life.
It only takes a visit to ssristories.com to have data on violent behaviour promote by SSRI alone.
Eric Harris and Columbine; Phil Hartman's wife to remember the most known.

This is a very complex issue and many factors are involved.
By law the fact that the murderer is a mental illness is taken into consideration.

"$ paying for people who have committed violent crimes to sit in "group" all day processing their feelings"
Lisa,
This is the last thing you must fear. Either the murderer is locked on a mental institution or in prison he will not be on therapy.
Not even those who didn't commit a crime have therapy of any kind in mental institution wards.
They spend the whole day doing nothing, nothing.
You'll be paying for his madications in prison or in a mental ward.
The food is almost the same.
Perhaps the taxes go to the psychiatrists.
Does anybody know how much tax is involved in both cases: a person in a prison and the one in the mental hospital?

Lisa,

In my state, there is a separate high-security hospital for violent offenders. Chester

I find it hard to imagine that there is any state that doesn't routinely separate the violent crime population from the the rest of the patient population. It's not that there is never any violence in psych hospitals or units for the non-criminal population, but they don't put patients who've "hacked people to death" in with non-violent, non-criminal patients.

Dr. X, that's good to know. Because in my state they put sexual predators in with the rest of the patient population, so I naturally thought then why not murderers, too? I'm sure they will tell you they don't but that would not be the truth. I was in a county psych facility (for less than 24 hrs) on one occassion & the staff were concerned about my safety because of a couple of the male patients' histories. I was encouraged to sit close to where staff were sitting. Certainly not a place you want to spend the night if you're a young woman.

Dr. X, I guess you have never worked in a Virginia state hospital. They let NGRI violent offenders work their way up to a mixed unit with others who have never committed a crime, in fact it is the only way someone who is NGRI can get out of a state hospital, by stepping down units. It is a dangerous and reprehensible practice in my opinion.
As to this person in NY, he will not be held for life because he is currently not competent to stand trial, he will be re-evaluated at regular intervals until he is competent to stand trial. Competent to stand trial is a lower bar than being found NGRI also so he could be found competent to stand trial and then found NGRI and then committed but still not for life in a state without the option of guilty but insane as a verdict.

In Alabama and Georgia, routinely, people charged with committing violent crimes who are being held for "psychiatric evaluations" are kept with the regular inmates (er patients) and the wards aren't sex segregated. It's a fact.

I was going to let this one go, without comment. First of all, no one deserves to die, and no one, I repeat, NO ONE deserves to die in the manner this woman did. I still feel sick to my stomach reading or watching on TV about this case.

That said, I agree with Alison and Sally. I can tell you honestly, I WAS in a mental hospital last November. Because they had me on another floor the previous month, I had to go to the basement floor-where they house the involuntary patients. That is right. They have six voluntary and 40 involuntary beds. The involuntary patients were usually brought in by the cops,, often in handcuffs. They are more violent, and scared the crap out of me. I learned quickly to give away my dinners if one or two of them wanted to eat more than what was offered on their trays. I gave away all my cigarettes as well, so they left me alone. I was afraid to shower should one of them corner me in there. And in the hospital, there is nothing to do but smoke and watch TV. The therapy they offer is a joke, and they keep you so drugged up you don't even know what day it is. Just sit in a overstuffed chair, watch Oprah and all the Judge shows and every hour go outside to smoke one cigarette that they light for you.

Would you believe I cried myself to sleep every night and never was so scared in my life except for the time I was 21 and missed my subway stop and ended up in Harlem and had to change trains? And I lived like this for 15 days in a constant fight or flight response, petrified one of these people would beat the stuffing out of me ( saw them do that on another patient) or worse. And I am just talking about the girls here, not the men.

And just to let you all know- this was not a state hospital. This was at one of the top hospitals in my state, which houses the best and the brightest psychiatrists in the state. (According to NJ magazine who ranked them in 06). Yes it had beautiful grounds. But this floor was the basement, there were no windows, and the only time you could see sunlight was to go outside to smoke.

I cannot get back those 15 days, but I gladly take them if I know someone I love and care about, and the readers here never experience this.

Peace.

Susan, I feel for you but violence is not a pre requisite for involuntary commitment and most people involuntarily committed are not violent and in fact are less likely to have a history of violence than other "mental" patients or the general public.

When you commit yourself you are saying that you are a danger to yourself or someone else. Yes, it's true voluntarily seeking help because you are suicidal is the same thing as voluntarily seeking help because you want to murder someone else in the eyes of the law and of psychiatry. Thus you are no more or less dangerous than the person involuntarily committed for something someone thinks they might do.

There is no moral, medical or social justification for involuntary commitment.

Anyone who commits a violent crime is dangerous and upset I believe jails should be more compassionate places.

As for mental distress, Bipolar Bunny wrote a great post a while back about how people who voluntarily seek inpatient mental health care are put in horrible punitive settings such as the one you describe. It's a travesty. If psych hospitals really were safe and secure environments, so much would be different.

I'm appalled by Susan's testimony.
That is right. They have six voluntary and 40 involuntary beds. The involuntary patients were usually brought in by the cops, often in handcuffs. They are more violent, and scared the crap out of me. I learned quickly to give away my dinners if one or two of them wanted to eat more than what was offered on their trays.
All of what you said Susan is pretty scary and disturbing.
I've just stressed this part because I cannot understand 1) 40 involuntary bed and 6 voluntary 2) patients being brought be cops in handcuffs; 3) they are more violent (?):o)
As it is not a state hospital and reading all of what you've described I cannot help myself thinking if these people were mental patients after they commit a crime.

I feel very conflicted about this site. Decisions made are so uneven. "Punishment sites"' are so uneven. Could this person have been put in a general prison, attendants forgetting his meds, behavior becoming erratic, and ending up in isolation? The only person I know who is mentally ill and in a hospital for ? Life? is John Hinckley at St. Elizabeth's in D.C. He is probably the last occupant of the place and so is not threatened by anyone else. His medications have apparently stabilized him. Yes, while mentally ill he killed a policeman and hurt Reagan but these crimes were done while he was psychotic, as was the person under discussion here. I always worried that my son would be killed by a policeman while psychotic but never worried that he would harm someone else, only himself. The only thing I think I can positively say is that the death penalty is wrong for anyone, mentally ill or not.

NY State Office of Mental Health explains what happens when people are found incompetent to stand trial on felony charges:

http://www.omh.state.ny.us/omhweb/forensic/Populations_served.htm#730

Criminal Procedure Law § 730: Not Competent to Stand Trial as a Result of Mental Illness.
..........

CPL 730.40 Temporary Order of Observation pertains to felony charges. Under finding of incompetence, defendants are committed to OMH under CPL § 730. Charges are not dismissed. Purpose of hospitalization is to restore competency to stand trial.

CPL § 730.50 Order of Commitment pertains to indicted felony defendants and are valid for one year. OMH may continue to retain defendants under CPL § 730 for up to two-thirds of the maximum sentence the patient would have received if convicted.

Bureau of Forensic Services' policy is to hospitalize Temporary Order of Observation and Order of Commitment defendants in Mid-Hudson and Kirby Forensic Psychiatric Centers as well as Rochester Regional Forensic Unit."

This doesn't necessarily mean people are released after the expiration of two-thirds of the maximum sentence they'd have received if convicted. If still considered to be mentally ill/dangerous to self or others they can be civilly committed under other statutes. Being locked up for life is a possibility. So is eventual release, with or without an order of conditions.

I disagree with the blogger saying this man needs to be in a hospital.

He murdered someone he deserves to be treated like other murders, and have his freedom taken away, in a prison.

There is nothing medical about blasting people's neurology with major tranquilizers. Other murderers have their neurology left alone.

We don't torture murderers for life. Sometimes we kill them by lethal injection, but in the years waiting on death row, they are left alone.

It is torture to throw psychiatry's guesswork at this man because he and every other murderer have at least this in common, psychiatry has never seem or tested their brains with any disease test or genetic test, so leave his brain alone.

If I was condemned to be not only imprisoned, but drugged for life, I would immediately suicide.

Mental healthcare does not exist, anyway in the world. Lies and wishful thinking exist. Policing activities like seclusion exist. Nothing medical about it but the veneer of the language and the white coats.

Sorry to disappoint. This poor man's life is completely over. He will never live a day of his life ever again with either mind freedom or physical freedom. And that, is diabolical compared to the other murderers who are sitting in their cells reading a book, thinking about their crime instead of this guy, who will be a zombie forever thanks to drugs.

Dear Philip:

Murder is a crime and horrible whether it's committed by a so called criminal or a person deemed mentally ill. Either way society has a responsibility to lock these people away for our safety and in doing the right thing for a greater good for us all and the victim of this tragedy.
Not guilty by reason of insanity is a touchy and controversial issue when you get into the meat of the issue. You can be found not guilty by reason of insanity for a relatively minor felony and spend the rest of your life in an institution. You can be found incompetent to stand trial and spend years, if not the rest of your life in a mental institution also. There are really no sentencings guidelines accept whether you’re sane and able to walk free in society once more safely and function, or insane/dangerous and stay locked up forever in a mental institution.
Treatment is a whole other ballgame, it’s fairly obvious that very little actual treatment happens in these institutions; which then goes to how effective the medications are and if the deemed insane person continues to take them after being found no longer a danger to society before a release. Not a good bet that I would be willing to take with someone capable of murder!
Even though the insanity defense is only effective in less than 1% of trials it’s used in. That still leaves a gaping hole for some to slither through. I don’t know this person, his history, symptoms, severity of illness, diagnosis, or would even care to guess on whether he is capable of committing another murder. I just don’t believe we should be taking that type of chance on someone with that potential for gruesome violence. That’s just my personal opinion though.

I have worked in places where the criminally insane were treated less than human though, and that does disturb me to my very core. I’m not one that is Mr. Softy on crime, but I do believe in basic humanity and dignity.

Let me quickly define the difference between being found not guilty by reason of insanity, where you go to a mental institution for supposed treatment and eventual release if able to regain sanity and function in the opinion of doctors that you are once again safe/sane enough to be in society.

As for the criminally insane; which are found guilty of a crime and then sent to prison to serve your sentence and are deemed mentally ill once in the system. I happen think there are large gaping holes and arguments in each population that could be debated on many fronts.

The Bottom line is if we are to error, I hope we error on the side of the common good, safety, and justice. Justice has never been perfect, it never will be perfect, it’s just the best tool we have.

Yours truly
Stan

Some great responses here that definitely made me think. My greatest concern is safety - as long as he never gets out, as long he is not mixed in with patients who are not criminals, and is well guarded then I don't really much care where he is. Hopefully, no psychiatrist would be so stupid as to ever allow him to move down into a less secure unit in a state hospital. However, Hickley gets to go on field trips so who knows what will happen with this guy. He may be vacationing in Florida before long.

Susan, in response to your post - my heart goes out to you. I don't know how you got through 15 days of that. I was only in the county psych ward for

Even if he ends up in prison he can still get Seroquel, since it's being abused in prisons, BY CHOICE of the inmates.

Anyone remember how he murdered the therapist? it was a planned attack to kill his psychiatrist, and she was in the wrong place at the wrong time. He drug a suitcase into the building on purpose with the weapon.

She didn't deserve to die, and know one has a solution or answer as to why he did it, or was capable of doing it.

He will no doubt end up in a locked down mental institution.