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Law & Psychiatry
Published Online: 24 May 2023

Prosecutors, Judges, and the Punishment of Mental Illness

Abstract

People with mental illnesses are markedly overrepresented in U.S. jails and prisons. Although a variety of factors account for this overrepresentation, punitive actions by prosecutors and judges in response to behaviors caused by mental illness play an important role. A recent Maryland case illustrates how such actions can occur, with excessive charges filed against a woman whose behavior was clearly related to a mental health crisis and the imposition of a disproportionate sentence. Educating prosecutors, defense attorneys, and judges about the nature and consequences of mental illnesses is an essential step toward mitigating the punitive approach of the current U.S. criminal legal system.
Why are so many people with mental illnesses in U.S. jails and prisons? It is commonplace to note that more people with serious mental illnesses are confined in the U.S. correctional system than are being treated in the country’s hospitals (1). A report by the U.S. Bureau of Justice Statistics found that 14.5% of persons confined in prisons and 26.4% of jail detainees met criteria for current serious psychological distress, and 36.9% of prison inmates and 44.3% of jail detainees had been told at some point by a mental health professional that they had a mental disorder (2). One study of five jails indicated that 14.5% of male and 31.0% of female inmates were experiencing a serious mental illness (3), somewhere between three and six times the rate in the general population (4).
The causes of this overrepresentation of people with mental illnesses in correctional facilities are complex, including reliance on the police to handle calls about what are often called “emotionally disturbed persons,” difficulty in accessing psychiatric emergency services and hospital beds, and a tendency to view disruptive behavior as a criminal offense rather than a result of a mental disorder. A recent, egregious case from Maryland highlights the ways in which a punitive mindset in the criminal legal system can lead to punishment rather than treatment of a person experiencing a mental health crisis (5).

Police Response to Disturbed Behavior

On a midafternoon in April 2019 in Cecil County, Maryland, two off-duty sheriff’s deputies spotted Alaina Robbins walking in the middle of a road, blocking traffic, and holding a rifle in her hands. Several years before, Robbins had been sexually assaulted at gunpoint and subsequently diagnosed with posttraumatic stress disorder (PTSD). That afternoon, while cleaning the house she shared with a friend, she found the rifle wrapped in some blankets. By her account, seeing the weapon triggered her PTSD symptoms, and she rushed to get it out of the house. She was confronted by the deputies, who ordered her to drop the rifle, which she did. As she fell to her knees and held her hands behind her back, the deputies approached, at which point she pulled out a knife. Ordered to drop the knife, she did. Perhaps because both deputies were in civilian clothes, Robbins questioned whether they were actually officers. One of the deputies showed her his badge as they escorted her to a marked patrol car.
At that point, the situation began to escalate. Robbins became combative and started kicking the officers, apparently hitting one in the chest. After arrival at the sheriff’s office, she was placed in a cell, where she was observed to be rubbing her wrist repeatedly on the metal door frame in an apparent attempt to injure herself, and she began disrobing. The officers later noticed a smell of urine and feces from her cell. The decision was then made to transport her to the local hospital. When two officers opened her cell door, a struggle ensued. Three other officers joined to help subdue Robbins, by now entirely naked. During the altercation, the officers observed that she held a syringe in her hand, although the evidence is conflicting as to whether the syringe had an attached needle. Robbins yelled that she had HIV and hepatitis C, which the officers took as a threat to infect them. Two of the officers reported minor scratches resulting from the struggle but later tested negative for both viruses.
Robbins’ interaction with the criminal legal system could have ended at that point, with her transfer to a hospital where she could receive appropriate treatment. But it did not. Three weeks later, Robbins was indicted on 35 counts of nine different criminal offenses, ranging from first-degree assault to attempted second-degree escape and including resisting arrest. At trial in January 2020, a judge dismissed 12 of the counts against her, but the jury convicted her on 10 others, among them four counts of first-degree assault and three counts of second-degree assault. She was sentenced to 15 years in prison for the former set of charges and to 10 years for the latter. However, 10 days after the trial had ended, the sheriff’s office produced a surveillance videotape of Robbins’ time in the cell and of the officers’ attempt to extract her—which the office had previously claimed could not be found because of a change in the cell’s monitoring system. Robbins asked the trial court to throw out her convictions on the grounds that vital evidence had been withheld, but the judge found that the tape would not have made a difference to the jurors and declined to do so.

Robbins’ Appellate Journey

What should have been a short-term psychiatric crisis that ended in hospitalization and treatment now became a tortuous journey through the judicial system. Robbins appealed her convictions on several grounds, including the missing videotape that had suddenly appeared after trial. Her case was heard by a three-judge panel of the Court of Special Appeals of Maryland. Unanimously, the judges threw out the convictions on first-degree assault, the most serious of the charges against Robbins, on the grounds that this offense requires an intent to cause serious physical harm, of which there was no evidence. The remaining convictions were overturned because of a 1963 U.S. Supreme Court decision in Brady v. Maryland, which requires prosecutors to turn over to the defense all exculpatory evidence that is material to a finding of guilt or the determination of punishment (6). After reviewing the videotape that had appeared posttrial, the appellate judges concluded that it could have been used to challenge the veracity of the testimony by the officers and hence may have been exculpatory.
At this point, more than 2 years after Robbins’ arrest, given the irregularities that attended her trial and reflecting on the fact that the entire episode stemmed from an acute psychiatric crisis, the State’s Attorney for Cecil County could have declined to take the case any further. However, he elected to retry Robbins on all charges except the charges of first-degree assault, which the appellate court had found not to be supported by the evidence. At retrial, Robbins’ attorney put on a defense that, at best, could be described as lackluster. He waived the right to a jury trial on her behalf, called no witnesses to support her case, never noted that the episode that triggered the charges had occurred in the context of a psychiatric event, and conceded that the state had presented sufficient evidence to proceed with the charge of second-degree assault on the arresting officer (7).
Unsurprisingly given the circumstances, Robbins was again convicted on eight counts, including resisting arrest, second-degree assault on the arresting officer, five counts of second-degree assault that occurred in the sheriff’s office, and malicious destruction of property for damage to the doorframe of a police cruiser during her transport to the hospital. For the second-degree assault convictions related to the struggle inside the sheriff’s office, she received five 5-year sentences, to run consecutively (i.e., for 25 years), plus a 5-year term of probation. Sentences for the other convictions were to run concurrently. The sentences were suspended, meaning that she would be placed on probation for their duration, a total of 30 years, and as long as she remained compliant with the terms of probation, she could remain at liberty in the community.
Robbins again appealed the findings, which ended up before the same three judges on what was now called the Appellate Court of Maryland. She argued that her waiver of a jury trial had been accepted improperly, that there was insufficient evidence to support the resisting arrest and assault convictions, and that the assault on the arresting officer and the charges of resisting arrest should have been merged. Although the appellate court agreed with the last of these claims, it rejected the others and upheld her convictions and sentence, holding that there was adequate evidence to support the remaining charges. What followed, though, is what makes the decision of the court remarkable (7).
The appellate court’s opinion includes a final section titled, “This case was overcharged and overprosecuted, and the end result is legal but not right.” The judges characterized the legal process that Robbins experienced this way: “The charges, trials, and resulting sentence in this case have needlessly and cruelly criminalized the acute mental health crisis that Ms. Robbins suffered on April 16, 2019, and to no productive end.” Recognizing that the sheriff’s officers who found Robbins in the roadway did an effective job of disarming her and defusing the potential danger, the judges had no problem with the “relatively minor” charges of resisting arrest and damage to the patrol car.
However, they noted, “From that point on . . . the charges and prosecutorial decisions defy any sense of proportion.” Emphasizing that Robbins was unarmed and naked during the struggle to extract her from her cell, they said, “Yes, it took some work to get Ms. Robbins out of the cell and to the hospital. But getting her out of the cell and to the hospital was their job. The deputies were in charge the entire time, and their barely discernible physical injuries represented a rational occupational hazard, and not remotely a criminal assault.” The first set of charges she faced were “incredibly aggressive,” and when her convictions were overturned, “the State could have said that enough was enough and focused its prosecutorial attention and resources elsewhere.” In the end, “This whole saga punished Ms. Robbins severely while making nobody in Cecil County any safer.” But the appellate court, which is empowered only to decide issues of law, felt powerless to change the outcome.

Robbins and the Overpunishment of People With Mental Illness

Although Alaina Robbins no longer faces the immediate prospect of an extended prison term, as the appellate court noted, she now has a sword hanging over her: should she fail to observe the terms of her probation, she could end up serving 25 years in prison. How can we understand what occurred in her case? Primary responsibility for an egregious outcome would appear to lie with the state’s attorney. Prosecutors have enormous discretion in deciding whether to bring charges against someone and which charges to bring. A more enlightened prosecutor’s office would have recognized that Robbins’ behavior was driven by her psychiatric condition. Whether she was experiencing the effects of PTSD or psychotic symptoms—as her disrobing and defecating in her cell might suggest—is unclear. But there is no indication that the prosecutor (or for that matter, the defense) requested a psychiatric evaluation that might have clarified precisely what had occurred or even obtained her hospital records.
Thirty-five criminal counts are an extraordinary set of charges to arise from the interactions of law enforcement officers with a clearly distraught person. As the appellate court noted, the list of charges “can be viewed only as punishment for her failure to comply obediently with the officers’ directives,” a way of demonstrating to the citizenry that anything short of complete and immediate compliance will lead to the most severe consequences. But the blame in this case does not belong to the state’s attorney alone. After Robbins’ convictions in each of her trials, the judges—a different one presided each time—who have considerable discretion regarding sentencing, imposed sentences totaling 25 years, a duration usually associated with the violent offenses of career criminals. Although the second judge suspended the sentences, the first judge had not. A punitive approach to mental illness clearly affected the Cecil County judiciary, as well as its state’s attorney’s office.
Another failure of the system should be noted as well. The appellate court found the behavior of Robbins’ defense counsel “inexplicable” in failing to introduce evidence regarding the psychiatric crisis that she was facing at the time of the events. Moreover, it noted that the defense attorney also failed to cross-examine the testifying officers about the contradictions in their testimony across the two trials. Whether she was being represented by a public defender or whether she had engaged private counsel, the weakness of the efforts made in her defense clearly contributed to the unhappy result.
It is unclear how many people with mental illness who end up in jails and prisons have been overcharged by prosecutors and oversentenced by judges. But Robbins’ case is almost surely not unique. The lack of knowledge among judges and attorneys about mental illness contributes to a default position that characterizes much of the U.S. criminal legal system: prosecute and punish chargeable misconduct as aggressively as possible. And the absence of diversion programs leaves a gap in the options available. As a result, our jails and prisons have become our new mental asylums. And as the appellate court asked about Robbins’ case, “What was the point, other than to punish a citizen whose mental health crisis required law enforcement officers to do their jobs?”

References

1.
Torrey EF, Kennard AD, Eslinger D, et al: More Mentally Ill Persons Are in Jails and Prisons Than Hospitals: A Survey of the States. Arlington, VA, Treatment Advocacy Center, 2010. https://www.treatmentadvocacycenter.org/storage/documents/final_jails_v_hospitals_study.pdf
2.
Bronson J, Berzofsky M: Indicators of Mental Health Problems Reported by Prisoners and Jail Inmates, 2011–12. Washington, DC, US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, 2017. https://bjs.ojp.gov/content/pub/pdf/imhprpji1112.pdf
3.
Steadman HJ, Osher FC, Robbins PC, et al: Prevalence of serious mental illness among jail inmates. Psychiatr Serv 2009; 60:761–765
4.
Mulvey EP, Schubert CA: Mentally ill individuals in jails and prisons. Crime Just 2017; 46:231–277
5.
Unreported in the Court of Special Appeals of Maryland, No 651, September Term, 2020—Alaina Robbins v State of Maryland. Opinion by Nazarian, J. Elkton, MD, Circuit Court for Cecil County, 2021. https://mdcourts.gov/sites/default/files/unreported-opinions/0651s20.pdf
6.
Brady v Maryland, 373 US 83 (1963), 1963
7.
Unreported in the Appellate Court of Maryland, No 644, September Term, 2022— Alaina Jean Marie Robbins v State of Maryland. Opinion by Nazarian, J. Elkton, MD, Circuit Court for Cecil County, 2023. https://www.courts.state.md.us/sites/default/files/unreported-opinions/0644s22.pdf

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 778 - 780
PubMed: 37221886

History

Accepted: 3 May 2023
Published online: 24 May 2023
Published in print: July 01, 2023

Keywords

  1. Criminal law
  2. Jails and prisons
  3. Mental illness
  4. Criminal justice system
  5. Mental health services

Authors

Affiliations

Paul S. Appelbaum, M.D. [email protected]
Department of Psychiatry, Columbia University, New York City.

Notes

Send correspondence to Dr. Appelbaum ([email protected]). Dr. Appelbaum is editor of this column.

Competing Interests

The author reports no financial relationships with commercial interests.

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