Recognizing And Confronting
Mental Health Issues In Your
Sentencing Practice
Frank Draper, Attorney Advisor,
Defender Services Office Training Division,
Washington, DC
Resources for Mental Health: Mitigation at Sentencing
Frank Draper
Attorney Advisor
Defender Services Office –
Training Division
(202) 502-3418
frank_draper@ao.uscourts.gov
BJS Special Report, MENTAL HEALTH PROBLEMS OF PRISON AND JAIL INMATES (Sept. 2006) at
http://www.bjs.gov/content/pub/pdf/mhppji.pdf
LEARNING TO OBSERVE SIGNS OF MENTAL IMPAIRMENT© BY DEANA DORMAN LOGAN
http://www.dpa.state.ky.us/library/manuals/mental/ch17.html
SOCIAL HISTORY: A TOPICAL CHECKLIST at
http://www.fd.org/pdf_lib/FJC2011/Co_Occurring_Disorders.pdf
INFORMATION THAT WILL BE HELPFUL TO EXPLAIN MENTAL ILLNESS TO THE COURT
Resources
• Information about Mental Health - www.mentalhealth.gov
• National Institute of Mental Health (NIMH) - www.nimh.gov
• Substance Abuse and Mental Health Services Administration (SAMHSA) http://www.SAMHSA.gov
• Department of Veterans Affairs- Office of Mental Health - http://www.mentalhealth.va.gov/
Promoting Mental Health and Preventing Mental Illness
• Suicide Prevention Resource Center - http://www.sprc.org
• The Institute of Medicine’s Preventing Mental, Emotional and Behavioral Disorders Among
Young People: Progress and Possibilities http://www.iom.edu/Reports/2009/Preventing-Mental-Emotional-and-Behavioral-DisordersAmong-Young-People-Progress-and- Possibilities.aspx
• Addressing Bullying - http://www.stopbullying.gov
• National Center for Mental Health Promotion and Youth Violence Prevention http://www.promoteprevent.org
• Find Youth Info - http://www.findyouthinfo.gov
• Million Hearts - http://millionhearts.hhs.gov/index.html
Addressing Public Attitudes
• Resource Center to Promote Acceptance, Dignity, and Social Inclusion http://promoteacceptance.samhsa.gov
• Voice Awards - http://www.samhsa.gov/voiceawards
• Children’s Mental Health Awareness Day - http://www.samhsa.gov/children
Evidence-Based Practices for Treatment
• National Registry for Evidence-Based Programs and Practices - http://www.nrepp.samhsa.gov
• National Center for Trauma-Informed Care - http://www.samhsa.gov/nctic
• Children’s Mental Health Initiative Technical Assistance Center http://www.cmhnetwork.org
Recovery Support Services
• National Consumer Technical Assistance Centers - http://ncstac.org/index.php
• Homeless Resource Center - http://www.homeless.samhsa.gov
• Shared Decision Making in Mental Health Tools - http://162.99.3.211/shared.asp
• College Drinking: Changing the Culture - http://www.collegedrinkingprevention.gov
FIGHTING FACTION WITH FACT TO ATTAIN LOWER SENTENCES at
http://www.fd.org/pdf_lib/FJC2012/Fighting_Fiction.pdf
DEVELOPING MITIGATION EVIDENCE at http://moe.fd.org/Dev_Mitigation.php
REPORT OF THE ATTORNEY GENERAL'S TASK FORCE ON CHILDREN EXPOSED TO VIOLENCE at
http://www.justice.gov/defendingchildhood/cev-rpt-full.pdf
ADVERSE CHILDHOOD EXPERIENCES (ACE) STUDY at http://www.cdc.gov/ace/index.htm
CHILDREN’S EXPOSURE TO VIOLENCE AND THE INTERSECTION BETWEEN DELINQUENCY AND
VICTIMIZATION at http://www.ojjdp.gov/pubs/240555.pdf
DISPELLING THE MYTH THAT GREATER JUDICIAL DISCRETION IN SENTENCING CREATES GREATER
RACIAL DISPARITY IN SENTENCING
•
•
Sonja B. Starr & M. Marit Rehavi, Mandatory Sentencing and Racial Disparity: Assessing
the Role of Prosecutors and the Effects of Booker, 123 Yale L.J. 2 (2013).
• Contrary to other studies (and in particular, the dramatic recent claims of the U.S.
Sentencing Commission), we find no evidence that racial disparity has increased since
Booker, much less because of Booker. Unexplained racial disparity remains persistent,
but does not appear to have increased following the expansion of judicial discretion.
Fact Sheet: No Evidence that Judicial Discretion Increases Racial Disparity
• Rebutting the Sentencing Commission's claims in its December 2012 Report on the
Continuing Impact of United States v. Booker, including its claim that advisory
sentencing guidelines have increased racial and ethnic disparity.
INMATES WITH HISTORY OF MENTAL HEALTH PROBLEMS HAVE HIGHER RATES OF SEXUAL
VICTIMIZATION THAN OTHER INMATES.
• The Prison Rape Elimination Act of 2003 (PREA; P.L. 108-79) requires the Attorney General
to submit to Congress a report on the activities of the Bureau of Justice Statistics (BJS) for
the preceding calendar year. http://www.bjs.gov/content/pub/pdf/pdca13.pdf
• Sexual Victimization in Prisons and Jails Reported by Inmates, 2011-12 (May 2013)
Mental Health Background
• 1 in 5 American adults experienced a
mental health issue
• 1 in 10 young people experienced a period
of major depression
• 1 in 20 Americans lived with a serious
mental illness, such as schizophrenia,
bipolar disorder, or major depression
Percentage of inmates with mental-health problems as of 2004:
Federal prisons
State prisons
local jails
Locked Up. But Where?
Rates of institutionalization, per 1oo,ooo adults
1,000
• Prison and jails
Mental hospita Is
• Combined
O '---_____L__ _
'40
'50
L _ __
___.___--~...
'60
_ _...~___
'70
'80
___J___
'90
_____.l_
'00
States of Denial
Mental-health spending per capita
.. -
...
• $75 or less
• $76 to $105
• $106 to $1 6o
$161 or more
Sources: Bernard E. Harcourt; SAM HSA; NASMHPD
Myth: Personality weakness or
character flaws cause mental
health problems. People with
mental health problems can
snap out of it if they try hard
enough.
Booker & Mental Health
• mental health no longer pigeon holed in
departure land
• mental health now relevant to variances
from the guidelines
• 3553(a)(l) requires Ct to consider nature
& circumstances of offense and history &
characteristics of our client
NEGLECT MEANS FAILING TO PROVIDE:2
FOOD
CLOTHING
ADEQUATE
SUPERVISION
PROTECTION
FROM KNOWN
DANGERS
SAFE/HYGIENIC
SHELTER
EDUCATION
MEDICAL
CARE
NURTURING(
AFFECTION
Note: Legal deflnltiOI'IS var1 across states and differ
Ut:IJellllill!j Ofl Ihe ddld ~our~ ·~t:tl ror rlll<'lf''~
LONG-TERM EFFECTS
PSYCHOLOGICAl
BRAIN
RELATIONAL
HEALTH
DEVELOPMENT
SKILLS
• Depression
• Posttraumatic stress
disorder
·Heightened anxiety
·Changes In the prefrontal
cortex of the brain
• Chang.es to the stress
response system
• Poor peer relations
· Difficulty at woli<
· Aggression
RISK
BEHAVIORS
• Alcohollsm
• Early sexual activity
Learning to Observe Signs of
Menta/Impairment
by Deana Dorman Logan
• Reality confusion
• Personal insight &
• Speech & language problem solving
problems
difficulties
• Memory & attention • Problems related to
issues
physical ability
• Medical complaints • Unusual social
• Inappropriate
interactions
emotional tone
Interview of Mother
• talks to himself a lot
• He has entire conversations with himself. He
will have a conversation with an empty chair.
Sometimes these conversations had an angry
tone.
• Refuses to seek any mental health treatment
• Mr. Smith would pick up odd things on the
street and bring them nome. They included:
old car brake pads, broken children toys, &
pieces of metal
• place mirrors in his window so that the
reflective side was directed out the
window
• believed that he was being followed from
work
• Mother can hear him walking in the house
all night talking to himself
• He often wore hooded hats to cover his
ears 1n summer
• used tin foil to hold the mirrors
•
Expert Mitigation Specialist
• Investigation: conduct witness interviews,
gather records
• Mental Health: diagnosis, prognosis,
treatment plan
• Family/Community: place client in larger
context, explain biological &
environmental influences
Report of the Attorney General's National Task Force on
Children Exposed to Violence
DEFENDING
CHILDHOOD
PAOIECI HEAL THRIVE
Depression
• ''I can remember it started with a loss
of interest in basically everything that
I like doing. I just didn't feel like
doing anything. I just felt like giving
up. Sometimes I didn't even want to
get out of bed."
• Rene Ruballo, Police Officer
2Chl orpromazine, also known as Thorazine. is used to treat psychotic d i sorder~
(conditions that cause di ftl culty tel ling the di tlcrcncc between thi ngs or ideas that arc real and
things or ideas tr hat are not real) and to treallhe symptoms of mania (frenzied. abnormally exci ted
mood) in people who have bipolar disorder (mani c depressive disorder; a co ndition that causes
episodes of mania, episodes of depression. and other abnormal moods).
http ://www . n l m . ni h .gov/m~d l incplus/drugint(lhn~ds/a6R2040.html (Last visited March 22.
_o 12).
2
~nllll'ldez has a history of mental illness. See PSR ll t paragraph 125. A review of tbe medical
record.lrom the Maryland Correctional Adjustment Center (MCAC, now known as !he Chesapeake
Detent
rl£l n• v• confums that Mr. Hernandez has been diagnosed with BiPolar Disorder, NOS
(oot olhe
specified). A health assessment cotlducted by medical personnel when Mr.
Hemande:l
tnMI'etred to tvhrshal's CUS!ody indicated a hisrory of depte.s.siOtl and bipolar
disorder.
time of his transfer from state to federnl custody, Mr. Hernandez wns taking
1 and Oepakote.l His clinical assessment in Marchof2011 a1 MCAC
Trazodone,
found two coex
clinicnl diagnoses: Bipolar Di901'der, NOS. chronic (Axis I • 196.80) and
by inaeasang the amoUIIt of serotonin, a
balance."
1
1Chlorpromazine, also known as Thotazine, is LL<~ed ro !real psycbolic disorders
(oonditions lha! causedifrM:Uity teUing the difference between lhingsor idees that are rea l and
things or ideas lhnt are oot real) ll.Dd IQ 1rea.t the symptoms of mania ( frenz~ aboonnalty excited
mood) a:n people wbo have bipolar disorder (manic depressive disorder; a condition that causes
episodes of mania, episodes of depression, and other abnormal moods).
hnp://www.nlm. run.gov/medl inmiLL~druginfo.lmed.~a6~040.html (La..~
visited March 22.,
2012).
lJDepakote is • bra.nd narne for valproic acid which is used to t.reat m1111ia (episodes of
fJenZied. aboormallyexoited mood) in people witb bipolar disorder (roanio-depressive ~a
d:iseare that causes episodes of depression, episodes of mania, a.nd other abnomtal
moods). hun:I/W ww. nlm. nih. gov/medlmepht~druginfolmt'ldqfo68141 2.hunl (Last visited Mnrch
22, 20 12).
CHARLES TURNER I
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