Media and Mental Illness

The Los Angeles Times newspaper report was horrific. In an eruption of primordial rage, 34-year-old Raphael wielded a sharp-edged, bowed samurai sword to exact his rage on Karina for rejecting him. On a sunny California afternoon, in broad daylight, Rafael savagely slashed and bludgeoned Karina to death with such frenetic viciousness that he almost beheaded his former lover.

During his trial, the prosecution argued that the defendant was solely motivated by a revenge-filled vendetta for having been rejected. The defense attorney claimed that his client was mentally ill at the time of the killing. The jury found Raphael guilty of first-degree murder and the judge sentenced him to 25 years to life.

Was the defendant mentally ill or simply vengeful and wildly violent? It’s impossible to reach an informed impression from the Times’ account, as it was devoid of crucial pieces of information required before the reader could begin to understand the motivation driving such abject violence. And, by virtue of omission, its storyline was misleading.

The Times reported that Rafael underwent a mental competency evaluation and was found fit to stand trial. The article immediately followed with statements by the prosecutor, who asserted that “mental health had nothing to do with this case” and that the defendant “was perfectly sane at the time of the killing,” without mentioning if he was actually found to be sane by the court.

Any reader naive in criminal law is unwittingly eased into conflating the concepts of competency to stand trial and insanity. In fact, the legal roads that must be traversed before a judge or jury can reach those determinations are vast and consequential.

To be competent to stand trial, defendants must be able to understand the charges against them, have a rudimentary awareness of court procedures (i.e., know the job of the jury), and be capable of speaking with their attorney in a reasonably rational manner to prepare a defense. The standard to meet competency sets a fairly low bar, especially compared to the standard for insanity. It is a fairly straightforward assessment of the defendant’s basic functional abilities at the time the evaluation is completed.

To be found insane, defendants must be found to have suffered from a mental disease or defect at the time of the offense, and that a disordered mind interfered with one’s rational ability to know and understand that the criminal conduct was legally or morally wrong.

An insanity examination is an enormously more complicated endeavor. It requires the forensic psychologist to explore, in detail, the circumstances surrounding the offense and to closely investigate the defendant's thoughts and emotions, motivations, and intentions, at the time of the offense. As you might well imagine, it’s an intensely emotional and psychologically demanding experience for both participants. To begin an insanity evaluation requires the examiner to first establish a rapport with the defendant in order to prepare for the task ahead, which includes a detailed account of the defendant’s development and personal history, and his psychiatric and medical history. Then, the psychologist and defendant are in a position to collaboratively embark on the difficult, fraught-filled, and unpredictable exploration of the defendant’s thoughts that accompanied the offense.

In addition to such extensive interviewing, the forensic psychologist will typically administer a battery of psychodiagnostic tests, which includes measures to identify symptom exaggeration and malingering, cognitive or possibly neuropsychological testing, and personality testing. Also, the examiner conducts interviews with family members, prior treatment professionals, and others who might provide pertinent information about the defendant. Before all of this begins, the examiner completes an extensive review of medical and legal records.

Unlike an insanity evaluation, competency assessments are typically completed in one setting, with a personal interview and the use of a structured competency assessment instrument. In some cases, limited psychological testing may be helpful. All that is required is an assessment of the defendant’s functional abilities at the time of the evaluation.

The Times’ account of the killing provided no information on the defendant’s personal or mental health histories, both of which are crucial. Did he have prior episodes of violence? Does he have a criminal record? If he was previously violent, was he irrational or psychotic during those incidents, or might it reflect an impulsive personality? Did Raphael’s attorney in fact have him undergo an insanity evaluation for killing Katrina? Given the very bizarre circumstances of the crime, the chosen weapon, and the context—a samurai sword in broad daylight with multiple witnesses—the possibility of a severe mental illness seems like a possibility.

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Even the peculiarly strange circumstances of the crime do not ipso facto imply a successful insanity defense for Rafael. For instance, he could have been in a psychotic state at the time of the attack, yet aware that his actions were morally and/or legally wrong.

My point here is that the media generally does a very poor job of reporting on mental illness when it comes to criminal behavior, or of helping readers in their understanding of the complex nexus between mental illness and the law. It would have been helpful to simply note in this column that there is a difference between competency and insanity, especially since the reporter quoted the prosecutor’s comments on the defendant’s sanity.

It has become increasingly clear to the media and public at large that mental illness is a significant contributing factor that drives many criminal offenses. It’s also apparent that media outlets would do well by their readers to provide the necessary information, not only on the defendant’s criminal conduct, but also include an accurate description of the court’s criminal procedures in dealing with a defendant whose mental state is at play. Only then can readers develop a fuller understanding and appreciation of the complexity behind these human tragedies, especially ones as heinous as the one I described here.