The state’s lack of money for mental-health care was the elephant in the courtroom during an April 10 Augusta hearing in which a judge decided Riverview Psychiatric Center patient Michael James should be sent back to the Maine State Prison. (James was the subject of a Phoenix cover story, “Locking up the mentally ill,” on April 4.)
Riverview chief psychiatrist Brendan Kirby told Superior Court justice Donald Marden that the institution was looking closely at which patients should be there. The hearing made clear the state’s main mental hospital wanted to rid itself of patients with difficult “personality disorders” such as James.
Last year Riverview lost $20 million annually in federal funds because of treatment and safety deficiencies involving aggressive patients, who tend to have personality disorders requiring lengthy psychotherapy. And the state says it needs Riverview beds for county-jail inmates awaiting treatment.
The hearing’s topic was whether James’s “antisocial personality disorder” was enough of a mental disease to keep him from being sent to prison. Agreeing with a daylong parade of psychiatrists and psychologists, the judge decided it was not.
James, 31, has nine years still to serve on robbery and assault convictions. In 2006 Marden committed him to Riverview when a Rockland jury found him “not criminally responsible” because of insanity for assaults on prison guards. James had spent years in solitary confinement, which caused him to revert to “almost an animalistic state,” Marden noted at the Augusta hearing.
A Maine Supreme Judicial Court decision said James could be returned to prison if the state convinced a judge he was no longer dangerous to himself or others because of his mental illness or “not amenable to treatment.”
The state’s witnesses didn’t talk much about dangerousness and admitted that treatment had improved his behavior. But one after another they said Riverview had taken him as far as it could. They described his ongoing head-banging, self-cutting, threats, and “manipulation” of patients and staff.
With ill-suppressed emotion, psychiatrist Alexandar Raev called James a psychopath, saying he had threatened to kill him. Psychologist Arthur DiRocco said James was a master of “coercive behavior and control,” adding, “He has trained the staff very well.”
James’s attorney, Harold Hainke, dryly observed: “You’d think the staff would be more successful in running [the hospital] than the patients.”
In his decision, Marden relied on the law defining the insanity defense. James’s mental condition now, he said, shows he “does have substantial capacity to appreciate [the] wrongfulness” of his conduct.
A guard quickly put handcuffs on a forlorn-looking James and led him away. He may be held in the prison’s new Intensive Mental Health Unit. Hainke expected an appeal.
Disclosure: During years of writing about James I befriended him, and I briefly testified on his behalf, describing how Riverview had changed him for the better, but saying he needed a lot more care. I expressed disbelief that he controlled the hospital staff. If he did, I asked, “What kind of staff is that?”
Lance Tapley can be reached firstname.lastname@example.org.