September 11, 2009

Rare chance to view dueling experts live

Accused coach killer's Iowa competency hearing

Courtesy of the Des Moines Register, we have a rare opportunity to watch two experienced mental health experts testify in court about competency to stand trial. The experts were the featured event in this week's highly publicized hearing for Marc Becker, the mentally disturbed man accused of gunning down esteemed Iowa football coach Ed Thomas in front of about 20 students this past June.

Click on either image above to watch that expert's testimony. Dr. Michael Taylor's video (left) is about 79 minutes, the first 15 minutes of which are the testimony of a psychiatric nurse at the jail (manually move the time bar to 15 to start with Taylor). Dr. Dan Roger's video (right) lasts about 57 minutes.

The experts agreed that Becker is most likely schizophrenic. They differed vastly, however, on whether he evidenced symptoms of psychosis.

Testifying for the prosecution on Thursday, psychiatrist Michael Taylor said he found no evidence whatsoever of current psychotic symptoms. Dr. Taylor described the defendant as "a calm, relaxed, pleasant young man, well spoken, articulate, able to communicate clearly, able to joke."

"There's absolutely no hint in Mr. Becker's appearance or behavior that would raise any suspicion of any psychiatric disorder," Taylor testified.

On the other side of the aisle, defense-retained psychologist Dan Rogers described the defendant as "floridly psychotic," paranoid, and delusional. "He starts with a perfectly good thought and it just becomes filled with illogical concepts as he tries to proceed," he testified.

While the public may see this as an example of hired guns who will say whatever they are hired to say, an alternate possibility is that Becker presented differently to the two experts. Dr. Rogers evaluated Becker on two occasions, 32 days and 45 days after the offense. Dr. Taylor did not evaluate Becker until more than two months after the crime. By that time, Becker was being medicated with a high dosage of the antipsychotic Invega.

Becker appeared highly sedated in court, raising another competency issue: If his medication dosage is lowered so that he can stay awake in court, his psychosis will worsen, Dr. Rogers predicted.

Of note in this case is the informative, factually accurate coverage being provided by Jennifer Jacobs of the Des Moines Register. In Thursday's article, she quoted the illustrious Daniel Murrie of the Institute of Law, Psychiatry and Public Policy at the University of Virginia School of Medicine, talking about how uncommon incompetency findings are (only an estimated 20% of cases in which the issue is raised).

In her previous story, Ms. Jacobs quoted competency guru Thomas Grisso (of Evaluating Competencies fame) and cited recent empirical research on incompetency findings:
"Each year, about 7,000 defendants nationwide are involuntarily committed to public psychiatric hospitals for treatment intended to make them well enough to stand trial, according to a 2008 report in the American Journal of Forensic Psychiatry. About 78 percent are released in less than three months, according to a 2003 report by the Missouri Institute of Mental Health. Another 20 percent are released between three months and 12 months after committal, and 2 percent are released after 12 months."
After hearing from the two experts, Judge Stephen P. Carroll put the case against Becker on hold while he contemplates his competency ruling.

Hat tip: Luis Rosell

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