Flawed System to Screen Inmates Before Release

By MICHAEL SCHWIRTZ, MARC SANTORA and PAM BELLUCK. / New York Times News Service

Published Jun 7, 2014 at 06:36PM

During much of his five years of incarceration for choking his mother with an electrical cord, Daniel St. Hubert was prone to aggressive outbursts and violence, assaulting inmates and correctional workers. It took three years before he was even deemed psychologically fit to stand trial.

After years of mandatory therapy designed to stabilize him, he began to show signs of improvement: In the last six months, he had citations only for minor infractions like keeping a messy cell, officials said. And the last time he was cited for violent conduct was March 29, 2013.

But there was little that correction officials could do to ensure that St. Hubert received the therapy he needed outside the prison walls.

Nevertheless, on May 23, after a standard psychiatric evaluation, he was released.

Once out of prison, he was on his own. If the authorities’ suspicions are borne out, within a matter of days he had come apart, carrying out a bloody rampage through New York that left at least one person dead - a 6-year-old boy.

The numbers of inmates with mental illness have surged in jails and prisons across the country in recent years, and enormous resources are spent ensuring that they are competent to stand trial and stable while incarcerated. But as St. Hubert’s case underscores, the process of making sure they are fit to return to the community can be haphazard. Correction officials and mental health providers have to navigate between civil liberties protections and concerns for public safety, as well as the reality that the vast majority of people with mental illness are not violent.

For the most difficult cases, New York has more tools than do most states, including Kendra’s Law, which allows authorities to order people to receive outpatient treatment if they have a history of violence or repeated hospitalization and have rejected treatment in the past.

But there are many ways for mentally unstable people who might be dangerous to slip through the cracks. The safety net is particularly porous for those newly released from prison, experts said.

“Here is a person that has severe mental illness for many years, who tried to kill his own mother, who showed a propensity to violence,” state Sen. Catharine Young, R-Olean, who has pushed to expand treatment for the mentally ill, said of St. Hubert. “Every single danger was present, and it’s hard to believe that no one followed up when he was released from prison.”

State officials say roughly 3,500 inmates with mental illness are released from New York state prisons every year. Treatment for them can range from intensive to nonexistent.

For the most volatile cases, corrections officials have the option of involuntarily committing inmates to an inpatient psychiatric facility even after their sentences have been served. Two criteria must be met: a diagnosis of a mental illness requiring care and treatment, and a substantial risk of physical harm to themselves or others because of the mental illness.

The other option available is to put them in a mandated treatment program under Kendra’s Law, which was passed in 1999 and was named for a woman who was killed when a schizophrenic man pushed her into the path of a subway train.

Of the 45 states with outpatient-commitment laws, New York has by far the strongest. New York has invested about $32 million a year for people under court orders, and about $125 million for enhanced outpatient mental health services for other people who need them.

The law was strengthened in 2013 to allow for longer-lasting court orders and to require some criminals to undergo a mandatory evaluation before leaving prison. Studies have found that the orders have resulted in fewer rehospitalizations, fewer arrests, more refills of prescribed medications and more use of outpatient mental health services.

Even so, it is not widely applied. Since 1999, 11,700 people, many of whom are not former prisoners, have received outpatient-commitment orders; roughly 2,100 people are currently under such orders.

James Gilligan, a clinical professor of psychiatry who has conducted psychiatric evaluations for the Massachusetts prison system, said involuntary commitment was rarely used, out of what he described as an overabundance of fear of violating a person’s civil rights.

“There is such a revulsion against the old system of huge mental hospitals where people could spend years, that the pendulum has swung in the other direction,” Gilligan said.

St. Hubert did not fit any criteria for involuntary treatment, according to two state officials familiar with his record. They declined to say specifically why he would not qualify, citing privacy concerns, but suggested that his relatively good behavior in the months before his release would have been considered.

Upon release, St. Hubert was supposed to adhere to a list of conditions to be monitored by a parole officer. These included submitting to drug tests and participating in anti-aggression and anti-violence counseling. State officials said psychiatric care would have been “made available to him,” but they did not go into specifics. They declined to say if he had been directed to a psychologist or was on medication.

Judith Perry, St. Hubert’s sister, who saw him several times during the period he was free, said Friday that - as far as she knew - her brother was on no medications while in prison or after his release. She declined to go into detail about his mental health history or to speak about any past diagnosis, but she said no effort was made to get him help. “They did not set anything up,” she said.

As required, he met with his parole officer three times after his release. His last meeting was Tuesday, two days after authorities said he stabbed Prince Joshua Avitto to death and critically wounded the boy’s 7-year-old friend Mikayla Capers in an elevator of the Boulevard Houses in Brooklyn. Authorities also suspect that after his release from prison, he stabbed and critically wounded a 53-year-old man on the platform of a subway station and fatally stabbed an 18-year-old woman in Brooklyn.

While in police custody after his arrest this week, a law enforcement official said, St. Hubert made no “substantive” remarks to detectives regarding the knife attacks but did rant about the devil.

In a court appearance Friday, St. Hubert sat silently. His lawyer, Edward Friedman, said after the hearing that there was “nothing particularly different” that he noticed about his client in their brief initial meeting.

Asked if a defense based on mental illness would be considered, Friedman said, “Everything is up for exploration at this point.”

(STORY CAN END HERE. OPTIONAL MATERIAL FOLLOWS.)

Cases of released inmates with mental illness killing other people abound. In 2012, William Spangler Jr., who spent 17 years in prison for killing his grandmother with a hammer, ambushed a group of firefighters in western New York, killing two, before shooting himself. In 2010, Alejandro Morales, who had schizophrenia, fatally stabbed a 9-year-old boy in an apartment in Upper Manhattan. He had been paroled from prison months earlier after serving five years for assault.

Officials from the state’s Office of Mental Health and its Department of Corrections and Community Service said they were conducting an extensive review of their operations and would be assessing existing statutes, regulations, procedures and processes to develop recommendations in response to the issues raised in the case of St. Hubert.

On Friday, state . Young introduced legislation to further expand Kendra’s Law in hopes of closing loopholes.

“Here’s a crack you can drive a truck though,” she said. “And as a result we have a dead child and a child fighting for her life.”