Prisoner "reentry": Paradigm shift or empty rhetoric?

  Vindictive "imagined public" a barricade to real reintegration   

For many who have broken the law, the real punishment begins not when they are processed into prison, but when they are finally ejected from their concertina-enclosed cages into a vengeful society that won't allow them to redeem themselves, branding them as forever bad.

Despite the stacked deck, some former prisoners do manage to find a sense of hope and turn their lives around. Such desistance is especially likely when society welcomes prisoners and restores their status as full citizens. Indeed, a study by Florida's Parole Commission found that prisoners whose civil rights were restored were far less likely to reoffend than those who remained unable to vote, hold public office, sit on juries, or obtain certain state licenses.

This process of criminal desistance is the topic of a new film out of Scotland. The Road from Crime -- a 48-minute film that can be viewed by clicking on the image below -- is narrated by Allan Weaver, a Scottish ex-offender turned probation officer and author of the book So You Think You Know Me? The script was co-written by my friend Shadd Maruna of the Institute of Criminology and Criminal Justice at Queen's University Belfast, who wrote the groundbreaking book, Making Good: How Ex-Convicts Reform and Rebuild Their Lives.

Study: Reentry doesn’t equal reintegration

The film strikes an optimistic note, citing increasing government interest in alternatives to incarceration in these lean economic times. But a new study out of Colorado is less sanguine, at least as far as the USA is concerned. Even as policy makers give lip service to facilitating prisoners' successful "reentry" into the community, they cling to a risk reduction model that hamstrings true reintegration, the researchers found.

The researchers tracked the work of a Colorado state commission tasked with recommending changes in sentencing policies aimed at reducing sentencing costs while increasing efficacy. Analyzing the commission's discourse, study co-authors Sara Steen, Traci Lacock and Shelby McKinzey of the University of Colorado discovered that a powerful "imagined public" held these public servants hostage, forcing them to look over their shoulders and censor their humanistic impulses lest they be perceived as soft on crime.

The public of the commissioners' imaginations is a vengeful one, which promotes "victims’ rights" as antithetical to the rights of offenders. In this "zero-sum" wordlview (as David Garland labeled it in The Culture of Control), "concerns about offenders translate into attacks on victims and vice versa, so that actors have to forge an allegiance with one group or the other."

"This narrative implies that the real reentry problem is that this population is reentering society at all (if it were not for the expense, the reentry problem could be solved by keeping people who commit crimes in prison forever). The moral undertone to this narrative is one of anger and disgust toward (or, more mildly, frustration with) a group of dangerous people who need to be watched. [Former prisoners] are not people we want to help -- in part because they are, in some sense, beyond help…. [It] is clear that there is some interest in improving offenders' lives, but the main story driving the recidivism reduction narrative is that we (nonoffenders) should invest in reentry to make ourselves safer."

Indeed, risk-driven discourse has so become so naturalized that it takes a very active effort to step back and realize that it is only one of several possible ways of thinking about citizens who have committed crimes. Indeed, Shadd Maruna and Thomas LeBel (in an article available online) identified two dominant recidivism-reduction narratives:

• The CONTROL NARRATIVE views ex-prisoners as dangerous creatures who require close supervision at all times.

• The SUPPORT NARRATIVE regards ex-convicts as bundles of deficits with “needs” that must be attended to.

Although these narratives are superficially dissimilar, in essence they are fundamentally alike in that both dehumanize and problematize former offenders. Indeed, the so-called "risk/needs" paradigm so popular in forensic psychology circles arose squarely from the recidivism reduction discourse that overarches both the control and support narratives. As the researchers discovered in the Colorado case, much more time and energy is put into risk assessment than in providing the external resources necessary for change; “no matter how precisely one can measure an individual’s needs, without resources to attend to those needs the measurement is in some sense meaningless.”

Source: Steen et al (2012)

Imagined public: More vitriolic than actual public opinion?

The irony is that, in their hearts, many public officials and practitioners would like to do more for paroling prisoners, but are paralyzed by fear of a public that in reality may be less vengeful than they imagine. As Steen and her colleagues note:

"Commissioners routinely raised the specter of public discomfort with their recommendations, and they always assumed that the public was punitive and would oppose reforms that benefited offenders in any significant way. While the commissioners themselves had complex views of crime and punishment, they  almost universally assumed a deeply simplistic view on the part of the public, a view based on retribution  to the exclusion of all other considerations. Despite its mandate to continually draw on evidence to support its conclusions, the Commission completely ignored (or was unaware of) recent social scientific evidence of a shift in public opinion about crime and punishment."

They cited a 2002 poll conducted for the Open Society Institute in which the majority of those surveyed believed that the primary goals of the criminal justice system should be rehabilitation and crime prevention.

In other words, public officials may be generalizing about the public's attitudes based on a skewed perception created by handful of vocal -- and often rabid -- constituents. Because of this, public policy remains firmly entrenched in an irrational, hysterical loop tape from which escape is nigh impossible. As the Colorado researchers conclude:

"Many academics equate reentry with rehabilitation, and assume that the popularity of the reentry concept has resulted in discourse and policy that are friendly toward offenders, decreasing the distance between 'us' and 'them'. Our analysis suggests that reentry has not significantly changed the discourse, and we show how practitioners and policy-makers have molded the reentry concept to fit comfortably within the existing punitive discourse by focusing on recidivism reduction rather than reintegration…. In the end, we rather pessimistically conclude that the high hopes of many that reentry could fundamentally change the nature of punishment discourse in the 21st century is to date misplaced."

Resources:

For more information about The Road from Crime and the wider desistance project visit the Discovering Desistance Blog. An evidence summary on desistance, How and why people stop offending, is also available online. The film was funded by the Economic and Social Research Council and George Mason University.  In addition to Shadd Maruna, project members include Fergus McNeill of the Scottish Centre for Crime and Justice Research at the University of Glasgow, Stephen Farrall of the University of Sheffield and Claire Lightowler of the Institute for Research and Innovation in Social Services.

The featured article is: Unsettling the discourse of punishment? Competing narratives of reentry and the possibilities for change by Sara Steen, Traci Lacock and Shelby McKinzey Punishment and Society 2012 14: 29 DOI: 10.1177/1462474511424681. Click HERE to request a copy from the first author.

Related blog posts: 

• Systems failure or black swan? New frame needed to stop "Memorial Crime Control" frenzy

• Book highlights prisoner reentry obstacles: Marked: Race, Crime, and Finding Work in an Era of Mass Incarceration

• Brooklyn, NY prisoner reentry program: Prosecutors push alternatives to crime 

Evaluating vets for disability: Recommended reading

As thousands of U.S. vets stream back from the battlefields of the Middle East with physical and/or psychological problems, more and more forensic practitioners are being called into service to perform disability evaluations. Veterans who suffered illness or injury due to military service are eligible for disability compensation. But first, they must meet eligibility requirements, which typically include undergoing a disability evaluation (referred to as a "Compensation and Pension examination" or "C and P" in VA parlance).

Not surprisingly, the majority of psychiatric evaluations are for PTSD.

A group of psychologists and psychiatrists who conduct such evaluations has put together a reading list of recommended resources for evaluators. Although one obvious audience is the mental health staff of the Veteran's Administration, the group is also reaching out to clinicians in private practice who conduct mental disability evaluations with veterans, either directly for the veteran or via private companies who have contracts with the VA.

For questions about this reading list, please contact Mark D Worthen, PsyD, who has blogged here before and led the effort to compile the list. Dr. Worthen is also co-author of the only article published in a peer-reviewed journal that describes how to conduct mental disability evaluations with veterans.

Best of all, many of these resources are available online; just click on the embedded links.

ARTICLES AND BOOK CHAPTERS ON PSYCHOLOGY AND PSYCHIATRY

Foote, W. E. (2008). Evaluations of individuals for disability in insurance and Social Security contexts. In R. Jackson (Ed.), Learning forensic assessment (international perspectives on forensic mental health) (pp. 449–479). New York: Taylor and Francis Group.

Moering, R. G. (2011). Military service records: Searching for the truth. Psychological Injury and Law, 4(3-4), 217-234. doi:10.1007/s12207-011-9114-3

Rubenzer, S. (2009). Posttraumatic stress disorder: Assessing response style and malingering. Psychological Injury and Law, 2(2), 114–142. doi:10.1007/s12207-009-9045-4.

Strasburger, L. G., Gutheil, T. G. and Brodsky, A. (1997). On wearing two hats: Role conflict in serving as both psychotherapist and expert witness. American Journal of Psychiatry, 154(4), 448–456. (Available online.)

Worthen, M. D. and Moering, R. G. (2011). A practical guide to conducting VA compensation and pension exams for PTSD and other mental disorders. Psychological Injury and Law, 4(3-4), 187-216. doi:10.1007/s12207-011-9115-2.

ARTICLES ON THE LAW

Allen, M. P. (2011). The law of veteran's benefits 2008-2010: Significant developments, trends, and a glimpse into the future. Veterans Law Review, 3, 1-66. (Available online.)

Ogilvie, B. and Tamlyn, E. (2012). Coming full circle: How VBA can complement recent changes in DoD and VHA policy regarding military sexual trauma. Veterans Law Review, 4, 1-40. (Available online.)

Ridgway, J. D. (2011). The splendid isolation revisited: Lessons from the history of veterans’ benefits before judicial review. Veterans Law Review, 3, 135-219. (Available online.)

Ridgway, J. D. (2012). Erratum to: Mind reading and the art of drafting medical opinions in veterans benefits claims. Psychological Injury and Law, 5(1), 72-87. doi:10.1007/s12207-012-9119-6. (Available online.)

BOOKS

Cocchiarella, L. and Gunnar, B. J. A. (2001). Mental and behavioral disorders. In Guides to the Evaluation of Permanent Impairment, 5th Edition. Chicago: American Medical Association Press. [Although there is a 6th edition of this text, most jurisdictions still refer to the 5th edition]

Institute of Medicine and National Research Council (2007). PTSD compensation and military service. Washington, DC: National Academies Press. (Available online.)

Kennedy, C. H. and Zillmer, E. A. (Eds.) (2012). Military psychology: Clinical and operational applications, 2nd Edition. New York: Guilford Press.

Rogers, R. (Ed.). (2008). Clinical assessment of malingering and deception (3rd ed.). New York: Guilford Press.

COURT CASES

Jones v. Shinseki, 23 Vet. App. 382 (2010). (Available online.)

Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). (Available online.)

GUIDELINES

American Academy of Psychiatry and the Law (2008). AAPL practice guideline for the forensic evaluation of psychiatric disability. Journal of the American Academy of Psychiatry and the Law, 36(4), S3–S50. (Available online.)

Committee on Ethical Guidelines for Forensic Psychologists (2011). Specialty guidelines for forensic psychologists. (Available online.)

VA PUBLICATIONS

Department of Veterans Affairs (2001). C and P clinicians guide. (Available online.)

Department of Veterans Affairs (2002). Best practice manual for posttraumatic stress disorder (PTSD) compensation and pension examinations. (Available online.)

WEBSITES

National Center for PTSD

MST SharePoint (VA intranet only). In particular, see the PowerPoint presentation, MST C and P exams and the VBA Training Letter - Adjudicating Posttraumatic Stress Disorder Claims Based on Military Sexual Trauma.

Veterans Law Library

Caveat: This list is not an official recommendation of the U.S. Department of Veterans Affairs.

Mass Shootings and Mental Illness: KQED Forum 9:00 a.m. Wednesday

If you’re free at 9:00 a.m. PST this Wednesday morning (Aug. 15), I invite you to listen to KQED's Forum show, where I will be a featured guest discussing the topic of MASS SHOOTINGS AND MENTAL ILLNESS: “Can anything be done to predict and prevent such violent acts, and what do we know about what causes people to commit them?” Also featured will be Dave Cullen, journalist and author of the book Columbine, and David Eagleman, director of the Initiative of Neuroscience and the Law at the Baylor College of Medicine. The guest host is Spencer Michaels of PBS NewsHour.

If you are not local to the San Francisco Bay Area, you can still listen live, by clicking HERE.

If you missed this Forum episode, listening is easy: Simply click on the below arrow icon. Or you can download an MP3 audio podcast at the show's website (HERE).

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Thanks very much to those of you who listened and sent me feedback via email. I appreciate the support.

Related blog posts:

Arizona rampage: Analyzing the analyzers (Jan. 23, 2011)

 Can school shootings be prevented? (April 19, 2007)

Aurora massacre: To speak or not to speak? (July 22, 2012)

Mental health expert witnesses slammed in court

A pint-sized hired gun

Are accusations of bias on the rise?

Hired gun.
Charlatan.
Quack.
Hack.

It's every expert witness's worst nightmare. Vitriolic accusations of bias hurled at us on the witness stand, just because the cross-examining attorney doesn't like our opinion, or we have the audacity to charge for our services. (Have you heard of auto mechanics, plumbers or attorneys being called "whores" because they don't work for free?)

Unfortunately, it goes with the territory.

Now, a group of psychologists has tried to figure out just how big a part of the legal landscape accusations of bias against mental health expert witnesses are. The researchers scoured the LexisNexis legal database for insinuations of bias, with an eye to quantifying and categorizing the name-calling. In an article just published online in the journal Psychological Services, prominent forensic psychologists John Edens and John Petrila and four colleagues divided accusations of bias into five major categories:

Starting with a list of 46 different ways of calling an expert biased, the authors searched and found 160 legal cases in which attorneys and judges made disparaging comments about forensic mental health experts. In these cases, 185 individual case participants made a total of 245 separable statements asserting a lack of objectivity and impartiality among mental health experts and/or the fields of psychology and psychiatry more generally.

• FOR SALE: In the largest category, 28 percent of the total, experts were disparaged as financially biased (e.g., "hired guns" or "prostitutes").

• PARTISANSHIP: Following close behind, with 27 percent  of cases, were accusations of advocacy, or having an "axe to grind."

• PSEUDOSCIENCE: About 14 percent of cases involved accusations of non-scientific testimony (e.g., "charlatans" or "junk science").

• MYSTICISM: Psychologists and psychiatrists were accused of babbling nonsense (e.g., "witch doctor," "voodoo" or "hocus pocus") in 6 percent  of the cases.

• NONSPECIFIC BIAS: About one fourth, or 24 percent, of cases involved nonspecific accusations or other types of allegations of bias. 

Interestingly, in more than a fourth of the cases, the disparaging comments were a basis for an appeal, typically by the defense calling foul over prosecutorial slurs against mental health experts. Such appeals were relatively unsuccessful, with only 18 percent of cases being reversed in part due to on-the-record accusations of expert bias. All of the successful appeals were in criminal trials, eight involving sanity or diminished capacity. 

Uptick in nasty name-calling?

Similar to a 1999 study by Doug Mossman, which was the only other known study to look at this issue, the researchers noticed a steady upward trend in disparaging comments in more recent years.

It might be tempting to get depressed by this study, which at first blush seems to validate what we all know and fear. However, if we think about it, the results could be seen as mildly encouraging.

First of all, if a thorough search of the massive LexisNexis database could locate only 160 cases, then blatant accusations of bias may be rarer than we think.

Secondly, there are a heck of a lot more expert witnesses in court these days than ever before. Courts and attorneys increasingly rely on forensic psychologists and psychiatrists to assist in a wide range of psycholegal areas, from child custody to tort damages to criminal sentencing and civil commitment. As well, we are increasingly called upon to explain broader social science research, such as the accuracy of eyewitness identification, to judges and juries. So, as the authors acknowledge, any increase in accusations of bias could just be an artifact of our growing presence in court.

Third, and perhaps most importantly, there really are hacks and quacks, charlatans and hired guns among are ranks. The methodology of the current study did not enable analysis of whether the accusations of partiality or bias were legitimate. In other words, attorneys may not have been just engaging in legal gamesmanship in some of these cases; they might have been righteously upset over actual bias or pseudoscientific methodology on the part of forensic psychologists or psychiatrists.

Hopefully, that's a study someone else will take up on another day.

For now, we're left with a couple of take-home messages:

First, this is not a field for the thin-skinned. We must steel themselves to have our objectivity challenged, sometimes very rudely and without basis.

More fundamentally, assuming that these accusations are tapping into popular perceptions and prejudices, forensic professionals need to work harder to reduce both actual bias and the perception of bias in our work.

The articles are:

" 'Hired Guns,' 'Charlatans,' and Their 'Voodoo Psychobabble': Case Law References to Various Forms of Perceived Bias Among Mental Health Expert Witnesses" by John F. Edens, Shannon Toney Smith, Melissa S. Magyar, Kacy Mullen, Amy Pitta and John Petrila, Psychological Services, 2012. 

" 'Hired Guns,' 'whores,' and 'prostitutes': Case law references to clinicians of ill repute" by Doug Mossman, Journal of the American Academy of Psychiatry and the Law, 1999. 

Psychiatrist accused of faking dementia to thwart retrial

Ayres found competent to stand trial in long-running molest case

William Ayres

In a dramatic twist to a case that's already had as many twists and turns as a roller coaster, allegations surfaced this week that psychiatrist William Ayres faked severe dementia in order to avoid a retrial on multiple charges of child molestation.

Ayres used his knowledge of psychiatry to circumvent psychological testing in an elaborate, two-year hoax, according to a report by state hospital psychologist John McIlnay. Around-the-clock observation at Napa State Hospital uncovered discrepancies between the dementia diagnosis and the day-to-day conduct of the former president of the American Academy of Child and Adolescent Psychiatry, the psychologist reportedly wrote in a report filed under seal with the San Mateo County, California court.

Ayres, 80, was arrested in 2007 on suspicion of sexually abusing six boys, some of them sent to him by the juvenile courts, between 1988 and 1996. As I reported at the time, his 2009 criminal trial ended with a hung jury.

After that trial, a new lawyer took over the case and raised the issue of competency to stand trial. A jury trial on competency last year ended with another hung jury. The defense and the prosecution eventually stipulated that Ayres was incompetent and should be sent to Napa State Hospital. He was there for about nine months.

Vincent "The Chin" Gigante

Faking dementia is not commonplace or easy, but it can be done. The most famous case of a defendant faking dementia in order to avoid criminal trial was that of Vincent "The Chin" Gigante, a Mafia don who for years wandered the streets of New York City in a bathrobe. He fooled a bevy of eminent forensic psychologists for psychiatrists into believing he was both insane and demented.

Due to his medical training, a psychiatrist would have an advantage in faking a dementia and in avoiding obvious mistakes. But never letting down one's guard would be difficult in an environment of 24/7 observation. According to news reports, line staff such as nurses and janitors were among those who noticed discrepancies between Ayres's day-to-day functioning and his purported dementia. This was also what eventually tripped up Vincente Gigante; forensic evaluators who interviewed line staff in that case learned that "The Chin" had dropped his guard in jail, when outside the presence of evaluating psychologists and psychiatrists.

On the other hand, state hospital clinicians are rather notorious in local circles for being quick to label defendants as malingering, a topic on which I published a peer-reviewed case study a few years ago. The diagnosis helps open up space in the overcrowded competency restoration wards, which are under pressure from California judges to become more efficient and reduce long waiting periods for beds, and can rid staff of nettlesome criminal patients.

Also, as regular blog readers know, reasonable clinicians often differ as to whether someone is incompetent. In this case, the competency trial featured a 2-2 split of experts. The two original court-appointed psychologists, Paul Good and Jatinder Singh, both initially opined that Ayres was competent to stand trial. However, Singh later changed his mind, which prompted the appointment of a third, "tie-breaker" evaluator, psychiatrist George L Wilkenson, who also thought Ayres was competent. Joining those three as witnesses at last year's competency trial was a defense-retained neuropsychologist, Amanda Gregory, who opined that Ayres was incompetent.

The new hospital report will prompt yet another court hearing on competency. This time, a judge rather than a jury will make the decision on competency, with the defense having the burden of proving that the defendant is unfit for trial on nine felony child molestation charges. The October hearing will include a string of lay and expert witnesses and is anticipated to last about seven days.

My prior posts  (it's been a while) on the case: 

• Lesson to abusers: Target socially disempowered (April 23, 2007)  
• Professionals behaving badly: Mistrial in psychiatrist molestation case (July 27, 2009) 
• Ayres exposer wins award (Aug. 19, 2009)

Violence risk instruments overpredicting danger

Tools better at screening for low risk than pinpointing high risk 

The team of Seena Fazel and Jay Singh are at it again, bringing us yet another gigantic review of studies on the accuracy of the most widely used instruments for assessing risk of violence and sexual recidivism.

This time, the prolific researchers -- joined by UK statistician Helen Doll and Swedish professor Martin Grann -- report on a total of 73 research samples comprising 24,847 people from 13 countries. Cumulatively, the samples had a high base rate of reoffense, with almost one in four reoffending over an average of about four years.

Bottom line: Risk assessment instruments are fairly good at identifying low risk individuals, but their high rates of false positives -- people falsely flagged as recidivists -- make them inappropriate “as sole determinants of detention, sentencing, and release.”

In all, about four out of ten of those individuals judged to be at moderate to high risk of future violence went on to violently offend. Prediction of sexual reoffense was even poorer, with less than one out of four of those judged to be at moderate to high risk going on to sexually offend. In samples with lower base rates, the researchers pointed out, predictive accuracy will be even poorer.

What that means, in practical terms, is that to stop one person who will go on to become violent again in the future, society must lock up at minimum one person who will NOT; for sex offenders, at least three non-recidivists must be detained for every recidivist. This, of course, is problematic from a human rights standpoint. 

Another key finding that goes against conventional wisdom was that actuarial instruments that focus on historical risk factors perform no better than tools based on clinical judgment, a finding contrary to some previous review.

The researchers included the nine most commonly used risk assessment tools, out of the many dozens that have now been developed around the world:

• Level of Service Inventory-Revised (LSI-R) 
• Psychopathy Checklist-Revised (PCL-R) 
• Sex Offender Risk Appraisal Guide (SORAG) 
• Static-99 
• Violence Risk Appraisal Guide (VRAG) 
• Historical, Clinical, Risk management-20 (HCR-20) 
• Sexual Violence Risk-20 (SVR-20) 
• Spousal Assault Risk Assessment (SARA) 
• Structured Assessment of Violence Risk in Youth (SAVRY) 

Team leader Fazel, of Oxford University, and colleagues stressed several key implications of their findings:

One implication of these findings is that, even after 30 years of development, the view that violence, sexual, or criminal risk can be predicted in most cases is not evidence based. This message is important for the general public, media, and some administrations who may have unrealistic expectations of risk prediction for clinicians. 

A second and related implication is that these tools are not sufficient on their own for the purposes of risk assessment. In some criminal justice systems, expert testimony commonly uses scores from these instruments in a simplistic way to estimate an individual’s risk of serious repeat offending. However, our review suggests that risk assessment tools in their current form can only be used to roughly classify individuals at the group level, and not to safely determine criminal prognosis in an individual case. 

Finally, our review suggests that these instruments should be used differently. Since they had higher negative predictive values, one potential approach would be to use them to screen out low risk individuals. Researchers and policy makers could use the number safely discharged to determine the potential screening use of any particular tool, although its use could be limited for clinicians depending on the immediate and service consequences of false positives. 

A further caveat is that specificities were not high -- therefore, although the decision maker can be confident that a person is truly low risk if screened out, when someone fails to be screened out as low risk, doctors cannot be certain that this person is not low risk. In other words, many individuals assessed as being at moderate or high risk could be, in fact, low risk. 

The study, Use of risk assessment instruments to predict violence and antisocial behaviour in 73 samples involving 24,827 people: systematic review and meta-analysis, is published in the British Medical Journal and is freely available online (HERE).

My blog post on these researchers' previous meta-analytic study, Violence risk meta-meta: Instrument choice does matter, is HERE.

Blogger featured on BBC talk show on Aurora massacre

For those of you who are still tuned in to the Aurora massacre story, I was the featured expert on a BBC radio talk show today, on whether tragedies like this can be prevented. (The short answer, from my perspective, is “No”). Alongside me were the mother of a young man who was at the theater, another man from the local community of Aurora, and a survivor of the recent massacre in Oslo, Norway. We four were on similar wavelengths, but things got a bit heated when a psychologist from California called in to say that more could and should have been done to prevent the killings by the Man Who Has No Name.

To listen to the BBC's World Have Your Way segment, click HERE.

(Don’t let the 55-minute length scare you; it’s only the first half of the hour-long show.)

Aurora massacre: To speak or not to speak?

The blood on the movie theater floor was still tacky when mental health professionals began pontificating on the psychology of the mass murderer. Among the brashest self-promoters was a forensic psychologist who shamelessly asserted his preternatural ability to "look inside the mind" of the Aurora, Colorado massacre suspect.

Much of the psycho-punditry reads like it was pulled from a psychoanalytic fortune cookie:

• James Holmes is a "deeply disturbed" individual. 
• He may, or may not, be psychotic and delusional. 
• He harbors a lot of rage.

Such "armchair psychology" is a natural byproduct of the news media's frenetic competition for online traffic. To object is as pointless as it would have been to stand in the killer's way and shout "stop!" as he opened fire during the Batman movie.

But some are nonetheless voicing criticism, saying it is both misleading and irresponsible to speculate at this early stage about the accused's state of mind. Curtis Brainard of the venerated Columbia Journalism Review goes so far as to call it unethical, a violation of the so-called "Goldwater Rule" of 1973. That principle cautions psychiatrists not to offer a professional opinion without having conducted a psychiatric examination and "been granted proper authorization for such a statement."

While that ethics rule applies only to psychiatrists, the American Psychological Association has a very similar one. Section 9.01 cautions psychologists to "provide opinions of the psychological characteristics of individuals only after they have conducted an examination of the individuals adequate to support their statements or conclusions."

But it is in the gray area of interpreting these ethics rules that reasonable minds differ. Indisputably, we should not attempt to clinically diagnose Mr. Holmes absent a formal evaluation. But must professionals with expertise in the general patterns underlying mass killings stand silently on the sidelines, refraining from offering any collective wisdom to the public?

As a blogger who frequently comments on breaking news stories pertinent to forensic psychology, I have often grappled with this conundrum. When the UK Guardian asked me to write a commentary on Phillip Garrido, the kidnapper and rapist of Jaycee Dugard, I ultimately decided that providing general information about the forensic implications of the case was an appropriate public service that did not violate any ethics rules.

Consider this commentary by high-profile forensic psychiatrist Michael Welner on a Washington Post blog:

Mass shooting cases have the common motive of an attacker seeking immortality. Each of the attackers have different degrees of paranoia and resentment of the broader community. Some are so paranoid that they’re psychotic. Others are paranoid in a generally resentful way but have no significant psychiatric illness. But you have to hate everyone in order to kill anyone. The threshold that the mass shooter crosses is one in which he decides that his righteous indignation and entitlement to destroy is more important than the life of any random person that he might kill. This is why mass shooting are invariably, invariably carried out by people who have had high self esteem. They are people who had high expectations of themselves. It’s not at all surprising to hear about these crimes in people who either valued their own intelligence or their own career prospects at one time. They’re people who are unfailingly unable to form satisfying sexual attachments and their masculinity essentially gets replaced with their fascination for destruction.

Now, I don't always see eye to eye with Dr. Welner, author of the controversial "Depravity Scale." But the above perspective has the potential to contribute to informed discussion of the Aurora tragedy. It doesn't matter whether every single detail turns out to be a precise fit; the comments are general enough to enlighten without stepping over the line to claim an ability to see into Holmes's troubled soul.

One could even argue that we as professionals have an affirmative duty to help offset the inane speculation that pours in to fill any vacuum in the cutthroat world of daily journalism: Portrayals of Holmes as a "recluse" and a "loner" because he didn’t converse with his neighbors; assertions that he "didn’t seem like the type" to massacre a dozen people, because he appeared superficially "normal"; simplistic theories blaming the tragedy on violence in the media or the legality of gun ownership.

Our field is positioned to help the public separate the wheat from the chaff. We can discuss the complex admixture of entitlement, alienation and despair that contributes to these catastrophic explosions. Equally important, we can remind the public that such rampages are rare and unpredictable, and that knee-jerk, "memorial crime control" responses are unwarranted and potentially dangerous. We can urge restraint in jumping to conclusions absent the facts, lest we -- as journalist Dave Cullen, author of the book Columbine, warns in yesterday's New York Times -- contribute to harmful myth-making:  

Over the next several days, you will be hit with all sorts of evidence fragments suggesting one motive or another. Don’t believe any one detail. Mr. Holmes has already been described as a loner. Proceed with caution on that. Nearly every shooter gets tagged with that label, because the public is convinced that that’s the profile, and people barely acquainted with the gunman parrot it back to every journalist they encounter. The Secret Service report determined that it’s usually not true. Resist the temptation to extrapolate details prematurely into a whole…. The killer is rarely who he seems.

But we should also recognize the limitations of our discipline’s micro focus on the individual, and encourage the public to grapple with the larger issues raised by this cultural affliction of the late-20th and early 21st century. As I commented last year in regard to the media coverage of the Jared Loughner shooting rampage in Arizona, journalists need to train a macro lens on the cultural forces that lead disaffected middle-class men -- like canaries in a coal mine -- to periodically self-implode with rage. Disciplines such as sociology, anthropology and cultural studies have much to contribute to this much-needed analysis.

The irony of the Aurora case is hard to miss. An attack in a movie theater featuring The Dark Knight Rises, a movie in which a masked villain leads murderous rampages against unsuspecting citizens in public venues including a packed football stadium and the stock exchange.

As Salon film critic Andrew O'Hehir noted in an insightful essay entitled, "Does Batman Have Blood on his Hands?":

Whether or not Holmes had any particular interest in “The Dark Knight Rises,” he saw correctly that in our increasingly fragmented culture it was the biggest mass-culture story of the year and one of the biggest news stories of any kind. Shoot up a KenTaco Hut or a Dunkin’ Donuts, in standard suburban-nutjob fashion, and you get two or three days of news coverage, tops. Shoot up the premiere of a Batman movie, and you become a symbol and provoke a crisis of cultural soul-searching.

Bottom line: The larger error is not for informed professionals to respond -- cautiously, of course -- to media inquiries but, rather, for the public to settle for facile explanations, in which calling someone crazy or disturbed is mistaken for understanding what is going on. 

POSTSCRIPT: See media critic Gene Lyons's article, linking to this post, at the National Memo. 

Related blog posts: 

• Arizona rampage: Analyzing the analyzers
• Can school shootings be prevented? 

Land of the Free: The best investigative reporting on U.S. prisons

by Cora Currier, ProPublica*

The U.S. has the highest reported incarceration rate in the world. We've rounded up some of the best investigative journalism on U.S. prisons and the problems that plague them. These stories cover juvenile justice, private prisons, immigration detention and other aspects of America's vast incarceration system.

Louisiana Incarcerated: How we built the world's prison capital, The Times-Picayune, May 2012

Louisiana's incarceration rate tops the U.S.'s, Iran's and China's. This eight-part series explains how it got there: lobbying from private prison companies, cash-strapped municipalities, harsh sentencing, and limited rehabilitation for those who make it out.

Moose Lake sex offender facility, Minnesota

America's Expensive Sex Offenders, Salon, April 2012

Programs that keep some sex offenders detained indefinitely after their criminal sentences are up have grown drastically in recent years, and so has their cost—“civil commitment” is on average four times as expensive as prison. But releasing sex offenders has proven politically fraught. (For a few state-by-state investigations, see these muckreads on Washington, Virginia, and New York.)

Bail Burden Keeps U.S. Jails Stuffed With Inmates, NPR, January 2010

Thousands of inmates are stuck in jail for petty, nonviolent crimes simply because they can't make bail. This NPR series showed how the country's bail system "exists almost solely to protect the interests of a powerful bail bonding industry."

What the Jail Guard Saw, Village Voice, July 2007

Some guards at New York City's prison island, Rikers, weren't just turning a blind eye to violence--they were encouraging it. The Voice has been covering the fallout from Rikers' " Fight Club" ever since, and five years later, they obtained gruesome photos showing rampant violence persists, despite the Correction Department's efforts.

Pelican Bay (California) solitary confinement,
prisoner sketch

Hellhole, The New Yorker, March 2009

Atul Gawande looked at the U.S.'s widespread use of isolation, which has ballooned in the past 20 years. At least 25,000 prisoners are now held in isolation just in so-called super-max prisons. And their minds can quickly degrade. "The experience," Gawande writes, "typically leaves them unfit for social interaction."

Why Are Prisoners Committing Suicide in Pennsylvania? The Nation, April 2012

An investigation the effects of solitary confinement on mentally ill prisoners in Pennsylvania. Also see this account from the Arizona Republic: nineteen prisoners in Arizona have killed themselves in the last two years, many of them while in solitary confinement—a widespread practice in the state.

The Devil's Playground, Westword, February 2011

Earlier this year the Justice Department laid out new rules aimed at eliminating widespread sexual abuse in U.S. prisons. This article chronicles the ordeal of one inmate who tried to report rape in a Colorado prison.

Juvenile InJustice, Richard Ross

Uncompromising Photos Expose Juvenile Detention in America, Wired, April 2012

America locks up children at a quicker rate than all other developed countries, with about 60,000 juveniles imprisoned on any given day. Photographer Richard Ross spent five years photographing the little-seen conditions inside 350 correction centers across the U.S.

For teens guilty of murder, penalties can vary widely, New England Center for Investigative Reporting, December 2011, and Direct Fail: Colorado's policy of sending teens to adult court, 5280 Magazine, December 2011

In light of the Supreme Court's decision this week  to strike down mandatory life-without-parole sentences for juveniles, it's worth revisiting these exposes of juvenile justice in Colorado and Massachusetts, two states that often sentence teens as adults.

A Death in Texas: Profits, poverty and immigration converge, Boston Review, December 2009

Privately run immigration detention facilities have proliferated along the U.S.-Mexico border. But the small towns where they're located have rarely benefited. (Such tales aren't limited to the border, as this report from Georgia tells).

Immigration prisoners, Arizona

Private Prisons Profit From Immigration Crackdown, Federal And Local Law Enforcement Partnerships, Huffington Post, June 2012

The country's two largest private prison companies have spent tens of millions on lobbying in the past decade and doubled their campaign contributions, as the government launched tougher immigration rules. Since 2005, they've also more than doubled their revenues from immigration detention.

Clarification (6/29): We've clarified this story to note that the U.S. has the highest reported incarceration rate in the world. There are a few countries—notably North Korea—for which reliable prison statistics aren't available.

*Creative Commons license; reprinted with permission of ProPublica, "Journalism in the public interest."

Brazilian prisoners riding toward freedom

Photos: Felipe Dana, AP

Brazilian prisons, criticized by human rights groups for their miserable conditions, are getting some good press this week over an innovative rehabilitation program that allows prisoners to pedal their way to freedom.

Prisoners in the small mountain town of Santa Rita do Sapucai, in southeastern Brazil, can shave one day off their sentences for every three days spent generating energy for the local township by pedaling stationary bikes.

Not only do the prisoners benefit, but so do local dog walkers, joggers, bicyclists, children and strolling couples: The generated power lights lamps along a riverside promenade that was heretofore abandoned after dark.

Lots of local citizens chipped in to create the program: A judge got the idea from reports of U.S. gyms using stationary bikes to generate energy, police contributed old bicycles, and engineers transformed them into stationary bikes and hooked them up to batteries donated by local businesses.

It's one of a series of new projects being implemented across Brazil to enable prisoners to improve their lives and health while working their way toward freedom, according to a story by Associated Press reporter Jenny Barchfield. With an estimated half a million people behind bars, the nation is also hoping to ease rampant prison overcrowding.

With one in 10 Brazilians over the age of 15 unable to read, literacy is a major focus of these rehabilitation efforts. A federal "Redemption through Reading" program allows prisoners in four federal penitentiaries to shave up to 48 days a year off of their sentences. In the labor-intensive program, a judge reads each prisoner's book report and decides on a sentence reduction of up to four days per book, for a maximum of 12 books per year. The prisons are offering similar time-reduction incentives for taking classes ranging from the elementary school to college level.

These types of educational programs are commonplace in Europe. Indeed, the European Prison Education Association sees prisoner education as a "moral right." They used to be widespread in U.S. prisons, too. But in 1994, with the elimination of federal funding for prisoner education, the number of higher-education programs in prison plummeted overnight from more than 350 -- serving about 40,000 prisoners -- to fewer than a dozen, despite their proven efficacy in reducing recidivism.

Let's hope that other countries struggling with overcrowded and dismal prisons will follow Brazil's lead and implement similar rehabilitation efforts that provide a sense of hope and some chance for prisoners to turn their lives around.

Sanity opinions show "poor" reliability, study finds

Independent evaluators agree only about half the time 

Did you hear the one about the JetBlue pilot who suddenly began rambling incoherently, bolted out of the cockit and ran through the aisles of the plane, screaming about Jesus and Al Quaeda? Not surprisingly, a judge this week found him not guilty by reason of insanity.

But insanity isn't always so obvious. In fact, the innovative team of Murrie, Boccaccini and Gowensmith -- which last year brought word of troublingly low reliability among forensic psychologists and psychiatrists assessing competency to stand trial -- has even worse tidings on the sanity front. 

Set once again in the Aloha State, the soon-to-be-published study examined 483 evaluation reports, addressing 165 criminal defendants, in which up to three forensic psychiatrists or psychologists offered independent opinions on a defendant's legal sanity.

Evaluators reached unanimous agreement regarding legal sanity in only 55 percent of the cases. The agreement rate was a bit higher, 61 percent, if one counted as agreement cases in which two evaluators shared the same opinion about sanity and the third declined to give an opinion (for example, because the defendant was incompetent to stand trial or did not want to consider an insanity plea). Either way, that's significantly lower than the rates of agreement that the team found in their previous study of competency evaluators in Hawaii. Among initial competency referrals, evaluators reach unanimous conclusions in 71 percent of cases.

The base rate of sanity to insanity opinions by the individual evaluators studied was about two-thirds sane to one-thirds insane.

Not surprisingly, evaluators agreed most often when a defendant had been psychiatrically hospitalized shortly before the offense, or when he or she had a psychotic disorder. They tended to disagree in cases in which alcohol and/or drugs played a role.

Opinions about sanity carry enormous consequences. If someone who was genuinely insane at the time of an offense is precluded from mounting an insanity defense, he or she may be unjustly convicted and sent to prison. On the other hand, a sane person who successfully fakes insanity can avoid criminal prosecution and be sent to a psychiatric hospital, where he or she may be disruptive, waste limited treatment resources, or have an unfair opportunity for early release back to the community.

At the same time, insanity is a slippery construct with many shades of grey. Reasonable experts may differ about whether a defendant meets the legal criteria for insanity at the time of an offense, for example by lacking the capacity to appreciate the criminality of his conduct or to conform his conduct to the law. It is unrealistic to expect perfect agreement among evaluators; the question is how much agreement or disagreement is acceptable to the courts. Collecting baseline data on reliability is a great first step toward more judicial and professional awareness of this issue.

Hawaii is an outlier that makes it an ideal site for naturalistic studies such as this: When the question of sanity is raised, the court solicits three concurrent and wholly independent evaluations, each with a written evaluation report.

Hawaii also provides better compensation than many mainland U.S. jurisdictions, perhaps making for a higher-quality end product. The researchers told me that an initial evaluation -- typically covering the issues of competency, sanity and dangerousness -- pays $1,000. That's not great, considering that an expert may need to invest 30 or 40 hours in a complex case. But by way of comparison, here in the San Francisco Bay Area where I am, most counties pay only $300 to $500 per evaluation. The essentially pro bono compensation encourages newbies and hacks, while discouraging highly trained, experienced and thorough forensic experts. Local judges don't seem concerned about reliability and error rates, often appointing only a single evaluator as if alienists are just interchangeable warm bodies with appropriate initials after their names.

As in their competency study, the team also examined how judges handle disagreements among evaluators. In nine out of ten cases, judges went with the majority opinion of the experts. But when judges broke with the majority, it was usually to find a defendant legally sane. "This pattern seemed generally consistent with the courts' conservative approach toward insanity cases, and the tendency for insanity pleas to fail," the authors note.

The researchers said that this is the first study to examine independent evaluations of legal sanity in routine U.S. practice. As such, the levels of agreement among forensic evaluators were "surprisingly poor," and far poorer than the field tends to assume.

[I]n light of our findings, courts should consider carefully the rationale underlying an evaluator's final opinion. Because sanity is a legal (rather than clinical) decision, courts must base their decisions on the data, observations, and clearly articulated inferences that an evaluator provides, rather than simply the evaluator's final opinion…. [T]olerating poor reliability among forensic evaluators is also costly, in that it might undermine goals of equitable justice, undermine confidence in the mental health field, and increase costs associated with inappropriate placements in hospitals, jails, or prisons.

The article, “How Reliable Are Forensic Evaluations of Legal Sanity?” is forthcoming from Law and Human Behavior. Correspondence may be addressed to W. Neil Gowensmith.

Groundbreaking research: One out of every 10 rape convictions wrong?

As a young man, Michael Jones pleaded guilty to back-to-back attempted molestations of two girl strangers. However, he adamantly maintained his innocence while in prison and on parole. He said his lawyer had coerced him into pleading guilty by threatening him with life in prison if he went to trial. Michael was one of a handful of Black people in a rural white community; both of the little girls were white. He was identified when police brought him to the station and showed him to the girls. There was no lineup procedure with foils; he was the only choice the girls were given. On the basis of his two convictions, government evaluators diagnosed Michael with pedophilia and recommended civil commitment.

As a teenager, Paul Smith tried to molest a younger boy. He was arrested at the scene and confessed. He disputed only one point in the victim’s statement: that he had threatened the younger boy with a gun. Police searched his home and found no gun. Pre-conviction polygraph testing indicated he was being truthful when he denied having a gun. Over the ensuing years, however, clinicians in sex offender treatment programs hammered at him to admit that he had used a gun. Government evaluators said Paul’s “denial” and “minimization” of his gun use influenced their recommendation for civil commitment.

In cases such as these, I am consistently struck by the naïveté of clinicians and forensic evaluators alike, who accept police reports and especially victim accounts as the gospel truth. From my former career as a criminal investigator, I can attest to the fact that even impartial observers with no conscious motivation to distort are never 100 percent accurate in describing events they have witnessed. As Daniel Schachter so clearly articulates in Seven Sins of Memory, distortion is the nature of the human animal. It is even more likely to occur in situations involving high levels of stress, fear and emotionality.

So I was happy to see that the issue of false convictions for sex offenses is getting some much-needed and long-overdue attention. Or, let me qualify that: Happy about the empirical research, but less than thrilled with a theoretical article on the psychological dynamics underlying false accusations. Let me take those up one at a time.

Dredging old cases for DNA matches

The most methodologically rigorous study to date, released in June, suggests that somewhere between 8 and 18 percent of men convicted of sexual assault may be innocent. The federally funded research project randomly sampled convictions in Virginia between 1973 and 1987, before DNA testing was widely available, and compared preserved physical evidence with the DNA profiles of convicted men.

After poring through more than half a million cases, researchers found 422 sexual assault cases in which DNA evidence was preserved. In 8 percent (33) of those cases, the DNA evidence was exculpatory and supported exoneration. Because many of the DNA comparisons were inconclusive, this amounted to 18 percent of the cases in which it was possible to make a definitive determination one way or the other based on DNA analysis. (The data and the analyses are complex and not without flaws, so I recommend reading the study itself before relying on these numbers.) Noted the researchers:

"Even our most conservative estimate suggests that 8 percent (or more) of sexual assault convictions in a 15-year period may have been wrongful. That means hundreds, if not more than a thousand, convicted offenders may have been wrongfully convicted. That also means hundreds (if not more) victims have not received the just result, as previously believed. Therefore, whether the true rate of potential wrongful conviction is 8 percent or 15 percent in sexual assaults in Virginia between 1973 and 1987 is not as important as the finding that these results require a strong and coordinated policy response."

Bennett Barbour. Photo credit: 

Joe Mahoney, Times-Dispatch

Unfortunately, the researchers ran out of money before they could do more exhaustive analyses of the cases in which innocence was suggested. In the project’s wake, the government is battling with false confession activists who want access to the data, reports the Richmond (Virginia) Times-Dispatch. Police and prosecutors want to restrict access; exoneration activists argue that people have a right to know when their DNA does not match that collected in the crime for which they were convicted.

The project has led to the exoneration of at least four men. Putting a face to them is Bennett S. Barbour, who served a prison sentence for a 1978 rape. He had moved and did not receive the 2010 letter notifying him that the DNA specimen cleared him and matched a convicted rapist instead. A volunteer lawyer finally tracked him down and broke the good news by phone 18 months later.

Research into wrongful convictions has pinpointed several leading causes. These include:

Top sources of wrongful convictions. The Innocence Project

• False witness testimony (including mistaken identification and lying codefendants) 
• Faulty forensic evidence (especially comparisons of hair and bite marks) 
• False confessions 
• Police being influenced by prior knowledge of a suspect 
• Brief jury deliberations 

These problems are compounded by racial bias both in the criminal justice system and in society more broadly. African American men make up far more than their share of those who were convicted and later exonerated based on DNA evidence.

False accusations: A role for psychology?

Flat-out false accusations of rape -- like that depicted in To Kill A Mockingbird -- are rarely the cause of exonerations. But they do occur. Now, a prominent forensic psychology professor and his student propose 11 pathways to false allegations, and suggest that psychology could play a role in helping to sort reliable from unreliable reports. Write Jessica Engle and William O'Donohue in the Journal of Forensic Psychology Practice:

"[W]e suggest that some psychological disorders may increase the likelihood of believing a sexual assault occurred when it did not. Additionally, some psychological disorders may be related to an increase in motivation to fabricate an allegation of sexual assault in an effort to achieve what may be believed are the positive consequences of a false report…. [P]sychological evaluations may inform forensic evaluators of psychological processes by which a person may either intentionally or unintentionally file a false allegation of sexual assault."

The motivational and information processing pathways they propose lean heavily on psychiatric disorders -- including antisocial personality disorder, borderline personality disorder, histrionic personality disorder, psychotic disorders and intellectual disability -- as causes of false allegations. For example, here’s how they suggest that a histrionic personality style could lead to a false allegation:

"[A] person who is histrionic may, after a co-worker complements her clothing and accidentally bumps into her during the day, construe these actions as intentional communications of sexual interest. This misperception can lead her to feel that if the individual had touched her chest while bumping into her, it was an intentional action of unwanted assault. Thus, a pathway to false allegations of sexual assault may be through individuals with a diagnosis of histrionic personality disorder who for reasons of attention and misinterpretation may knowingly or unknowingly make a false allegation of sexual assault."

Okay, I’m not saying that people don’t lie, or make mistakes. Other research suggests that anywhere from 2 to 10 percent of all sexual assault reports may be false. But some of the examples provided in this article stretch credulity, and reek of sexism. I don’t know too many women, histrionic or not, who don't know the difference between an innocent compliment and a sexual assault.

A classification system based largely on pathologizing women runs the risk of reifying the mythology of so-called “rape myths,” in which only “good,” virtuous women can be raped. It seems especially problematic to disbelieve women with psychiatric problems when -- as the authors acknowledge -- they are the ones most likely to be sexually victimized.

More broadly, it is improper for clinicians to wade into the waters of truth-telling or lie detection. We weren’t there, and we don’t know what happened. It's problematic enough when we use character traits to predict the future. Stating that people (read: women) with this or that disorder are more likely to be lying or distorting reality opens the door for yet more improper use of psychiatric diagnosis in court.

Rather, as suggested by the Virginia data, we need to be skeptical at all times, and to keep our minds open to competing hypotheses based not on psychiatric stereotyping, but on the individual case facts. Maybe an assault happened, maybe it didn’t. Maybe the witnesses have their facts straight, maybe they don’t. Maybe the person who was convicted is the real culprit, and maybe he isn’t.

It’s clear that false convictions and false allegations are two separate beasts. And if that’s not complicated enough, there are true cases that are falsely recanted! For example, in a recent Welsh case, “Sarah” was repeatedly raped and forced into prostitution by her husband. When she recanted her report, she was convicted for perverting justice.

So, did Michael Jones (top of post) try to molest the two little girls? Maybe. Maybe not. The point is that we will never know for sure, and we should embrace -- rather than avoid -- that uncertainty. Present the competing scenarios, and analyze the case both ways, so that the trier of fact has all of the information.

The complexities in understanding sexual assault patterns are mind-boggling, and can make your head spin. False convictions, false accusations, false retractions. And then there's the other end of the spectrum: A vast proportion of sexual assaults – probably somewhere between 85 and 95 percent – are still going unreported altogether. And when victims do come forward, prosecution is rare, and convictions even rarer.

It's one gigantic mess, all around.

The U.S. Department of justice Study is: Post-Conviction DNA Testing and Wrongful Conviction by John Roman, Kelly Walsh, Pamela Lachman and Jennifer Yahner.

Mute mystery man baffled jail psychologists

 Deemed incompetent to stand trial after month of silence

How do you provide treatment to someone who won't talk, when you know absolutely nothing about him -- not even his name? That was the problem facing clinical staff at the San Mateo County Jail this month.

"John Doe" was arrested May 30 for shoplifting two frozen pizzas and several candy bars from a local supermarket. But it was no ordinary theft: Store personnel described him as semi-catatonic, making no effort whatsoever to conceal what he was doing, private investigator Rich Fischer told me today. Perhaps because of his odd behavior, supermarket employees didn't even call the police until Mr. Doe's third attempt to make off with the food.

When police responded, the disheveled man placidly declined to communicate. And he has remained mute ever since, not speaking a single word to anyone for an entire month.

He had no identification, and his fingerprints didn't show up in any databases. No missing persons reports could be found.

He seemed to understand simple commands, both in English and Tagalog. (About one out of five residents of the local community of Daly City are Filipino.) But he wouldn't sustain eye contact or write. In the sole clinical breakthrough, when a nurse asked him if he was "happy or sad," he drew a picture of a happy face. Consistent with his sketch, he seemed perfectly content with his situation, according to an article in today’s San Francisco Chronicle about the mystery..

Knowing nothing about him, jail mental health personnel concentrated on ruling out medical causes for his muteness, such as a stroke or a brain hemorrhage. No medical causes were found, and no clinical interventions were successful.

He was not in any immediate danger, as he was able to understand enough to take care of his basic needs in jail. But he did not seem to be in a position to rationally assist his attorney with his criminal case, so he was found incompetent to stand trial and transferred to a local hospital for further treatment.

Meanwhile, the private defender's office (the local version of a public defender's office) retained investigator Rich Fischer to solve the mystery.

In addition to plastering the local community with fliers, Fischer contacted the news media, which ran an article with a photo. Finally, just today, he got a lucky break when someone who knew the mystery man alerted the family, who contacted Fischer and identified him from a photo. As it turns out, the family had filed a missing persons report in San Francisco, but it had fallen through the cracks.

Maguire Jail, Redwood City

Although Mr. Doe has now been identified, some mystery remains as to his clinical condition. The 44-year-old Filipino native, who holds advanced degrees in computer science and electric engineering, began withdrawing about a year ago, Fischer said. He continued to deteriorate until he finally disappeared from his San Francisco apartment about a month ago.

So, in the end, it was old-fashioned gumshoe work as opposed to psychological detection that cracked the case. In the absence of any collateral information there is only so far that psychology can go in cases of psychogenic muteness.

"I’ve got a reputation for being able to find people when I have a name," a satisfied Fischer told me. "But this was the opposite situation. It was a little unusual."

Now that Mr. Doe has been identified and his family can provide collateral information about his condition, it will be up to the court-appointed experts to decide whether he is competent to stand trial, or can be restored to competency.

Somehow, I doubt he will ever face trial. After all, a couple of frozen pizzas and a few candy bars is hardly the crime of the century. Especially when the alleged culprit isn't talking.