Opinion ID: 852044
Heading Depth: 2
Heading Rank: 2

Heading: Intoxication and Mental Disease or Defect

Text: In this case, the trial court concluded that Berry did not meet either requirement for a successful insanity defense. Specifically, the trial court found that Berry did not suffer from a mental disease or defect and that he appreciated the wrongful nature of his conduct. The trial court's conclusions were as follows: (1) The Defendant's conduct and statements before, during, and after the attack point to his knowledge of the wrongful nature of his actions. (2) The Defendant's conduct during the assault constituted a substantial step toward the commission of the intended crime of killing Tony Monday. (3) The psychotic symptoms displayed by the Defendant began during his alcohol binge on Saturday and Sunday and continued into the morning of the assault. Given the Defendant's longstanding and chronic alcoholism, coupled with his heavy drinking on the weekend preceding the assault on Monday morning, February 9, the Court concludes that these symptoms were brought on by the Defendant's voluntary abuse of alcohol, rather than the result of Bipolar Disorder or other mental disease or defect. The Court of Appeals reversed, finding that the trial court erroneously rejected Berry's insanity defense. Berry, 950 N.E.2d at 837. On the issue of whether Berry suffered from a mental disease or defect, the Court of Appeals disagreed with the trial court's conclusions and determined that (1) there was no evidence from which a reasonable inference could be drawn that Berry was intoxicated at the time of the offense and that (2) Berry's psychotic state was a product of his settled insanity. Id. at 832, 835. The State argues that the Court of Appeals did not adhere to the applicable standard of review in this case. Specifically, the State claims that the Court of Appeals reweighed the evidence and assessed witness credibility. The State further argues that the Court of Appeals sua sponte found that Berry suffered from settled insanity even though no expert suggested that Berry suffered from such a condition. Ultimately, we must decide the following issue: considering the evidence most favorable to the trial court's judgment, was it contrary to law for the trial court to conclude that Berry's psychotic symptoms were the result of his voluntary abuse of alcohol and not a mental disease or defect? This necessarily requires us to delve into the presented evidence and the fuzzy area of law on intoxication and insanity. Three experts submitted reports and testified to Berry's mental status during the commission of the crime. Dr. Parker, a psychiatrist hired by the defense, was the first expert to testify at trial. He met with Berry in September 2009. In Dr. Parker's report, he noted that Berry said he drank a fifth of hard liquor daily for many years and freely admitted that he was an alcoholic. But Dr. Parker's ultimate conclusion was that with reasonable medical certainty during the time of the offense Berry suffered from a mental disorder, namely bipolar disorder, and accordingly did not appreciate the wrongfulness of his conduct. Dr. Parker elaborated on his conclusion, Mr. Berry meets criteria for diagnosis with bipolar disorder, most recent episode mixed, with psychotic features.... In the days prior to the assault, Mr. Berry started to experience visual hallucinations and delusions of an evil presence in his friend's house. His delusions and hallucinations continued upon his return to his father's house and he began to experience auditory hallucinations on the morning of the assault.... Mr. Berry was described by the ER psychiatrist as delusional, with a disorganized thought process, shortly after his arrest. All but one of the reports noted the defendant had used alcohol fairly heavily over the weekend preceding the assault, but had not been drinking heavily before then and had not consumed alcohol for nearly 24 hours at the time of the attack. It is therefore unlikely the defendant was intoxicated on alcohol at the time of the assault. It is also unlikely the defendant was experiencing delirium tremens.... In addition, the ER physician specifically stated the defendant was not experiencing delirium tremens. At the time of the clinical interview, the defendant had no memory of the assault itself.... Based on the defendant's active psychosis at the time of the assault, his attribution of the assault to an eagle (a symbol for God) and to God's message to him, and his lack of any attempt to flee the scene or destroy evidence, I believe the defendant did not appreciate the wrongfulness of his actions at the time of the alleged offense. At trial, Dr. Parker stated, consistent with his report, that Berry met the requirements for a successful insanity defense because Berry was suffering from bipolar disorder, which had rendered him unable to appreciate the wrongfulness of his conduct at the time of the offense. Dr. Parker also opined that Berry was most likely sober when the incident occurred and that the psychosis was not related to alcohol use or withdrawal. He again noted that the emergency-room physician specifically stated that Berry was not suffering from delirium tremens at the time of the incident. Dr. Olive, a court-appointed psychologist, testified after Dr. Parker. He met with Berry in May 2009. Dr. Olive's report referenced both Berry's bipolar disorder and the resulting inability to appreciate the wrongfulness of his conduct. Dr. Olive specifically stated as follows: With regard to his mental state at the time of the offense, in reviewing his narrative as well as the Probable Cause Affidavit, there appears to be evidence that Mr. Berry was unable to appreciate the wrongfulness of his conduct. Per the admission summary from Wishard Hospital from February 9, 2009, Mr. Berry appears to have been in the midst of a manic episode with psychotic features, as evidenced by persecutory delusions, derealization, and thoughts of control. Although the record from Wishard indicates that Mr. Berry might possibly had been in the midst of alcohol withdrawal, there is no evidence of delirium tremens, the latter of which might potentially account for some of his symptomatology. Thus, I am of the opinion that Mr. Berry's alleged conduct appears to be the direct product of the aforementioned symptomatology stemming from his Bipolar Disorder With Psychotic Features. At trial, Dr. Olive testified consistent with his report, noting Berry's history of bipolar disorder and concluding that Berry could not appreciate the wrongfulness of his actions. Dr. Olive also stated that although he could not rule out alcohol definitively, he did not think that alcohol intoxication or withdrawal played a significant role. He further noted that there was no evidence that Berry was suffering from delirium tremens during the offense. Dr. Masbaum, a court-appointed psychiatrist, was the last expert to testify. He met with Berry in April 2009. Dr. Masbaum's conclusions from his report differed from Dr. Parker's and Dr. Olive's conclusions. Specifically, Dr. Masbaum believed that voluntary alcohol abuse was the likely cause of Berry's symptoms: Due to this individual's history of a diagnosis and treatment of Bipolar Disorder as well as his history of alcohol withdrawal & Polysubstance use, it is difficult to determine with reasonable medical certainty whether he was of unsound mind and unable to appreciate the wrongfulness of his conduct at the time of the alleged offense. It is likely that his symptoms were a result of voluntary alcohol & substance use/intoxication/withdrawal or a combination of all. Based on my experience and training, violent behavior is more likely with the combination of alcohol & substances and a severe mental disorder rather than the disorder alone. His multiple hospitalizations gave him much opportunity to understand his disorder and the importance of taking his medication and the danger of using substances and alcohol with his disorder. At trial, Dr. Masbaum was able to form more definite conclusions on Berry's condition at the time of the offense. Dr. Masbaum stated that at the time of the alleged offense, it was my diagnostic impression there were four possibilities associated with the alcohol use at that time to explain [Berry's] symptoms and behavior. Dr. Masbaum named the four: alcohol intoxication, pathological intoxication, alcohol hallucinosis, and delirium tremens. Dr. Masbaum explained that the first three are connected with voluntary alcohol use whereas delirium tremens is the only one to fall in the category of being a severe mental disorder. The trial court then asked Dr. Masbaum which of the four diagnostic possibilities outlined he would choose based on the course of Berry's treatment at the hospital after the incident and the manner in which Berry responded to the treatment. Dr. Masbaum responded, Well, since [Berry] did not go into delirium tremens ... then I believe one of the other three alcohol situations explain his symptoms and probably the first one, acute alcoholic intoxication, although the second also could be a factor. The trial court explored this issue further and asked Dr. Masbaum, Did you, do you feel that absent delirium tremens that the patient could have been in alcohol withdrawal without any sign of D.T.? Dr. Masbaum responded, Yes. [Berry] could have had just a low grade type of withdrawal. There are all grades of it. The State then asked Dr. Masbaum, So, basically, your diagnosis, the defendant placed himself in the alcohol-induced psychosis by voluntarily abusing alcohol; is that correct? Dr. Masbaum responded, Yes. Dr. Masbaum also explained that Berry could have been intoxicated without showing any signs to that effect: a person with chronic alcoholism can be drinking and not show any signs of intoxication outwardly whatsoever. Dr. Masbaum also explained that although Berry reported that he stopped drinking twenty-four hours before the attack, based on his clinical experience alcoholics are not truthful in reporting how much they drank. Dr. Masbaum also made it clear that he believed that the bipolar diagnosis was questionable because there was just too much alcohol awash here. Several lay witnesses testified after the experts. Richard Lee Smith, a chemical dependency technician and Berry's Alcoholics Anonymous sponsor, testified to the various stages that Berry would go through when he drank. Specifically, Smith testified that Berry would first be intoxicated, then go through a withdrawal stage that would last two to three days, proceed to a normal state, and finally become depressed. [3] Cassandra Turner, who had been married to Berry, and Michelle Thompson, who had dated Berry, both testified to Berry's violent nature after he had been drinking. [4] As stated earlier, temporary mental incapacity produced by voluntary intoxication is not an excuse for a crime. Fisher v. State, 64 Ind. 435, 440, 1878 WL 3066, at . In other words, that sort of temporary mental incapacity is not considered a mental disease or defect under Indiana's insanity statute. On the other hand, Indiana recognizes situations where the ingestion of intoxicants, though voluntary, has been abused to the point that it has produced mental disease. Jackson, 273 Ind. at 52, 402 N.E.2d at 949. This type of mental disease is now commonly referred to as settled or fixed insanity. State v. Sexton, 180 Vt. 34, 904 A.2d 1092, 1101-04 (2006) (citing numerous cases and other sources that have discussed the concept of settled or fixed insanity). In cases where a defendant's conduct is caused by his or her settled or fixed insanity, the defendant would be able to meet the mental-disease prong of Indiana's insanity statute. Here the experts disagreed as to what caused Berry's behavior. [5] Both Dr. Parker and Dr. Olive attributed Berry's behavior to his bipolar disorder. Dr. Masbaum, on the other hand, found that diagnosis questionable. And at trial Dr. Masbaum opined that Berry's symptoms were caused by the voluntary abuse of alcohol and not his bipolar disorder. Notably, none of the experts suggested that Berry suffered from settled or fixed insanity; in fact, all of the experts ruled out delirium tremens, a type of settled insanity caused by the chronic abuse of alcohol. See Fisher, 64 Ind. at 440, 1878 WL 3066, at . The intersection of voluntary intoxication and insanity is murky at best. Jeff Feix & Greg Wolber, Intoxication and Settled Insanity: A Finding of Not Guilty by Reason of Insanity, 35 J. Am. Acad. Psychiatry & Law 172-82 (2007) (describing the complicated process of untangling the effects of mental illness and substance abuse and noting that the picture becomes more clouded when substance abuse is involved in an insanity defense). Certainly, not all chronic alcoholics have destroyed their mental faculties to the point where they suffer from a mental disease as defined in Indiana's insanity statute. On the other hand, consumption of alcohol prior to committing an offense does not automatically rule out the insanity defense, as the underlying cause of a defendant's behavior could be a mental disease. Ultimately, it is for the trier of fact to determine whether the accused's conduct was the result of a diseased mind  regardless of the source of the disease  or was the result of voluntary intoxication. Jackson, 273 Ind. at 52, 402 N.E.2d at 949. Although we agree with the Court of Appeals that settled insanity is a mental disease or defect as defined in the insanity statute, we fail to see how the evidence was without conflict that Berry suffered from such a condition. As stated earlier, no expert suggested that settled insanity was the cause for Berry's behavior; in fact, all three experts ruled out delirium tremens, a form of settled insanity. It is true that Dr. Masbaum could not give an exact label to Berry's condition. [6] But, in the end, Dr. Masbaum did opine that Berry's behavior was caused by his voluntary abuse of alcohol. And the trial court, as the trier of fact, was within its province to accept Dr. Masbaum's testimony at trial, draw reasonable inferences from it, and discredit conflicting testimony. A reasonable inference from Dr. Masbaum's detailed testimony on the subject was that Berry's behavior was due to either voluntarily induced alcohol intoxication or voluntarily induced alcohol withdrawal. The subsequent lay testimony on Berry's post-intoxication behavior buttressed Dr. Masbaum's conclusions. [7] Given the highly deferential standard of review and the expert and lay testimony supporting the trial court's findings, we affirm the trial court. Because the trial court appropriately found that Berry's conduct was not caused by a mental disease or defect, we need not address whether Berry could appreciate the wrongfulness of his conduct.