Excerpt: Representing People with Mental Disabilities, 2nd Edition |
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The following is excerpted from a chapter written by Dr. Carol J. Weiss of Cornell Weill Hospital on substance use disorder. Her entire chapter will be included in the upcoming 2nd Edition of Representing People With Mental Disabilities, Elizabeth Kelley, Editor. The chapter is a guide to the neurobiologic-psycho-social aspects of substance use disorder. |
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The criminal legal system is founded on responsibility. As such, people with substance use disorders who are charged with crimes are entangled in a world where they are criticized for moral failings, or the simple inability to Just Say No. It is not that simple. Moreover, people with mental disabilities who have co-occurring substance use disorders may be more susceptible to substance use, or the symptoms of substance use may mimic mental illness. The criminal defense lawyer must understand the complexities of addiction and remission, be able to navigate those complexities when working with the client, and work for an appropriate resolution in a legal system that is often intolerant.
Substance use disorders (SUD) have come to be understood as biologic disorders, replacing earlier beliefs of moral weakness. Although it is important to appreciate the full bio-psycho-social aspects of this chronic, relapsing, treatable condition, the neurobiology of individuals with substance use disorder likely underlies their behavior, more significantly than psychology and socio-economic variables. The perpetuation of addiction can be described as a repeating cycle with three stages: (1) binge/intoxication, (2) withdrawal/negative affect, and (3) preoccupation/anticipation (craving). This relentless cycle can compromise a client’s capacity to be collaborative, and productively engaged with their legal representation.
Understanding the role of biology in SUD is key to managing interactions and expectations with this population. Appreciation of the biologic and sociologic determinants of the behaviors associated with SUD can help generate compassion and patience. The structure and expectations of the legal system do not necessarily align with the structure and expectations of someone with SUD.
Stress, which is practically unavoidable in legal contexts, is a precipitant for use and relapse. Treatment can be an effective source of stress management. Clients should be encouraged to pursue treatment as a means to help them endure their legal course. Of course, where there is access to drug courts, treatment can also be an alternative to incarceration.
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If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental disabilities. To schedule a consultation call (509) 991-7058.
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Representing People with Mental Disabilities: A Practical Guide for Criminal Defense Lawyers
Edited by: Elizabeth Kelley
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The second edition of Elizabeth’s groundbreaking book, Representing People with Mental Disabilities: A Practical Guide for Criminal Defense Lawyers, will be released later this summer. This edition will include new chapters on Substance Use Disorders and Post-conviction remedies, as well as updated chapters on Competency, Sanity, False Confessions, and Neuro-imaging. |
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Mental Disability and the Criminal Justice System |
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A podcast which provides information - and hope - to people with mental disabilities ensnared in the criminal justice system, as well as to their families and attorneys. |
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N.Y. Prisons Holding Mentally Ill People in Solitary, Lawsuit Says
Each time Stephanie Peña was placed alone in a prison cell the length and width of a parking spot, she could feel herself losing it.
Ms. Peña, 23 and living with post-traumatic stress and antisocial personality disorders, would recoil from the bloodstained mattress and the feeling of pests crawling over her as she slept. Desperate, she sometimes tried to harm herself just so her guards would let her out.
When New York banned the use of long-term solitary confinement in its prisons and barred the practice entirely for certain people, including mentally ill prisoners like Ms. Peña, it was hailed as a groundbreaking measure that would fundamentally change life behind bars.
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America’s prison system is turning into a de facto nursing home
In late 2018, Richard Washington sent a memo to the US Court of Appeals for the Ninth Circuit with the subject line “Notice I am being killed.”
The 64-year-old man, who decades earlier was convicted on armed robbery charges, was serving a 63-year prison sentence in Arizona. In his letter, he alleged that the Department of Corrections was refusing to give him medication for his various health issues, which included diabetes, hypertension, and hepatitis C. Because of the lack of treatment, Washington wrote, “My greatest fear is that I’m going to die more sooner than later.”
About six weeks later, he was dead.
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When Prison and Mental Illness Amount to a Death Sentence
Markus Johnson slumped naked against the wall of his cell, skin flecked with pepper spray, his face a mask of puzzlement, exhaustion and resignation. Four men in black tactical gear pinned him, his face to the concrete, to cuff his hands behind his back.
He did not resist. He couldn’t. He was so gravely dehydrated he would be dead by their next shift change.
“I didn’t do anything,” Mr. Johnson moaned as they pressed a shield between his shoulders.
It was 1:19 p.m. on Sept. 6, 2019, in the Danville Correctional Center, a medium-security prison a few hours south of Chicago. Mr. Johnson, 21 and serving a short sentence for gun possession, was in the throes of a mental collapse that had gone largely untreated, but hardly unwatched.
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Menendez Lawyers Cite ‘Traumatic’ History to Explain His Cash Stockpile
When Senator Robert Menendez was charged last year with participating in a complex bribery scheme, news headlines highlighted a peculiar detail: Investigators had discovered more than $480,000 in cash and 13 bars of gold during a June 2022 search of his house in New Jersey.
Days later, the senator offered an explanation for the cash, saying he routinely withdrew large sums of money from his savings account, a custom he said he had learned from his Cuban immigrant parents.
Now, Mr. Menendez’s lawyers have gone further, asserting that the habit was rooted in deep psychological trauma tied to his father’s suicide nearly 50 years ago and a family history of confiscated property in Cuba.
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The Threat
ENDICOTT, N.Y. — The night he made the threat, Joe Morelli was exactly where he is now two years later, on his couch.
The couch is blue and beginning to sag. It sits in the living room of his small apartment in south-central New York. Since Morelli, 52, also sleeps on the couch every night, he keeps a piece of plywood beneath the cushions, because the softness of the cushions makes his back hurt. At the foot of the couch, he stores a few stacks of old family photos, including several of his two children, and he looks at the photos sometimes when he is feeling lonely, which is not all the time, but does happen, because he lives alone and has not spoken to his children in more than 20 years. When he wakes up on the couch each morning, he walks to the kitchen to make a pot of coffee and then returns to the couch, where most everything else that he needs is on the table in front of him. His pills, which he uses to treat his bipolar disorder. His gum, his glasses, his phone, and his remote, which he picks up now to turn on the television and watch the news, which is what he had been doing the night he got so angry that he made the threat.
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A Colorado family's struggle with young woman's mental illness faces frightening reality
The mother of Olivia Schack sits in her home and worries. "We are trying to protect her from herself. She's more of a danger to herself than anyone else. But it's just almost impossible," says Kendra Anderson. "I'm just at a loss."
Schack is now 24. She has been at the Colorado Mental Health Hospital in Pueblo for nearly a year as she is evaluated to see if she is competent to stand trial. Four times, experts have determined she is not.
Now her family worries that she will be turned back out onto the streets where she is in danger.
"She's a 24-year-old young girl who's been assaulted many times. I mean, she doesn't even tell us everything. I mean, she's been in and out of the hospital I don't know how many times," said her mother.
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