Murder cases in Washington state highlight poor services for people with mental illnesses

From The Daily Herald in Washington State:

EVERETT, Wash. — Jody Sands was off his medication and suffering from hallucinations when he killed his grandfather by clobbering him with an ax.

In another case, authorities warned that it was only a matter of time before Ryan Miller (pictured), homeless and mentally disabled, hurt someone. He confessed this summer to helping beat a Marysville grandmother to death with a hammer.

Both men had documented histories of mental illness that required professional care. Over the years, they were hospitalized and medicated.

Now, Miller and Sands are off to prison for murder.

Both are extreme examples of a system failing people living with serious mental illnesses, according to some in the criminal justice system and mental health professionals.

“The mental health system in this community has become the criminal justice system,” Snohomish County deputy prosecutor Paul Stern said at Sands’ sentencing late last month.

“We end up trying to figure out what to do with the Jody Sandses of the world instead of figuring out how not to create the Jody Sandses of the world,” Stern said.

Snohomish County Superior Court Judge Linda Krese agreed, then sentenced Sands to prison. Too often, mentally ill people end up in front of her instead of receiving the services that may prevent them from landing behind bars, she said.

Natalie Tarantino, an attorney with the Snohomish County Public Defender’s Association, estimates that a fourth of her clients have some form of mental illness.

“We have not built the right net for these kind of people. If we’re trying to solve the mental health crisis, jail is not the answer,” said Tarantino, who represented Miller.

Mental health care advocates caution that the majority of people living with mental illnesses do not commit violent crimes. Most times they are victims, not perpetrators, according to Barbara Bate, president of the Washington Chapter of the National Alliance of Mental Illness.

Bate added that up to 90 percent of the people with a mental illness get better when they receive appropriate treatment. But about half of those who need help don’t get it, primarily because of a lack of access to medical care or unwillingness to seek treatment because they fear being stigmatized, she said.

“We don’t have a publicly funded mental health care system. We have a publicly funded mental illness system,” county Human Services Director Ken Stark said.

State-funded services often are available only to those who have serious mental illnesses, he said.

“People have to establish negative symptoms before they are seen,” Stark said.

A national study released earlier this year found that 14.5 percent of the men and 31 percent of the women booked into jail suffer from a serious mental illness. That is three to six times higher than in the general population, according to researchers working with the Council of State Governments Justice Center.

Approximately 24 percent of the people booked into the Snohomish County Jail have mental health issues and about 6 percent have a serious and persistent mental illness, said Stark. Meanwhile about 70 percent of the people booked into the jail have some sort of drug or alcohol addiction, he said.

“Has the jail become the largest mental health facility in the county? I would say there are a lot of people with mental health issues in the jail. Is it the majority? No,” Stark said.

The jail is not intended to be a mental health hospital, said Greg White, the lockup’s lead mental health professional.

“It’s not our primary purpose, but by default we are faced with inmates who must be monitored and managed. We do what we can do,” he said.

The jail offers a transition program intended to connect mentally ill offenders with resources before they leave jail. The program hopes to eliminate lapses in services, White said. The program is voluntary, and often those who refuse the help end up back in jail, White said.

Miller and Sands were sentenced last month in Snohomish County Superior Court for separate crimes.

Miller, 22, beat Shirley Sweeton to death in June in her Marysville home. He quickly pleaded guilty to first-degree murder and was sentenced to more than 23 years in prison. Co-defendant Joshua Gilliam, also charged with murder, is scheduled to go to trial later this year.

Court documents paint a picture of Miller as a young man who began his journey into the mental health system at age 10. Miller was removed from his mother’s care after her boyfriend kidnapped the family. Even as a boy he was sent to psychiatric hospitals and group homes. He’s been diagnosed as having paranoid schizophrenia and bipolar disorder. He also has disabilities that his treatment providers say have left him with sub-average intelligence, court records show.

Community corrections officers and mental health professionals predicted that it was only a matter of time before Miller seriously injured someone. His mother last year told a social worker she didn’t think it was safe for him to be free and unsupervised, but no one would help, court papers said.

A caseworker in 2008 said that Miller needed to be confined in a facility where he could receive drug treatment, anger management counseling and other services. There was no place for Miller to go, the woman said. Instead the caseworker checked on Miller twice a day and on the weekends while he lived at a Marysville group home.

Miller began a downward spiral earlier this year when his caseworker left her job at Compass Health. He was evicted from two group homes and ended up at a homeless shelter. He stopped taking his medications and began spending his disability checks on drugs.

Miller once told a community corrections officer he knew that it was wrong to do drugs but they helped him make friends, court documents said.

Miller met Gilliam at the shelter. Gilliam once had lived with Sweeton while he was dating her granddaughter.

“He was left adrift in the system,” Tarantino said of Miller.

Miller received help and shelter when he was docile and compliant. He had nowhere to go when his behavior became erratic, a symptom of his mental health problems, Tarantino said.

“Seemingly at every turn there were recommendations for intensive services that would have protected both (Miller) and the community from exactly the kind of crime he is now charged with. However, one gets the sense that the agencies charged with upholding those protections did not want the burden of Ryan Miller, and so as a matter of convenience the buck was passed again and again,” Eric Johnsen, a social worker, wrote in a report to the court.

Johnsen works for the Snohomish County Public Defender Association. He does evaluations of clients in the initial stages of prosecution and also identifies and proposes alternative sentences.

Miller’s case highlights a flawed system that failed to serve a mentally ill man and protect the community, Johnsen wrote.

“Maybe if people received treatment we wouldn’t have these outcomes,” Stern said. “I’m not criticizing anything people in the community are doing ... They are understaffed and underfunded. We are so frustrated that so many are coming through the criminal justice system with mental health issues.”

Stern also prosecuted Jody Sands, 34, for the murder of Albert Beasley.

Sands, who has paranoid schizophrenia, wasn’t taking his medication and was hallucinating when he bludgeoned his grandfather. Investigators don’t know what provoked the attack.

Prior to the killing, there was no indication that Sands could be violent, his attorney Caroline Mann said.

He’d been hospitalized on several occasions. Two months before killing his grandfather, Sands was ordered back to the Mukilteo Evaluation and Treatment Center.

Sands had become hostile at home and broke a mirror. Police were called. He was subdued after officers twice shot him with an electric stun gun. Sands was taken to an emergency room and strapped to a bed. He later was taken to the Mukilteo facility, where staff reported that he appeared to be experiencing hallucinations. Two weeks later he was released by the court without any further oversight, court papers said.

His next contact with authorities came the morning he called 911 reporting that he’d hit his grandfather in the head with the blunt side of an ax.

Albert Beasley, 87, died about a week later.

The killing occurred in 2007. On three separate occasions in the years that followed, Sands was deemed incompetent to stand trial. He received treatment, and doctors ultimately decided he was capable of helping in his defense.

In June and July, during his trial, Sands denied that he had any mental illness. He refused to be evaluated by a mental health expert who wasn’t on the state’s payroll. He also refused to allow Mann to pursue an insanity defense.

Sands doesn’t believe he’ll be imprisoned beyond Dec. 21, 2012 — the last day of the Mayan calendar and the day Sands is convinced the world will end.

Krese sentenced Sands to eight years in prison, a term about four years below the standard range. The judge found that Sands’ mental illness was a mitigating factor that significantly impaired his ability to understand his actions or behave in accordance with the law.

She also ordered him to be on community supervision for five years after he’s released from prison.

At Mann’s urging, Krese also ordered that Sands undergo evaluation for possible civil commitment to the state’s mental health hospital before his release.

Mann said she is concerned that Sands won’t get the treatment he needs in prison. He truly believes the world is going to end in 2012, and Mann worries he may end up in crisis when his belief is proven false.

“I just wish there was a third path between prison and Western State Hospital. There needs to be some alternative to prison, possibly a prison hospital,” Mann said. “They just don’t have the mental health resources in prison.”

Part of the answer is spending more on prevention and intervention efforts, said Jim Bloss, the president of the county’s chapter of National Alliance of Mental Illness.

“We need to quit spending money on more jail cells and prisons and pump money into the beginning — trying to catch kids in school or those with early signs,” Bloss said.

Early intervention may prevent some tragedies, Stark said. In some cases, however, people refuse help. They don’t want to take medication or follow through with treatment.

One of the biggest challenges is balancing the rights of an individual with those of the community, Stark said. There is strict criteria for committing a person against his will to a hospital.

Stern understands the dilemma.

“I don’t want to lock people up because they’re mentally ill, but I also want to be careful about community safety and holding people accountable,” he said.

Just because someone is mentally ill it doesn’t mean that they can’t be a criminal too, said White, who leads the jail’s mental health program.

The solutions are not easy or cheap, experts agree.

“We do have pieces of a system,” Stark said. “We still have a lot of people in emergency rooms who probably don’t belong there and people in jail who probably don’t need to be there either.”

A committee recently made recommendations to the county executive about how to spend money generated by an increase in sales tax that took effect April 1. The county council approved the tax, an extra penny for every $10 spent, specifically to fund services and create new ways of helping drug addicts and people living with mental illness.

One option being discussed is creating triage centers where law enforcement could take people for treatment instead of hauling them to jail or emergency rooms.

“With the sales tax dollars there is much more flexibility to use the money to improve the outcomes in the county for drug and alcohol and mental health problems,” Stark said. “We’re hoping to plug some of the gaps with that money. There are still going to be holes.”