It was a bitter pill to swallow but a nurse will be able to work again in his profession after accepting that he has a physical mental illness.
The hearings over the past four months were eye-openers. At one point the deputy prosecutor and public defender, along with psychiatrists, a forensic psychologist, probation officers, and a volunteer mental health worker, all stood before Judge Kathleen Watanabe in support of a treatment plan for the defendant.
The story started last April. A 32-year-old male came to Kauai for an extended break and suffered a manic episode. Police were called after he exhibited strange behavior.
He tried to escape police and was arrested. While at cell block the man struck an officer so hard he sent him to the hospital.
The odd part was that this was the first time the man had ever exhibited psychotic behavior, according to statements in court. With $10,000 bail he sat in custody at Kauai Community Correctional Center awaiting trial on felony charges and possibly more than 10 years in prison.
The defense attorney requested a fitness for trial motion before they could proceed. A panel of three doctors would determine the defendant’s ability to understand his situation and if he was competent at the time of the offense.
The Kauai Chapter of the National Alliance on Mental Illness was instrumental in coordinating an effort for supervised release. The deterioration of the defendant was a concern but the court couldn’t release him until a suitable living situation was arranged.
Doctors with Kauai Community Mental Health Center admitted the defendant to KCMHC. They designed a treatment plan that the court would agree satisfies the conditions of supervised release, while also addressing the concerns of the Department of Public Safety.
A month later, the court ruled with the panel and found the defendant was fit to proceed to trial. However, the evidence showed the defendant was affected by a physical or mental disease, disorder or defect at the time the offense was committed.
The court excluded the defendant from penal responsibility after finding that he suffered from a substantial impairment of capacity to conform his conduct or appreciate that his actions were wrongful at the time.
At this point the usual process is to keep the defendant committed to the State Hospital or other inpatient arrangement until a future review for restorative fitness could be conducted. In this case, the reports noted that as long as the defendant was practicing his mental health regimen then he presented a low risk of danger.
The defense presented NAMI again as a crucial partner for providing space and volunteer supervision. The court was not familiar with the volunteer support network but granted the motion after statements from professional mental health workers satisfied concerns about the liability and effectiveness.
The doctors said NAMI is a positive force as a support, education and grassroots advocacy organization that is dedicated to improving the lives of people affected by mental illness and also their loved ones.
The court released the defendant to a social worker, with conditions that he make weekly contact with probation officers and follow through with his mental health plan including a dual diagnosis group and NA/AA meetings three times a week.
In early July the defendant appeared for his jury-waived stipulated fact trial that resulted in an acquittal of all charges. The court granted a motion for supervised release after hearing reports of progress and improved conduct.
Attorneys and doctors stated that the defendant continued to follow his health plan and cooperate with KCMHC. The key for the court was evidence that the defendant could live in the community without presenting a danger to himself or others.
Nearly a month later the defendant was found in full compliance and the court granted a motion that would allow the defendant to leave the jurisdiction of 5th Circuit. He can now return to the mainland with a job, financial stability, a home, nearby support of family and continuing care.
The forensic psychologist said that only twice in all his years on Kauai did he suggest to the court that a patient was not likely to reoffend. This appeared to be a one-time bi-polar event, he said, and the type of illness, with medication and treatment, does not present a continuing physical degradation of the brain which is why he would be able to continue working as a transplant nurse.
The judge complemented the stakeholders involved for their cooperation in shaping an agreement that works not just in the best interest of the defendant’s health and welfare, but also satisfies the legal conditions needed to approve such requests.
If the motion was not consistent with the doctors statements in the fitness examination then the court would have denied the request and attorneys could then call for a new fitness motion, Watanabe said. With the motion granted, any new offense would be treated as a new event in another jurisdiction, and is not a violation of supervised release on Kauai.
With all of this support it was the defendant himself who made the difference in helping to preserve his life and move forward. He initially fought the diagnosis as an adult who never exhibited psychotic behavior and eventually came to terms with it and that it will require lifelong medication and treatment.
• Island Crime Beat is a weekly column that reflects on the current events and issues regarding the police, courts and criminal justice system of Kaua‘i.
