Showing posts with label schizophrenia. Show all posts
Showing posts with label schizophrenia. Show all posts

Wednesday, January 21, 2009

It Doesn't Get Crazier Than This

by Lucy Puryear, M.D.

In 2004 Andre Thomas killed his wife and children, cut their hearts out, put the hearts in his pocket, and walked outside. He then went home, put them in a plastic bag and threw them out. He stabbed himself three times in the chest and then walked into a police station to report his crime. What a horrible, heinous crime. He was understandably tried for capital murder. On the surface this looks easy--he turned himself in to the police and confessed his crime. He only needed to plead guilty and await his sentence. But while awaiting his trial in his solitary cell, he pulled his own eye out and ate it. Yes it's true, he plucked his own eye out and ate it, right there in his cell.

I have never evaluated Mr. Thomas, but according to newspaper reports he has a diagnosis of schizophrenia. His behavior now at least starts to make some sense. He suffers from delusions and altered reality. Maybe he hears voices. He reportedly believed that his family was possessed by the devil. Killing them was saving the world from evil. I couldn't find any report as to why he plucked his eye out. The prosecution suggested it was a ploy to appear insane. You've got to be kidding me.

I agree people try to fake mental illness to escape some form of punishment. I personally was duped by a fellow who showed up in the psych ward claiming to be a wolf. It took me about 30 minutes to figure out that his story was bogus and he was trying to find a warm place to stay for the night. He laughed when I told him that his diagnosis was that he was full of "s--t." He was quickly discharged.

Non-mentally ill people do not pluck their own eyes out for some secondary gain. People with
schizophrenia, when seriously ill, have been known to mutilate themselves in an attempt to cut off offending body parts, or kill themselves. I have personally witnessed one case of a man who cut off his own penis (fairly rare, but does happen), a man who cut off his arm with a circular saw, and a woman who slit her own throat. These persons had delusional "reasons" for doing these things and were "crazy" enough to be able to carry it out. I would propose that it would be close to impossible for any of us to pull out our eye voluntarily unless we were hallucinating on LSD or mushrooms. We would be temporarily "crazy."

In 2004 a judge declared Mr. Thomas competent to stand trial. He was found guilty and sentenced to death. While awaiting his sentence to be carried out, Andre Thomas last month plucked out his other eye and ate it. Yes really, he ate his other eye and is now blind.

The terrific blog,
Grits For Breakfast, posted on this story on January 9, 2009. The comments were amazing. Although there were several who were sympathetic with Mr. Thomas's mental health issues, many more suggested that he should be executed to put him out of his misery. Well that's one way to deal with the mentally ill in prison-- kill them.

To those of you who would suggest that I am soft on crime, consider this novel idea. How about we make mental health treatment available in the community to those who need it. Had Mr. Thomas been adequately treated and monitored he never would have killed his family or plucked out his eye. Three people would be alive today and an enormous amount of money would be saved keeping him out of the prison system. That's not soft on crime, that's preventing crime.

There are so many problems here. How do you find someone
competent to stand trial who is so severely mentally ill? The standard for competency is not very stringent. You have to understand the charges against you and be able to participate in your own defense. Those are easily met standards. How do lawyers and judges who may know next to nothing about mental illness evaluate the mental state of a defendant? By the time a defendant appears in court they have usually been medicated and no longer display obviously bizarre and crazy behavior. Someone who is no longer psychotic will often try to make logical sense out of the crime they committed and will say that they knew at the time that what they were doing was wrong.

There may be one way to make some sense out of the issue of the mentally ill who commit crimes. Several communities have
Mental Health Courts. These courts are in place for those defendants who have histories of mental illness before committing a crime, or committed a crime while mentally ill. The lawyers, judges, and others assigned to these courts have special training in mental illness and are equipped to knowledgeably handle these defendants. Instead of the revolving door from prison to back on the streets where psychiatric care is lacking, then back in prison when another crime is committed, these persons can be put into a system where follow-up is mandatory and resources are available. Another example of not being soft on crime, but preventing crime.

Harris County, Texas will soon have it's own mental health court.
Judge Jan Krocker's 184th District Court will hear felony cases of defendants diagnosed with schizophrenia, bipolar disorder and severe depression on a full-time basis. What a great idea: stop crime by making sure the revolving door is closed for those with mental illness. The perfect liberal and conservative agenda all rolled into one. Unfortunately for Mr. Andre Thomas and for his family it's too late in coming.