1. DEALING WITH THE MENTALLY ILL CLIENT
CPDA, April, 2013

2. 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.

3. How do I decide whether I need a mental health professional?

4. 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

5. 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

6. What are the facts of the case?
Impulsiveness
Emotionality
Idiosyncratic MO
Idiosyncratic motives
Insight

7. What do I want my mental health professional to do?

8. 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

9. 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

10. Using mental health professionals in more than one role
1368 vs. 1026
In re Hernandez (2006) 143 Cal.App.4th 459

11. Coping with your client’s mental illness

12. 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

13. 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

14. Should I present a mental health defense?

15. 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 ) and, if so, what, if any, are the risks associated with that?

16. 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?

17. What are the post-conviction ramifications of my client’s mental illness?

18. 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)