Opinion ID: 2995876
Heading Depth: 2
Heading Rank: 4

Heading: Brown’s Mental Health Examinations

Text: On November 19 and 21, 1991, doctors from the Cook County Circuit Court’s Psychiatric Institute, at the direction of the criminal court, interviewed and examined Brown to determine his fitness for trial, sanity, and ability to understand his constitutional rights. These examinations were conducted without the benefit of Brown’s history of mental illness, treatment, and confinement in the Menard psychiatric unit.3 His mental history had not been forwarded to the court. Despite her stated belief that there was “certainly an issue of sanity” and her prior request to the trial judge, Brown’s court-appointed attorney Kozlow- ski not only failed to follow up on her subpoena, but also failed to advise the court-appointed doctors (Psychiatric Institute) that she had been informed that Brown had a recent history of treatment for mental illness and of his confinement in the psychiatric unit at Menard. The record reflects that during Brown’s initial competency exam on November 19, he personally made the court- appointed psychologist, Dr. Rabin, aware of the fact that he had a history of prior psychiatric problems and treatment. Brown informed Dr. Rabin that he suffered from multiple hallucinations (“auditory, visual, olfactory, and tactile”), had been placed in a “special unit” at Menard, and was prescribed the anti-psychotic medication thiothixene 3 Whereas it is clear that individuals with chronic schizophrenia often do not fully recover normal functioning and typically require long-term treatment, generally including medication, to control the symptoms, conducting an examination without the benefit of Brown’s records is problematic, to say the least. 8 No. 01-2326 (“Navane”) for some two years while in confinement. Dr. Rabin’s report is summary in nature, evidenced by the fact that he made but a most modest effort to test the credibility of Brown’s assertions concerning his mental health history, his ingestion of prescribed anti-psychotic medication, and his confinement in a psychiatric unit at Menard. Furthermore, he made no effort to locate Brown’s medical records to ascertain the veracity of Brown’s claims. On the contrary, Dr. Rabin’s written report simply reflects his summary dismissal of Brown’s statements concerning his illness, and an acknowledgment that Brown “dropped his allegations of multiple hallucinations” after he had “confronted and pushed” Brown.4 Dr. Rabin’s conclusion that Brown was fabricating his history of mental illness (referring to him as “malinger[ing] in a half-hearted way”), is a particularly dubious judgment when the subject has just recently been diagnosed as a chronic schizophrenic.5 Two days later, on November 21, 1991, Dr. Gerson Kaplan, a psychiatrist at the Psychiatric Institute, met with Brown to evaluate his fitness to stand trial. Prior to interviewing Brown, Dr. Kaplan reviewed the arrest report as well as Dr. Rabin’s report. Even though Dr. Rabin’s notes reflected that Rabin had discussed Brown’s prior psychiatric treatment and confinement at Menard 4 It is well established that persons suffering from schizophrenia behave differently at different times and experience psychotic episodes that come and go. See National Institutes of Health, Schizophrenia, at http://www.nimh.nih.gov/publicat/schizoph.htm. 5 “A well-established history of disorder before the relevant criminal behavior is also useful in helping to rule out malingering [pretending to be ill], although it is not unheard of for even genuinely disordered persons to recall their symptoms at will if it appears to be in their interests to do so.” Robert D. Miller & Edward J. Germain, The Retrospective Evaluation of Competency to Stand Trial, 11 Int’l J.L. & Psychiatry 113, 122 (1994). No. 01-2326 9 with him, Dr. Kaplan also failed to conduct an adequate investigation into the possibility that Brown had in fact been diagnosed as suffering from chronic schizophrenia and had received treatment, including medication, for his mental illness. Dr. Kaplan’s report briefly discussed Brown’s claims of a previous history of psychiatric problems: Defendant states his only psychiatric history was in 1988, when he was stabbed while he was at Menard and he said at that point, he was placed on psychiatric medication, he is vague as to the reasons for this or what the medication was. . . . Defendant denies any other psychiatric history other then [sic] the above mentioned history from Menard. The record reflects that Dr. Kaplan, even though aware of Brown’s claim to have been confined in the Menard psychiatric unit, offered no explanation for his failure to attempt to get information from either Kozlowski or from Menard about Brown’s stated psychiatric problems in testing Brown’s history of past recollection for accuracy and truthfulness. In spite of the absence of information concerning Brown’s case history, Dr. Kaplan concluded that the defendant was “mentally fit for trial” as of November 21, 1991, and furthermore went on to find that he was legally sane at the time of the commission of the offense charged, and submitted this recommendation to the court.