DEALING WITH THE MENTALLY ILL CLIENT CPDA, April, 2013
Always R/O Mental Illness 2010 National Alliance on Mental Illness reported about 25% of California’s prison population is mentally ill (a figure commensurate with that in other states). 2005 Mental Illness Policy Organization found, assuming 16% of the prison population is mentally ill, an institutionalized mentally ill person in California has a 3.8 to 1 chance of being in prison rather than in a hospital.
How do I decide whether I need a mental health professional?
Have a good working knowledge of the nature and symptoms of the mental illnesses that are most likely to be seen in our clientele Psychotic disorders Mood disorders Substance abuse related disorders Personality disorders
What symptoms do you see? What is his life history? School Prior mental health treatment Job history Relationship history Contacts with the criminal justice system
What are the facts of the case? Impulsiveness Emotionality Idiosyncratic MO Idiosyncratic motives Insight
What do I want my mental health professional to do?
General examination and assessment of client Assessment of client’s competence to stand trial Assessment of potential NGRI defense Assessment of other potential mental health defenses Assessment of appropriate treatment/case resolution Amelioration of distress
Tactical/practical considerations in use of a mental health professional What are your resources? What kind of mental health professionals do you need? Timing of visits with client Timing of discussion of the facts of the case with client Testing issues Investigative issues
Using mental health professionals in more than one role 1368 vs. 1026 In re Hernandez (2006) 143 Cal.App.4th 459
Coping with your client’s mental illness
Don’t take it personally Be patient; don’t expect more from your client than he can provide Don’t fight with the symptoms Be consistent Pick your battles
What if he develops dangerous acute symptoms in custody? Deciding how/when to alert jail staff The ramifications of alerting jail staff Your relationship with jail staff and staff’s relationship with investigating officers and/or DA Getting help from your own mental health professional
Should I present a mental health defense?
Do I have any other viable defenses? Does a mental health defense conflict with other defenses? What harmful evidence will be admissible if a mental health defense is presented? Will the prosecution seek to interview the defendant if a mental health defense is presented (PC 1054.3) and, if so, what, if any, are the risks associated with that?
In a capital case, is there a conflict between the mental health evidence and other mitigation? In a capital case, is there a risk that the mental health evidence will be misused as an aggravator?
What are the post-conviction ramifications of my client’s mental illness?
Client’s ability to comply with mental health-related terms and conditions of probation Potential of post-conviction civil commitment as Mentally Disordered Offender (PC 2960, et. seq)