Jail is supposed to be a temporary affair. If bail is too expensive, defendants are held until they are sent to prison, or freed. The average length of stay in St. Louis jails is 233 days. That includes people serving short-term sentences.
Then there's the rare case of 37-year-old Calvin D. Brown.
Although he's been convicted of a murder in which he nearly cut off his grandmother's head, he still sits in the St. Louis City Justice Center downtown going on his seventh year.
Brown illustrates how the wheels of justice are slowed when dealing with defendants who may have extreme mental illness. Multiple judges, attorneys and medical experts have been bogged down on a murky path forward for Brown, who has largely refused to cooperate along the way.
If he does suffer from a severe mental illness, his case illustrates the worst-case implications of an untreated disease. It speaks to the issue of mixing the mentally ill with the criminally accused.
And it shows why courts increasingly look for signs of mental illness to get early treatment for people accused of crimes. An effort to establish a dedicated “mental health court” is underway in St. Louis.
Brown was a previous offender who first entered the prison system as a teenager. For years after his latest arrest in 2008 for murder and armed criminal action, he refused to see his public defender and family. A doctor hired by his defense early on to evaluate Brown's fitness for trial also struggled.
The doctor, John Rabun, wrote in February 2010 that Brown didn't participate in two separate interviews. Instead, Rabun “reviewed Mr. Brown's medical records and noted he has a history of suffering from a mental disease.”
Rabun noted that he and a jail social worker “discussed how it was possible Mr. Brown's behavior had deteriorated because of his mental disease and this deterioration was leading to his present refusal to speak.”
Five months later, Richard Scott, a forensic examiner for the Missouri Department of Mental Heath, tried to meet with Brown for a pretrial evaluation. Brown had to be forced from his cell. When he finally arrived, he reeked, and frequently belched.
He told Scott that jailers were trying to poison him with medication. He denied any history of substance abuse, despite previously pleading guilty to various drug crimes. He laughed at questions about homicide or suicide. And he refused to discuss his pending case, telling Scott that he was going to stay in his cell until he was allowed to go home.
At least once, Brown has rolled in feces to avoid showing up in court.
“The defendant could be psychotic or hypomanic or he could be intentionally refusing to cooperate and disrupting the legal process as a way to avoid facing criminal charges,” Scott wrote.
Scott ultimately asked for an in-patient evaluation. Since then, Brown has been on a merry-go-round of examinations and treatment, including stays at the Fulton State Hospital.
Once he's stabilized, he is returned to jail. His condition seems to worsen once he's back in jail.
Handicapped or Shrewd?
In Circuit Court, in Judge John Garvey's eyes, Brown was competent enough for a bench trial in November 2013. Still, after rendering a guilty verdict, Garvey allowed the defense to pursue a new round of examination.
It was determined that, indeed, Brown had been competent at trial. He is scheduled to be sentenced in August.
While some have questioned whether Brown has been malingering in the criminal justice system, it hasn't been proved.
Told about the case, Dar Walker, executive director of the St. Louis chapter of the National Alliance on Mental Illness, said mental disease can be complex because of the lack of absolutes.
“When people are symptomatic, there are things going on in their mind that aren't discernible,” he said. “It could be half and half. It could be he is severely handicapped with his symptoms but shrewd enough to get what he wants.”
Brown faces a sentence of life in prison without parole in the Nov. 11, 2008, killing of his grandmother, Clara Little, at her home in the 4000 block of Cora Avenue in north St. Louis. He attacked her with a kitchen knife after discussing a photo on the wall of her receiving a plaque. He was arrested soon after.
Mental Health Court
With a trend in recent decades to close state mental health institutions, jails and prisons now provide the largest psychiatric wards.
For that reason, in 1997, Judge Stephen Manley created one of the nation's first mental health courts, in Santa Clara County, Calif.
“We were getting terrible outcomes — too many people incarcerated and repeat offenses,” Manley said. “We were doing nothing to intervene. You should punish people in appropriate cases. I do it all the time. If you don't try to change the behavior, you don't get anywhere.”
Qualifying offenders are diverted to treatment in the community.
“There is no guarantee that this is going to stop a murder, none at all, but there is a guarantee that at least we know what is going on with people and know they are getting treatment,” he said. “If they don't follow through, that's on them. We monitor them, keep pushing them to follow through.”
Plans are being made to create a mental health court in St. Louis by October for misdemeanor and some low-level felony crimes.
Felix Vincenz, associate director of the Missouri Institute of Mental Health at the University of Missouri-St. Louis, is involved with the project, along with the likes of NAMI, BJC Behavioral Health and state officials. It will be similar to specialty courts already in place for veterans and drug addicts.
Vincenz said 16 percent of Missouri prisoners receive clinical care or are on medication for mental illness. (The Department of Corrections also reports that more than half the prison population has “mental problems”).
“Many of these folks don't need to be there,” Vincenz said.
He said schizophrenia, bipolar disorder and major depression should be viewed through the lens of illness, not criminality. Most people with mental illness are not violent. Trespassing or disturbances are frequent crimes they are charged with.
“They are just being sick,” Vincenz said. “Unfortunately, being sick can result with what the rest of us see as public nuisances.”
Vincenz said the mental health court would enable some defendants to be diverted from unnecessary incarceration into more appropriate forms of treatment while still subject to the leverage that the criminal courts provide.
“Individuals who can gain access to treatment can be prevented from having further deterioration that can result in more and more problematic behavior for themselves and others,” he said.
Jesse Bogan, a 2014 John Jay/Langeloth Mental Health & Justice Reporting Fellow, writes for the St. Louis Post-Dispatch. The above is an abridged version of a story published in the Post-Dispatch earlier this month. For the full version, please click HERE. Jesse welcomes comments from readers.