ILNews

Indiana courts grappling with requirement to use psychiatrists in insanity evaluations

Back to TopCommentsE-mailPrintBookmark and Share

Although members of the Indiana Legislature’s Commission on Courts appeared to be skeptical of a proposal to revise the statute concerning insanity evaluations, their concerns may be trumped by the need to be pragmatic.

Currently, courts in Indiana are required to appoint at least one psychiatrist to the team evaluating criminal defendants who enter a plea of insanity. However, judges say they are having trouble finding psychiatrists who are both qualified and willing to do the evaluations.

Courts in Evansville and Fort Wayne only have one psychiatrist in each community that they can call upon for help. Fitting the evaluation into one the doctor’s schedules can be difficult. If the lone psychiatrist in the area is too busy or has a conflict of interest, then these courts must look (and pay an added expense) for psychiatrists in other counties.

All the while, the accused usually wait in jail.

“It’s a nightmare,” said Beverly Corn, public defender for Vanderburgh County. “We’re talking months before an evaluation. We’re not talking days or a few weeks. We’re talking months.”

As a way to address long delays, the Indiana Psychological Association has proposed that the General Assembly eliminate the requirement for a psychiatrist from the statute. Doing so would give courts more flexibility by allowing them to appoint a team of only psychologists and help alleviate the problems caused by too few psychiatrists.

The association presented its idea during the Sept. 24 hearing of the Commission on Courts.

Already, Indiana’s statute provides courts with the option of also including a psychologist or physician in the evaluation. Psychologists receive an extensive amount of academic as well as clinical training and are well-qualified to assess the mental health of defendants, the association told the commission members.

However, Dr. George Parker, a certified forensic psychiatrist and associate professor of clinical psychiatry at Indiana University School of Medicine, argued against making the statutory change. He maintained that because of their medical school training, psychiatrists are “uniquely qualified” to assess any medication issues and physical conditions of the defendants being evaluated.

The members of the commission seemed to agree.

Indiana Supreme Court Chief Justice Brent Dickson pointed to the growing use of medications and drugs and questioned if psychologists have enough knowledge of pharmacology. Likewise Rep. Patrick Bauer, D-South Bend, bluntly stated he did not think a psychologist had the necessary training in chemicals or brain functions to be a “worthy substitute” for a psychiatrist.

Psychiatrist shortage

The commission’s discussion did not offer any alternative solutions for the shortage that is presently plaguing the state courts.

Indiana is not alone in grappling with the problem of finding psychiatrists. Across the country the number of these specialists is decreasing as medical school graduates choose the more lucrative practices in order to pay their school loans.
 

pigman-robert.jpg Pigman

As a long-term remedy, Vanderburgh Superior Court Judge Robert Pigman is unsure what the courts could do. In Evansville, the judiciary has reached out to every medical practitioner and has spoken to the local medical association trying to recruit more psychiatrists to do evaluations.

Although insanity pleas are very rare – totaling maybe 10 out of the roughly 33,000 felony cases handled each year in Vanderburgh County – when they are filed the court has only one psychiatrist available. And if that doctor cannot do the assessment, then the court has to tap the psychiatrist 55 miles up the road in Knox County.

The situation can become more complicated if members of the evaluating team submit contrary findings. Then the court has to schedule time during the jury trial for the experts to appear. With psychiatrists as well as psychologists having full calendars, Pigman said the court may have to deviate from the requirement that testimony be given after the close of evidence.

Pigman would like to see the Legislature remove the mandate for psychiatrists. This could ease some of the stress, he said, while still giving courts the option of appointing a psychiatrist if deemed necessary.

North in Allen County, the situation is much the same. Only one local psychiatrist is willing to evaluate defendants for the court and when that individual is not available, the county has to rely on a psychiatrist in Indianapolis.

Given the time it takes for the court to find a psychiatrist and appoint an evaluating team, coupled with the difficulty of scheduling the assessment and allowing time for the professionals to submit their reports, Fort Wayne attorney Michelle Kraus said the process is moving well if the report comes back 90 days after filing the petition.

Kraus asserted courts should not be bound by a requirement for a psychiatrist or have to pay attention to titles. Rather, the court should be allowed to enlist the help of the best qualified experts and appoint the professional it deems most qualified.

Competency

Two years ago, the General Assembly relaxed the rules on competency evaluations, removing the requirement that a psychiatrist be appointed there as well. The result, many say, has been good.

Even Parker said he has not noticed a significant impact on his practice since the change in the law. Yet, speaking after the commission hearing, he emphasized competency evaluations have a safety net in that the individual deemed not competent will be sent to a psychiatric hospital for observation and treatment.

“It’s not the same for insanity evaluations,” he said. “Once the jury or judge decides that somebody was or was not insane, it’s done, except for appeal. So it’s a higher stakes evaluation, the insanity evaluation.”

Fort Wayne forensic psychologist Stephen Ross said the psychiatrists are using the same arguments now that they made against changing the competency statute.

Most insanity evaluations do not need someone with extensive medical training, he said. Psychologists have the skills to do the retrospective analysis that is required in insanity evaluations.

When Ross evaluates a defendant, he reviews all the available records from physicians, schools and the Department of Correction. He also talks to family members and others who are close to the individual. Then he will spend upwards of an entire day with the defendant, administrating a battery of tests and taking two to three hours to interview.

“The important thing is that you need to be thorough in the evaluation and make sure you look at all the data because you could be setting up for an appeal if the evaluation has defects,” he said.

Parker said he will try to determine if mental illness played a role by interviewing the defendant and looking at the pertinent records.

He conceded that cases where a physical condition has caused a change in a person’s mental state come along maybe once every two or three years. But they do occur, and the evaluation can mean the difference between the defendant being found not guilty by reason of mental defect or guilty but mentally ill.

Although Corn sees a statutory change as making the process more efficient, she maintained psychiatrists should still provide evaluations in capital cases. There, the medical training and understanding of biology would “add just a little bit more.”

When the punishment is the most severe, the attorneys and courts have a “moral and legal duty” to bring in every person necessary to educate and help the jury make a good decision, she said.

Second guessing

As for credentials and training, Pigman said he understood the argument in favor of psychiatrists who have the medical background while psychologists do not.

“That is a concern and I think that is a legitimate concern,” he said. “On the other hand, this is a real practical problem in the state.”

Pigman noted that he believes psychologists have more in-depth training in cognitive and behavioral studies than psychiatrists. Kraus concurred. In her experience, she said, the psychologists spend hours evaluating the defendant before issuing a report, while the psychiatrists have based their opinion only on the 40 minutes they spent talking to the individual.

Allen Circuit Court Judge Thomas Felts serves on the Commission on Courts and heard the testimony by both sides. He indicated he was undecided but he did understand the need to be pragmatic.

“I do note, just from the availability standpoint, that it seems more beneficial to have more qualified people be they psychologists or psychiatrists,” he said. “If this proposal would make that available number higher, I would generally be in favor of that unless I could find some reason not to.”

Sometimes, Corn said, because of the wait to be evaluated, people just give up. The defendant may have been in jail long enough to receive treatment so he or she becomes able to participate in the trial. These cases produce lingering questions that nag at the attorneys about whether or not they did a disservice.

“I think everybody walks away second guessing themselves,” Corn said.•

ADVERTISEMENT

Post a comment to this story

COMMENTS POLICY
We reserve the right to remove any post that we feel is obscene, profane, vulgar, racist, sexually explicit, abusive, or hateful.
 
You are legally responsible for what you post and your anonymity is not guaranteed.
 
Posts that insult, defame, threaten, harass or abuse other readers or people mentioned in Indiana Lawyer editorial content are also subject to removal. Please respect the privacy of individuals and refrain from posting personal information.
 
No solicitations, spamming or advertisements are allowed. Readers may post links to other informational websites that are relevant to the topic at hand, but please do not link to objectionable material.
 
We may remove messages that are unrelated to the topic, encourage illegal activity, use all capital letters or are unreadable.
 

Messages that are flagged by readers as objectionable will be reviewed and may or may not be removed. Please do not flag a post simply because you disagree with it.

Sponsored by

facebook - twitter on Facebook & Twitter

Indiana State Bar Association

Indianapolis Bar Association

Evansville Bar Association

Allen County Bar Association

Indiana Lawyer on Facebook

facebook
ADVERTISEMENT
Subscribe to Indiana Lawyer
  1. So that none are misinformed by my posting wihtout a non de plume here, please allow me to state that I am NOT an Indiana licensed attorney, although I am an Indiana resident approved to practice law and represent clients in Indiana's fed court of Nth Dist and before the 7th circuit. I remain licensed in KS, since 1996, no discipline. This must be clarified since the IN court records will reveal that I did sit for and pass the Indiana bar last February. Yet be not confused by the fact that I was so allowed to be tested .... I am not, to be clear in the service of my duty to be absolutely candid about this, I AM NOT a member of the Indiana bar, and might never be so licensed given my unrepented from errors of thought documented in this opinion, at fn2, which likely supports Mr Smith's initial post in this thread: http://caselaw.findlaw.com/us-7th-circuit/1592921.html

  2. When I served the State of Kansas as Deputy AG over Consumer Protection & Antitrust for four years, supervising 20 special agents and assistant attorneys general (back before the IBLE denied me the right to practice law in Indiana for not having the right stuff and pretty much crushed my legal career) we had a saying around the office: Resist the lure of the ring!!! It was a take off on Tolkiem, the idea that absolute power (I signed investigative subpoenas as a judge would in many other contexts, no need to show probable cause)could corrupt absolutely. We feared that we would overreach constitutional limits if not reminded, over and over, to be mindful to not do so. Our approach in so challenging one another was Madisonian, as the following quotes from the Father of our Constitution reveal: The essence of Government is power; and power, lodged as it must be in human hands, will ever be liable to abuse. We are right to take alarm at the first experiment upon our liberties. I believe there are more instances of the abridgement of freedom of the people by gradual and silent encroachments by those in power than by violent and sudden usurpations. Liberty may be endangered by the abuse of liberty, but also by the abuse of power. All men having power ought to be mistrusted. -- James Madison, Federalist Papers and other sources: http://www.constitution.org/jm/jm_quotes.htm RESIST THE LURE OF THE RING ALL YE WITH POLITICAL OR JUDICIAL POWER!

  3. My dear Mr Smith, I respect your opinions and much enjoy your posts here. We do differ on our view of the benefits and viability of the American Experiment in Ordered Liberty. While I do agree that it could be better, and that your points in criticism are well taken, Utopia does indeed mean nowhere. I think Madison, Jefferson, Adams and company got it about as good as it gets in a fallen post-Enlightenment social order. That said, a constitution only protects the citizens if it is followed. We currently have a bevy of public officials and judicial agents who believe that their subjectivism, their personal ideology, their elitist fears and concerns and cause celebs trump the constitutions of our forefathers. This is most troubling. More to follow in the next post on that subject.

  4. Yep I am not Bryan Brown. Bryan you appear to be a bigger believer in the Constitution than I am. Were I still a big believer then I might be using my real name like you. Personally, I am no longer a fan of secularism. I favor the confessional state. In religious mattes, it seems to me that social diversity is chaos and conflict, while uniformity is order and peace.... secularism has been imposed by America on other nations now by force and that has not exactly worked out very well.... I think the American historical experiment with disestablishmentarianism is withering on the vine before our eyes..... Since I do not know if that is OK for an officially licensed lawyer to say, I keep the nom de plume.

  5. I am compelled to announce that I am not posting under any Smith monikers here. That said, the post below does have a certain ring to it that sounds familiar to me: http://www.catholicnewworld.com/cnwonline/2014/0907/cardinal.aspx

ADVERTISEMENT