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A strong case for the insanity defense

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This is one of the best articulations of a need for mental health evaluations I've ever seen. Superficially, the case looked cut and dry. Aaron Smith killed Henry McGlone because McGlone owed him money. But Smith's psychiatric history called his motive into question. Here's the summary of the examining doctor's report:

She said while she did declare him competent to stand trial, she had some concerns because he was not taking his anti-psychotic medication and had been doing 1,000 pushups a day at the detention center to “stop the voices.” She said the issues were resolved when Smith was referred to the Wyoming State Hospital and was started on anti-psychotic medication.

In her interviews with family and with Smith, she said it was unclear exactly when he began hearing voices and exhibiting other signs of schizophrenia. .... His main problems began in 2000, she said, while he was playing basketball overseas. She said he began to believe people were poisoning his food and stopped eating at restaurants. She said Smith told her that he had an hallucination of opening a drawer at a restaurant and seeing it full of old bones. ....

Once he was admitted to Wishard Health Services in Indianapolis, she said there was a series of consistent diagnoses, including in February 2001, psychosis; April 23, 2001, acute episode of schizophrenia; June to August 2001, and December 2002, schizophrenia of the paranoid type; and June 2003 to July 2005, schizophrenia.

She said along with the incidents previously mentioned, other schizophrenic behavior exhibited by Smith include having the letter “G” burned on the soles of his feet, collecting urine in bottles, seeing dead bodies in the street, believing his family was being threatened, attempting to set his clothes on fire, uncontrollable crying and hearing voices.

Gummow also said there was a notable incident where he asked to have his right arm cut off to prevent from hurting anyone. Under cross-examination, Bohling said that Smith is left-handed and asked why he would want his right arm cut off. Gummow said that was something others asked and no one knew.

Other symptoms, she said, were sexual delusions and not being able to tell fiction from reality. She said for years he believed he was developing a company and would talk to people on the phone who weren’t really there and pick up mail that wasn’t there. She said the delusion was continuing when she examined him in January.

Gummow said she diagnosed Smith with paranoid schizophrenia and a dependence on marijuana. She said while marijuana does not cause psychosis, it can make the symptoms worse. However, she said, she did not believe his marijuana use was a factor in the shooting of McCone. She said Smith told her the last time he used marijuana was about four days before the shooting, but said he used marijuana about four times a week.

Medication

Gummow said medication can help alleviate symptoms of schizophrenics but there are side effects, including making people feel drugged and that life isn’t fun or enjoyable anymore. At times it may make them jumpy and some schizophrenics on medication pace a lot.

Smith was treated with medication but didn’t always take it, Gummow said. She said that was one reason he had a state commitment in Indiana so they could keep track of whether he was taking medication or not. She spoke with a nurse who had helped treat Smith in Indiana and the nurse said he was a “volcano waiting to erupt.” Indiana authorities did not know he had left the state and would not have authorized his leaving.

She said Smith had prescriptions for anti-psychotic and anti-depression medications filled June 15, 2005. Previous testimony showed Smith arriving in Laramie on June 22.

Gummow testified that Smith could appear normal, especially to police officers or others who had not seen him before, during and after a schizophrenic episode. She said because of his intelligence, Smith would be able to recognize social situations and be able to control his thought processes for short periods of time in order to seem normal.

Bohling said, however, that by her own IQ tests administered on Smith, he was average.

Gummow said that people with schizophrenia do better with input, when being asked questions, when around people. She said symptoms become worse when the person is left alone and has no structure.

Regarding the shooting of McCone, Gummow testified that from police reports, including witness statements, it did appear Smith was still dealing with schizophrenic symptoms. The reports indicated that one witness said Smith was “acting strange,” and an officer said he was “visibly shaking.” Another officer said that Smith was vague with his answers and had difficulty understanding some questions. Other witnesses, she said, noted he wore heavy clothes which was unusual during the summer but not unusual for people suffering from schizophrenia.

Gummow said Smith’s recollection of the shooting does not coincide with the evidence at the scene.

She testified that based on her interviews and tests and Smith’s past history, he is not criminally responsible for the shooting death of McCone.

State statute states that, “a person is not responsible for criminal conduct if, at the time of the criminal conduct, as a result of mental illness or deficiency, he lacked substantial capacity either to appreciate the wrongfulness of his conduct or to conform his conduct to the requirements of law. As used in this section, the terms mental illness or deficiency mean only those severely abnormal mental conditions that grossly and demonstrably impair a person’s perception or understanding of reality and that are not attributable primarily to self-induced intoxication.”

Late in Wednesday’s hearing, Aaron Smith took the stand in his own defense. Testimony will continue today with cross-examination.

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About

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Liz Spikol is senior contributing editor of Philadelphia Weekly. She writes the award-winning column The Trouble With Spikol, which began as a chronicle of her struggle with mental illness, and has since expanded into humorous musings on everything from graphic novels to how to use a mop. She also writes the paper's book review column, Lit Gloss. This blog -- named one of the Top 10 Bipolar Blogs of 2007 by PsychCentral -- is about mental illness policy, news, personal journeys and more.