Louis Theroux s01e23 Episode Script
By Reason of Insanity: Part 1
For the first time in 60 years, Ohio's state psychiatric hospitals had allowed cameras in to film with patients.
Most of the men and women I'd be meeting have committed serious crimes but been found NGRI - not guilty by reason of insanity - and detained not for punishment, but for treatment.
Do you feel guilt over what happened? No, cos I wasn't in my right mind.
It wasn't my actions of wanting to do that, it was my illness.
This week I'd be talking to patients attempting to come to terms with their crimes I was so powerful, I thought I was psychic and that I could communicate with anybody I wanted to with my mind.
the clinicians entrusted with helping to make them safe Do you ever do what the voices tell you to do? Yeah.
If it's clearly a bad idea I won't listen to them.
and I'd be exploring the difficult question of when a patient with a serious crime in his past is ready for the outside world again.
I was at Summit Behavioural Healthcare in Cincinnati, heading to Unit.]
- home to long-term NGRI patients whose mental health symptoms are largely under control.
With me was unit psychologist Dr Borack.
Jonathan? We were meeting Jonathan, a forensic patient who'd committed a violent crime against a family member seven years earlier.
Can we come in? How are you doing? I'm Louis.
Hi, Louis.
Jonathan, nice to meet you.
How are you doing today? Fairly well, thank you, for being in the hospital.
Yeah.
How long have you been here? Just over two years now.
So the incident was about seven years ago, is that right? Yes.
When you were how old? 32.
32.
Had you had a history of mental illness before the incident? Yes.
Yes, I had.
Uh, since about puberty I had been dealing with symptoms of depression, but for a few years before I killed my father, I had developed delusions that he was responsible for the bad feelings, the depressive feelings I'd been having, and that the only way to feel better was to kill him.
So how did it happen that you actually ended up killing your father? I mean, I went out one day over to his house, when I suspected no-one else would be around.
I waited till he turned his back, then I drew a knife and attempted to cut his neck.
So you just You didn't creep in, you rang the doorbell Yeahor knocked on the door, and he said He let me in.
He said, "Hi, Jonathan, how are you doing?" Yeah.
He let me in, we walked up a few stairs to the main level, then he turned his back to walk down the hall.
After I began to attack him he asked me why, and I said something to the effect of, "This is for sexually abusing me 20 years ago," which he denied at the time, then.
While you were killing him? Yes.
This was seven years ago.
Between now and then, was there a time when you came to realise that you'd done something terrible? Yes, it took me several months to come to that realisation.
Was that an emotional realisation? There was emotion attached to it, certainly.
What kind? It was kind of amuted dejectedness.
I no longer believe that he physically or sexually abused me.
How long have you known Jonathan, Dr Borack? Two years.
Two years? Mm-hmm.
And what kind of progress would you say he's making? I think he is making very good progress.
What we've been primarily working on is helping him to access and express his emotions, because that kind of connection to other people and support is what'll be protective against there being any kind of a relapse.
What is your diagnosis? Schizophrenia.
Schizophrenia.
Yes.
What does that really mean? That term, schizophrenia? Well, it means It's a disorder of thought.
That the cognitive style, the perceptions, thinking, are improper, not connected to reality, distorted.
And the slight lack of an ability to express emotions, is that considered to be part of schizophrenia? Yes.
Indeed it is.
In Jonathan's case I believe that it's partially his upbringing and his personality.
It could also possibly be a little bit an effect of the medications.
It would sort of flatten him a little bit.
Were you raised in a family that was a little bit emotionally constipated? We didn't communicate a lot within the family.
Um I told Dr Borack that I was probably 18 years old the first time somebody asked how my day was.
Did you love your father? UmI believe I did, although we were certainly having problems with our relationship in the several years prior to my killing him.
Yes, we'd had challenges before that, but I was not aware of them.
It may sound really perverse, but part of me just wants to see more grief, and Is that the wrong thing for me to feel? It's an understandable feeling, and I think that this is part of why it's so important for us to develop this in him, because this is also how he would appear and present to evaluators and to the court and maybe to the public in general.
And the immediate impression one could gather is that he doesn't care, he doesn't have feelings, he's cold-hearted, but none of that is true.
I don't suggest that it isn't there, just that it doesn't It's less visible than one might wish, given the seriousness of the things that we've been talking about.
Treatment at the hospitals involves a timetable of classes and therapy So then, reach for the heavens, hope for the future, what is he encouraging all of us to do? Never give up.
but for them to be effective, patients' symptoms need to be under control, and that means a regimen of psychoactive medication.
Lithium, 300 milligrams.
It's for my mood.
Minocin, 100 milligrams.
40 milligrams Prozac.
Depending on their progress, patients are assigned a movement level from one to five, which dictates where they can go.
Those who are doing well can take hospital jobs.
It's another way to prepare them for the outside world.
At Kosar, one of Summit's sister hospitals, Eric was delivering comfort items.
Do you do this every clay? Every week.
Once a week? Yeah, once a week.
Can you show me what's in one of these bags? Sure.
So, first of all, this.
This is a soft animal.
They like to cuddle with these and Who does? The ladies, and some of the guys.
For what reason? Maybe agitated or upset.
Would they share it, or would that become one person's toy? One person.
One person.
Unfortunately we're not able to share things with each other.
Why? Contraband.
Some contraband, stuff like that.
This is interesting.
Yeah, there's a squeeze ball.
Those are for with when patients are upset too, and they need to calm down.
Do you have anything like these stress toys? Do you use any treatment like this? Do I have them? No.
No, Louis, I I'm not saying I'm better, I've just gotten past being angry and lonely.
I have a female friend that I'm involved with and Here on the unit? Not here on the unit, but outside, in the community.
And we date, we've been dating for a long time.
She comes to visit me.
Your emotional needs are being met.
Yeah.
Can you have physical contact? Yes, but not intimate.
Not intimate.
Hugs? Yeah, hugs.
I'm here.
OK.
So it just goes in here, with some of the other ones in here? Yeah.
Bubble mixture and socks See, this is other stuff that we have too.
Yeah.
What privilege level are you on? I got level three.
Level three.
Yeah, level three consists of going in the mallway, this end to that end.
Can you go outside? No, that's what I'm saying, I can't go outside, only through here.
Not even supervised? Well, not yet.
As soon as I get level four, then I'll be able to go out into the community.
And how long Not by myself, but with staff.
And how long did you say you'd been inside? 14.
14 years? Yeah.
And you still haven't made it to level four? I did, but the situation prevented me from staying over there and I had to move over here on K2.
I guess we'll say bye-bye now.
Thanks a lot, Eric.
You're welcome.
Until the next time.
All righty.
At Summit, those with the highest movement levels tend to stay on Unit K.
Hey, Corey.
Remember I mentioned to you going over your risk assessment? A patient named Corey was meeting his psychologist.
Back when you lost your mother, and you were dealing with a good deal of depression, you had expressed very clearly that you didn't have much interest in leaving the hospital.
Since that time, you've made a good deal of what we think is progress.
Do you still have concerns about, you know, "Can I make it on my own? How can I make it "without the supports I've had in place for so many years now?" I look forward to leavingnow.
But I'm not in any rush.
You're not in any rush? No.
Why do you say that? I do worry about what I'm going to do when I get out there.
Being able to take care of myself.
I'd like to think I've learned a lot since I've been here, though.
Yeah.
We see you as being very capable.
I mean, clearly you're intelligent.
But I think functionally you're much more capable than maybe you can recognise yet.
You see yourself ultimately living in an apartment maybe all by yourself and handling things like? Sounds lonely.
It does kind of sound lonely.
It does kind of sound lonely.
Uh-huh.
But are you going to stay kind of sequestered away in this apartment? I wouldn't want to live that way.
No, you wouldn't.
No.
What I'd imagine, instead, is that you would be meeting people in the process of getting back in the community.
Mm-hm.
Home, sweet home.
I visited Corey's room with nurse manager Cheryl Milstead.
What led to you being institutionalised? I was arrested.
For? I assaulted a police officer.
Can you talk about how that happened? My girlfriend had cut herself, slashed her wrists.
In a suicide attempt? Yeah.
And I wasn't stable at the time, and I thought there was a conspiracy happening, so I got angry with the woman at the hospital, and she called the police, told them I had threatened her at the hospital, so they came around to arrest me.
But I had heard a voice that night, telling me that I needed to commit suicide when the police came.
And I had a weapon, it was an iron fire poker about this long.
From your house? From my house.
I had it with me when the cop came to the door, I showed it to him.
I hit him in the arm with it, not all that hard, cos I was hoping he'd shoot me and kill me with his gun, but he shot me in the leg.
I didn't know what to do, so I hit him in the arm again.
He shot me in the leg again, and again.
And I was just standing there with three gunshots in my legs thinking my plan had just completely failed, cos I was still alive.
And the next morning I wake up and I'm on the news, on Martin Luther King Jr Day, on TV.
For what? For assaulting a police officer and getting shot, you know.
You made the news? I made the news.
How did that make you feel? I was proud of myself.
Why? Cos I thought it was going to change the election.
I thought Obama was going to get elected because of me, and it was going to be a great thing for the country.
Why did you think that you being shot would lead to Obama getting elected? Because the police shot me on Martin Luther King Jr Day.
And that's just not a good day to shoot somebody.
And Obama was black, and I thought it would work.
It all sort of made sense.
I guess there is a sort of logic there.
What do you think, Cheryl? If you look over here, you see this poster that says, "Darkness cannot drive out darkness.
Only light can do that.
" I look at that every day and think about that night that I got shot.
And there's no way to know if it made any difference at all.
I don't imagine that you getting shot by the police officer made any difference to the outcome of the election.
It's insane to think that it did.
You can see that now? I can see that much, yeah.
Would you agree with that, Cheryl? Yes.
And when you hit the police officer with the poker, how hard did you hit him? Very lightly.
On the arm? On the arm.
You didn't hurt him? No, I think I did hurt him, though.
You did hurt him? Yeah.
How did you hurt him if it was very light? Well, after he shot me three times I hit him again.
Harder? Harder, yeah.
Where? In the head.
Was he hospitalised? Yeah.
Yeah, I don't think he works for the police any more either.
I feel really awful about it.
Morning, John.
Morning, how you doing? Not too bad, thanks.
How are you? I was back at Unit.]
for Jonathan's monthly treatment team.
Morning.
Jonathan, how are you? Leading the meeting was Jonathan's psychiatrist, Dr Rukseniene.
Well, first problem on your plan is mental illness.
Having made good progress, he was being considered for a higher movement level.
We talked with the team about your level.
Mm-hm? And the team decision is to start process for level five.
Oh, good.
OK? Now we need to discuss what you would do on level five, and you know, we focus on therapeutic groups.
Yeah.
So if your mom comes to visit Mm-hm.
maybe you could go out to have a lunch with her.
Yeah, that would be good.
OK.
All right.
Well, anything else, Jonathan? No, I don't think so.
All right, thanks for coming.
OK.
Bye, Jonathan, thanks for coming in.
OK.
How did that go? I think it went well.
Yeah.
You seem pleased.
Yeah.
I don't think he was super-surprised.
I think he was hoping for and figuring maybe, and so it wasn't like this wonderful shock to him.
I mean, he is doing very well.
Clinically, no symptoms, other than negative symptoms.
Yeah.
Negative symptoms, meaning? Meaning deficit symptoms.
You know, his face is not moving when he talks, he doesn't make hand movements, head movements.
It's quite a challenge, you know, to develop that in somebody when it is quite possibly a symptom that won't go away.
Negative symptoms are very difficult, correct, Dr Rukseniene? They're the last to go, and sometimes they don't.
And he did make improvement, actually.
Yeah.
I mean, like, from just reading the records Yeah.
But it's still there.
It's still there.
It was a big day on the unit.
After five years at the hospital, a patient named William had been approved for conditional release, and was leaving.
I'm a guitar player.
You are? Yeah.
What do you play? I play blues rock.
I was doing a TV deal with Channel 12 where I preached the gospel.
On TV? On TV.
You had a TV job? I had a TV job.
Like me? Yes.
Are you kind of a celebrity? In a sense.
Do people recognise you? Yes, they do.
How long have you been here? Well, I've been here about five years.
What diagnosis? Schizoaffective bipolar type disorder.
Mm-hm.
So what happened? I was in my car, speeding.
I was causing traffic jams, I was going through red lights, I was going through stop signs.
I could have killed somebody.
Why? Why were you doing it? I felt that Wright-Patterson Air Force Base was watching me from space.
Is that a local Air Force Base? Yeah.
In Dayton.
You thought they were watching you for a reason? They thought that I was the Mahdi.
The Mahdi, which is the Muslim messiah.
I was so powerful I thought I was God.
I thought I could do anything.
I thought Benjamin Netanyahu was in Israel watching me.
I thought I was psychic and that I could communicate with anybody I wanted to with my mind.
And he told me to speed, so I sped.
Netanyahu did? Benjamin Netanyahu told me to speed, so I sped.
So you had a lot It's kind of funny now, is it? It's funny now because it's absurd.
Doesn't make any sense.
There was a lot going on in your mind.
Still a lot is going through my mind, but as far as I know, I'm well.
Well, William, you ready to go over your medicine? Yes.
All right.
If you feel you ever get stuck and you need more information I'll certainly have time to study this.
What is that? Especially when I get my own place.
Do you know what that is? That's documentation concerning my medication, so what they do and what they are.
It's a thick document.
Gosh, I know.
It's a lot of background on Lot of medication.
what they do for you.
So can you tell me what this one says? How often you One tablet three times a day.
OK.
This is for the side-effect, OK? Helps with involuntary movements.
This is to treat your manic-depressive disorder.
I got you.
You got me? Show me where the psycho The mood stabilisers and the anti-psychotics, those two are the ones I'm concerned about.
OK.
You want me to show you on the paper or you want me to show you with the medicine? Which is easier for you? I want to talk to Dr Rukseniene.
Dr Rukseniene? Mm-hm? I'm feeling low.
Feeling low? Low, low, low.
Low.
Why would you feel low? Theology.
Theology.
When I feel like God is pleased with me, I'm happy.
But when the blasphemous thoughts go through my mind, it brings me down.
Brings me low.
In two seconds from here, I may feel like a million bucks.
But, uh It sounds like manic behaviour, bipolar condition.
Maybe it is.
I think it is because I've been in here so long.
Have any thoughts to hurt yourself? No.
How about anybody else? No.
William, what will happen if you stop taking your medicine? I relapse.
I plummet back into insanity.
Which I do not want to go through ever again.
It's ruined my life.
I could've been married with a family by now, but instead, I'm in here at Summit.
The medication that I'm taking has been prescribed by the city, and I will take them as prescribed, because that's what I have to do.
You ready? Yeah, I'm ready.
OK, good luck.
Good luck with everything, William.
See you later, everybody! I'll see you.
Good luck.
Amen.
Stay out there.
I will.
Cool.
You'll be all right.
I know.
The last time I see you.
How did that go, from your perspective? Well, you probably noticed how anxious he was.
What was, you know, going through my mind, I mean, does he show any signs of psychosis or mood instability? Those were his main Mood instability? Right.
I didn't hear anything psychotic, actually.
When he was talking today, he was not talking about being a Messiah or And he was not talking about telecommunicating with others.
If you'd heard something that seemed to you like psychosis, what would you have done? I would hold the discharge.
Hold the discharge? Even though that would have been a huge blow for him? Yes.
But you were ready to do that? I was ready to do that.
Did it cross your mind? Um Well, I mean, I obviously was thinking about it, yeah.
If you get three of a kind, what do you do? You put them down.
All of them? Yes.
I was with one of Unit J's handful of female patients, Judith.
We were playing a game called Tunk.
So you win that hand.
That's one for you.
You know how to shuffle? I can do my best.
I play bridge with a bunch of people, and they said that officially, you're only supposed to shuffle them three times, but I don't find that enough.
Oh, really? Do you play bridge in here? At visitation.
My friends usually visit once a month.
And have you been here a while? Over five years.
Was there an incident that bought you here? Yes, they said I stabbed a woman on the bus with a pair of scissors for the nursery school.
Children's scissors? Mm-hm.
And they said I stabbed her and that with those pair of scissors.
Do you say that you didn't do that? Yes.
I do.
Were you there? I was there, and those were my scissors, but I didn't stab her.
All I know is they were laying on the bus floor.
What diagnosis do you have? Depending on the psychiatrist who's doing the evaluating, either paranoid schizophrenia or schizoaffective.
When did you first get diagnosed? The mid '70s.
With schizophrenia? Correct.
And do you feel that you do have that? No.
That's one of the impediments for me getting out of here.
So what privilege level are you at? Three.
I get to go out for leisure time.
But you can't leave the hospital.
Correct.
Would you like to be able to do that? I would like to be just discharged like they know I should be, but it's very embarrassing for a number of powerful people.
How do you like it here? I don't.
The treatment is abysmal.
Do you accept that the treatment team and the personnel here are doing their best to help you? No.
They're doing their best to help themselves.
Shall we play one more? OK.
Is that all right with you? Sure.
It was Sunday, and for many of the clinicians and psychiatrists it was a day off from the hospital.
But not for the patients.
Hi, Jonathan, how are you doing? Good, thank you.
You? Good to see you.
Not too bad.
Are you having a good Sunday so far? It's decent.
Weekends tend to be a little slow around here.
Is there a reason why you can't get a drink with caffeine in it? They changed the policy a few months ago.
Caffeine is allowed on weekdays before noon, but not in the machines or afternoon.
Why is that? Well, the justification was something like It was claimed that over-caffeination was causing too many codes and Codes? That you hear over the announcements.
Uh, incidents of violence, maybe.
You know, it's disappointing, cos I do like toself-stimulate using caffeine.
I guess I'll just get water for now.
Is that what you're getting? It's close to water, yeah.
Zero-calorie pop.
Can I see your badge? Oh, yes.
And that's you? Yes, that's before I lost about 40 pounds.
I think I was eating from stress.
I was still delusional, I didn't accept that I had a mental illness.
Really? I still felt justified in my acts and I felt like the NGRI plea would dismiss what I felt were justifications for killing my father.
Since meeting Jonathan, I'd found out more about his crime.
His father had been a much-loved professor of history in a small college town, and the killing shocking in its gruesomeness.
One newspaper reported 40 stab wounds.
I was struggling to square the Jonathan that did that with the one I knew.
You were saying that you were still basically, I guess, somewhat disordered in your thinking through the trial.
How did it come about that you feel you began to see things more rationally? Well, the medication may have had something to do with it, but I think a lot of it was just getting a consistent message in individual therapy.
It was challenging.
I mean, that meant that I had done something very wrong, and that was hard to accept.
It's hard to accept that one has had false beliefs.
If something like that were to creep up on you, either because your medication stopped working or because of increased stress or something else, you feel as though you would be able to recognise it? Certainly, yeah.
How? Well, I think I can recognise signs of paranoia.
The conclusions I came to about my father were not very quick.
They tookprobably years.
If I did start to suspect that somebody was hurting me or plotting against me or trying to drug or poison me, um, I can recognise that that's sufficiently unlikely as to probably require some attention.
Good.
I mean, it's a pleasure talking to you, Jonathan.
Thank you.
It's healthy for me to have some experience talking to someone who's not part of the medical profession.
You think so? Yeah.
In what way? You ask some questions that I may not have thought about much before.
You asked me did I love my father, previously, and I gave you an answer, something like, "Well, I may have loved him but didn't like him very much.
" I don't think I'd been asked that before, so I thought about it a little bit, and if I were asked that again my answer would probably be something like, earlier on in life, yes, I did love him, but as the illness progressed we grew more distant.
Are you able to love him now? Oh, I'm able to miss him now.
Yeah.
Seems to suggest that you did love him.
Maybe so, yeah.
Yeah.
Word had got out about my chat with Judith.
I was surprised to learn she had some of the most pronounced symptoms of psychosis of anyone on Unit J.
I arranged to talk to her again, this time with Dr Rukseniene sitting in.
Hi, Judith.
Hello, Louis.
Nice to see you again.
Thank you.
Nice seeing you again too.
So, how you been? My sister came Friday night.
We had a good visit.
And I told her about the BBC being here.
I think it's very exciting.
I'm glad to have the chance to dispel some of the myths about mental illness, even though I say I'm not mentally ill.
This came up when we played cards, didn't it? That you don't believe you are Mentally ill.
You don't believe you are mentally ill.
Is it OK for you to sort of agree to disagree about whether Judith has mental illness? Well, I think I think we do disagree, right? I know.
And, erm You know, we discuss that in treatment team.
All the time.
All the time.
That's one of my goals on my treatment plan.
To verbalise that I'm mentally ill.
And how are you doing with it? I won't do it.
Because I'm not mentally ill.
I'll tell you the last thing at the beginning, that I say I'm the real Jesus Christ and I am female, so you see the hard road I've had to hoe to convince people of that.
But I say that I lived at the same time as the Jesus of the Bible and was Jesus Christ back then, but when they wrote the gospels they confused Jesus and Jesus Christ together.
That didn't come up when we played cards, did it? No.
You mentioned that Dr Rukseniene is very professional.
Yes.
But not therapeutic.
So there's a positive and a negative for you, Dr Rukseniene.
Well, I mean, I enjoy talking with Judith.
Mm-hm.
You've said that before, that I'm very pleasant to talk with.
Very pleasant.
And Judith, you said that you were prepared to stay here in the hospital all this time.
No, I didn't, Doctor.
No? I know you threatened me with it.
It's a possibility, though.
Mm-hm.
Well, no, it's not even a possibility any more.
How come? Because the truth is going to come out.
Was that an emotional experience for you? I mean, I heard all that before.
It's weird, isn't it? Cos you have to sort of honour your sense of what reality is, but also her sense of what her reality is, and she disagrees with this, but she has an illness.
Well, from a clinical perspective there is no doubt.
On some level she might even understand it, because she's taking medicine.
Even though it is court-ordered.
Without insight into the fact that she is mentally ill, Judith is stalled in her treatment.
Considered incapable of facing trial, she could be detained for the maximum term her charges carry - eight years.
Don't these enchiladas look delicious? Amazing.
That looks tricky.
'Back with Corey.
' Is it OK? It's great.
Having made good progress in treatment, he was about to see his forensic review team, or FRT.
Hey, Corey.
Hi, Dr Borack.
How you doing? Very good.
They would be assessing him to see if he was ready to be sent before the courts with a recommendation for conditional release.
We read some very good things about you and talked with your treatment team and they said some very good things about you.
That's exciting.
Do you know what your diagnosis is? Paranoid schizophrenia.
Have you ever had paranoid thinking? Oh, sure.
OK, so before your treatment, you Yeah.
Do you have those kind of thoughts now? No, no.
OK.
I do still hear some voices, though.
I definitely see things.
What kind of things? Like, in the air, I see things in the air.
Like, lights flashing and stars shooting around.
OK.
Is that, like, happening now, or just? Yeah.
OK.
All right.
All the time.
How do you deal with that? I just try to get used to it, really.
And I hear voices too, I just try to get used to them.
OK.
Do you ever do what the voices tell you to do? Yeah.
Like what kind of things? Oh, I don't know.
I don't know.
If it's clearly a bad idea I won't listen to them.
OK.
Like, if it was to hurt myself or something like that.
OK, hurt self, or what about other people? Yeah, I wouldn't ever want to hurt anybody else.
OK.
I know they're not real.
OK.
Well, I guess that's all we've got.
Right.
Thank you, Michael.
Thanks, Corey.
Nice meeting you.
Nice meeting you.
In terms of the spectrum of patients that come to these assessments, where did he sort of score? Where did he fall? Oh, very good.
Very high? I would say, compared to many of the ones we evaluate.
He does admit to having still some residual symptoms.
Mm-hm.
Which adds to his credibility.
Yeah.
Slight concern about his statement that he does he'll do sometimes what the voices tell him to do.
However, he was pretty clear that he wouldn't if it was a bad idea, something harmful.
So it sounds like you're basically giving him the green light at this point, as far as the two of you are concerned.
Yeah, that's how I feel.
Would you say that? Yeah.
I think you aced it.
Yeah, I do too.
That's my dad right there.
Wow, that's It's at Indian Mound.
Did you get on pretty well with him? Oh, yeah.
What was he like? Real kind man.
Who's that? That's my mom.
There I am.
That's you as a baby? Yeah.
With my mom.
And was your childhood pretty happy? Oh, yeah.
Definitely.
These are great photos.
How old are you, Corey? 31.
And how old were you when you first realised you might have mental health problems? I'm not sure.
Uh, first time I was in a hospital I was 14, but I didn't think I had a problem.
I just couldn't sleep, I wasn't eating, wasn't making sense when I talked.
Was there any family history of illness like that? Yeah.
On which side? My dad's side.
And what about the future? I want to be a good influence on the world.
I want to make the world a better place, even in a small way.
That's all I can really hope for.
It just makes me have a lot of urge to leave the hospital and do something like Like I have a second chance, another life now.
Second life to make a difference.
That's all.
I was taking a break from the hospital with an appointment to see William, the ex-televangelist, accompanied by his mother, Beverley.
Bill? He'd now been outside for a month.
He was staying at a hotel on the outskirts of Dayton.
How you doing? Can we come in? Sure.
Come on in.
Welcome.
It's your medication that you're waiting for, they deliver it every day, is that right? Oh, my goodness.
Think my prayers are answered.
That may be somebody else.
Oh, hi.
Oh, hi.
Oh, my gosh.
Oh, my goodness.
Now this is a show.
My dad's on camera now.
Oh! Jesus, I didn't mean Come on in.
No, you can come on in, Bill.
He's the real mental patient right there.
He's the culprit.
Here.
How you doing? Good morning.
I'm kidding, I'm kidding, he's not.
No, I get it.
I'm Louis.
Bill.
Bill, nice to meet you.
Good to meet you, Louis.
You're up from Mexico? Yes, correct.
In your view, how's William doing? Well, he's doing OK.
Uh, personally Hey, this is really a coincidence that everybody comes all at once.
Everybody at the same time.
Now these are my morning meds, right, Bryan? Yep, the yellow ones.
Yeah.
So basically, you or someone comes every day to deliver William his meds? Mm-hm.
Makes it a lot easier for him.
And then for how long does that service continue, do you know? Depends on the client.
Depends on what their needs are.
If we have court orders, with some, it can be as long as the court wants us to.
See you this afternoon, Bill.
We will be by tomorrow.
Same time? Till then, you take care.
Thank you.
I'll see you later.
You round up the list of the meds that I'm taking on those bubble packs.
Yeah, yeah.
I'm taking Zyprexa too.
Yeah.
And Haldol.
Yeah, I know.
Both anti-psychotics.
I know.
Plus the mood stabiliser, the lithium.
What point are you making? That it's a lot? It's a lot.
It's a lot.
You're doing a great job.
I don't know.
I got some issues.
I shouldn't say that.
My life is rich, I'm doing well, I'm in my right mind, I'm aware of that.
I know my warning signs.
I know when I'm about to relapse.
Before you went to Summit for the car chase, had you been hospitalised before that? Many times.
Many times? Since the age of 17 years old, 18 years old, I've been hospitalised several times, I've had six mental relapses.
What happened when you were 17? Gosh, I can't remember now.
I just, erm Oh, I thought that there were Hindus or Muslims after me.
When you were 17? Yeah, I thought the Muslims were after me.
No, I can tell you.
I'll never forget it.
How do you remember it, Beverley? I remember the school calling.
This is hard.
I don't want to share tears, tears are a sign of weakness.
The school called and they said, "Your son is acting different," and I said, "How different?" And they said, "He thinks his dad is on the lawnmower mowing grass.
" He was paranoid, so I took him to a hospital to have them check him out and they said he was very ill, and then it kind of went from there.
I remember he said to me, he said, "Mom, you've never wanted to admit.
" Admit what? That he's mentally ill, or a schizophrenic, and I said, "You know what? And I never will.
" I said, "Do you want me to admit that I gave birth to a nut?" And he said He looked and he thought about it.
He never said another word.
He does fire differently, when he gets nervous, than the rest of us.
He has lost control.
But you're taking a nasty divorce, you're taking 16 or 17 hits of LSD to mess up the brain at age 12 or 13.
That's what I was going to say.
I was So I cannot say And I've said to the doctors, "Show me.
Show me his brain.
"You prove to me that it's different than all of ours.
" They can't do it.
Before I had my first relapse, before How old were you when you started taking LSD? I was young.
I was just a boy.
How old? 16.
15.
Lead the way.
Your house looks great.
Who wrote this? You? I did.
What is it? A diary? I wrote a story for the whole year for him up to age 18.
Ha.
Haven't seen these in a long time.
It says 18th birthday, you enjoy watching TBN - Trinity Broadcast Network Uh-huh.
and Benny Hinn, sometimes too much.
So that's interesting, that he was watching too much evangelical TV.
Yeah.
Does that ring a bell? When he was in the 12th grade, yeah.
When he was 18 or so? Yeah.
I was inspired by evangelism.
TV evangelism.
Do you think there's any way it was related to the onset of the mental illness? It's the other way round.
Go on.
I was exhibiting signs of madness, illness, for about a year.
When I stabilised, I realised what happened to me, and I just felt compelled to sort out my life.
I also felt led to be a preacher but I said to myself, looking in the mirror at myself, that "You don't have the ability to be a preacher, you just can't do it.
" The truth is I did.
I made myself known in the community.
I have tremendous faith.
Faith of 1,000 saints.
There's only one way to heaven and that's through Jesus Christ, and Jesus Christ came and split time as I said, and that's the message of Christmas.
This is me in my prime.
This is? Well, this is me when I'm a boy, I'm just a young kid.
In my life I've had four ministries, and they all have different names.
Are you enjoying it? Yeah, little bit.
We have denied God.
Yet we think we have all the answers, we have the answers for a perfect society, yet we can't solve our marriage problems or our social problems, we can't solve our crime problems.
In the beginning he came and he was born to redeem humanity.
The second time he comes, he will come to reap the harvest.
'When I was doing that I was an amateur.
I was just a kid.
' I'm 36 now, I can put on a show in front of a church and be fine.
I guess that's my calling.
God says believe in me, trust in me.
I am the God that can redeem, I am the God that can restore, I am the God that can lift you up.
I am greater than death and hell.
I redeemed humanity through the power of my word, the power of my spirit.
Receive me, my friends.
That's what God says.
For the hospitals, discharging patients involves a delicate balancing act, weighing their faith in recovery against the very real dangers of relapse.
In 1989, a patient on a weekend pass stopped taking his medication and shot and killed two strangers in a bar.
Hey, Eric, can we come talk to you? The patient's name was Eric - the same Eric I'd met handing out cuddly toys and toiletries.
Hi, Eric.
Good to see you again.
Good to see you too, Louis.
I'd arranged for another visit, this time with his social worker.
When we last spoke you were delivering comfort items in the cart, do you remember? Yeah.
And you were level three at that time.
Yeah, I'm level three right now.
And you're still level three.
But you'd spoken about a wish that you had to get more movement, isn't that right? Yeah.
So can you tell me a little about how that's progressing? Well, I'm in treatment now.
And, um, I'm trying to work towards the process of going back to court for a level four.
Mm-hm.
As I understand it, it's quite a sensitive case.
Would that be one way of characterising it? Yeah.
Mm.
For the hospital I can see, you know, you're rooting for Eric and you're rooting for him to progress through the system and to be given the level of movement that he deserves, and at the same time there's this terrible incident in the background that has to be taken seriously.
And that's why increasing movement is difficult.
So when we talk about holding back on the movement, we're talking about you being safe and the community being safe.
Sometimes it is depressing and other times I excel where I want to, in breakthroughs and my illness and stuff like that.
As far as your illness, do you feel Do you feel that's under control now? Now? Oh, sure, yes.
Very much.
Would you agree, Cathy? Um, I would say you're stable and I would say that you've grown a great deal.
I also see you as a human being Mm-hm.
Yeah.
And you're trying to push forward and you live in an environment that at times is unstable.
And when you've lived here as long as you have, I think it's normal to become frustrated and sometimes say things.
With me pursuing my level four again, we were going for it, and I had a couple of incidents and the hospital - my treatment team at the hospital - felt that we shouldn't go back at this time and go to court to try to advocate for this level four because I had a couple of incidents that happened.
Recently, do you mean? And how recently was this? Well About a month, maybe.
About a month.
It was about a month.
And it was verbal.
Yeah, it was verbal.
There was a verbal incident? Mm-hm.
In the hospital? So was it viewed as a little bit of a wobble? You know, a tiny setback? Yes.
It's a bump in the road.
And we have to be so careful.
How do you see the next few years panning out for you, Eric? I can be in line for another risk assessment in about a year or so.
And within that time I'm going to try everything within my power to do what I need to do in order to make that happen.
You haven't given up on the idea of getting out? No.
No.
No.
What is it that you'd want to convey to the people on the outside who might know about what happened, about the crimes, who might be afraid of the idea of you being released? There's nothing I can say to probably make them feel better at this point now, and in the future, it's not about what I say, it's what I do.
Do you feel guilt over what happened? No, cos I was not guilty.
I mean, it happened, but I wasn't in my right mind, it wasn't my actions of wanting to do that, it was my illness.
OK, thanks, Eric.
Bye, Louis, thank you too.
Thank you very much.
See you later, Eric.
Do you think there's a little part of him that maybe feels or suspects he's being strung along a little bit? I think that's where the anger comes in.
Mm-hm.
When he got so angry with the team for saying If we're going to wait a year, that's a long time to wait to go back to ask for a level where you have supervision in the community with a staff person or a case manager.
Just to get out of these walls.
Yeah.
While supervised for a few hours.
So that's a year.
The fact that he's done something like that once, albeit 25 years ago, does that mean potentially he could do that again? There's always the potential, if someone has done something, for it to happen again.
However, our task is to teach people the importance of staying on those meds, really using those mental health services.
And if the symptoms start to flare, he'll be able to reach out and say, "Something's not right.
" That's our task.
It was Jonathan's turn to face the forensic review team.
How you doing? Good to see you again.
The young man who'd killed his father would be facing two clinicians to see whether he might be ready for unsupervised trips into the community.
Tell us a little bit about level five and what you would do on level five.
OK.
We're requesting passes to the public library.
And a pass to church on Sundays, and also to be able to go out to lunch with my mother when she visits, which would be good.
I told her we're requesting that and she cried.
I guess it was emotional for her.
What triggers do you think would be out there for you? Things that could set you back or throw you off track? Um Stress can be a trigger for recurrence of symptoms, I understand.
Any particular kind of stress, or what? Er It would be stressful for me if someone says, "Hey, I heard about you, "and I don't want you to Around my family," or whatever.
Mm-hm.
Yeah, that would be stressful, but something I've already dealt with on at least one occasion.
And think I'd be able to handle fairly well.
Well, we appreciate you coming and talking to us here today.
OK.
And if you don't have any more questions, that's it.
All right.
Thank you for your time.
Thank you.
How did that go? I thought it went well.
I would be very comfortable recommending that he gets a level five.
Yeah, I don't see a problem with that at all.
This is not now by any means signed off in the full sense.
It still has to go to court, is that right? Yes.
Could the judge still say, "Well, it's still not good enough"? Yes.
Judge can do whatever they want.
If it's a high-profile case especially, if it's viewed as sensitive and controversial.
Yes.
And I guess there's another point that somehow people who get off because they're deemed not guilty by reason of insanity are somehow getting away with it.
People that are found not guilty by reason of insanity don't just walk.
They're under the thumb of the court for the maximum penalty if they were convicted.
Jonathan'll be under the thumb of the court for the rest of his life.
Are you doing a post-game debrief? Oh, little bit, yeah.
How do you feel? I think it went OK.
Yeah.
Yeah.
I've been through a few of those before so I had a sense of what they were going to ask.
You take an interest? Obviously.
You know, that's our project.
Oh, yeah.
Yeah, so I think it went We, you know, we cheer for you.
You said, "We cheer for you?" Yeah.
From the stands.
Because you're proud of Jonathan and the progress he's made? Absolutely.
And you feel he's got a good heart.
Can we say that, or did I go too far when I said that? No, I think you hit it.
Yeah.
What do you think about that? It's good to hear.
Thank you, I find that encouraging.
Yeah.
Thanks, Louis.
With Jonathan seemingly on the verge of a small victory, I found myself reflecting on the sadness his illness had bought into his life and his family's.
After more than a month at the hospital, I'd come to see it as a place of hope, tempered by an awareness of the limits of what medicine and caring can do.
Here, the most humane impulses, to help and to heal, exist in a tension with a fear of risking more lives and more crime.
Next week, I'd be going deeper inside the forensic world, getting to know patients whose personalities make them more difficult to treat I have narcissistic, attention-seeking and a little bit of antisocial.
and exploring the blurred line that defines what we consider insanity.
You OK over there, Charles? Yeah, I'm just playing crazy.
I'm not really here, I'm just playing, yeah.
Most of the men and women I'd be meeting have committed serious crimes but been found NGRI - not guilty by reason of insanity - and detained not for punishment, but for treatment.
Do you feel guilt over what happened? No, cos I wasn't in my right mind.
It wasn't my actions of wanting to do that, it was my illness.
This week I'd be talking to patients attempting to come to terms with their crimes I was so powerful, I thought I was psychic and that I could communicate with anybody I wanted to with my mind.
the clinicians entrusted with helping to make them safe Do you ever do what the voices tell you to do? Yeah.
If it's clearly a bad idea I won't listen to them.
and I'd be exploring the difficult question of when a patient with a serious crime in his past is ready for the outside world again.
I was at Summit Behavioural Healthcare in Cincinnati, heading to Unit.]
- home to long-term NGRI patients whose mental health symptoms are largely under control.
With me was unit psychologist Dr Borack.
Jonathan? We were meeting Jonathan, a forensic patient who'd committed a violent crime against a family member seven years earlier.
Can we come in? How are you doing? I'm Louis.
Hi, Louis.
Jonathan, nice to meet you.
How are you doing today? Fairly well, thank you, for being in the hospital.
Yeah.
How long have you been here? Just over two years now.
So the incident was about seven years ago, is that right? Yes.
When you were how old? 32.
32.
Had you had a history of mental illness before the incident? Yes.
Yes, I had.
Uh, since about puberty I had been dealing with symptoms of depression, but for a few years before I killed my father, I had developed delusions that he was responsible for the bad feelings, the depressive feelings I'd been having, and that the only way to feel better was to kill him.
So how did it happen that you actually ended up killing your father? I mean, I went out one day over to his house, when I suspected no-one else would be around.
I waited till he turned his back, then I drew a knife and attempted to cut his neck.
So you just You didn't creep in, you rang the doorbell Yeahor knocked on the door, and he said He let me in.
He said, "Hi, Jonathan, how are you doing?" Yeah.
He let me in, we walked up a few stairs to the main level, then he turned his back to walk down the hall.
After I began to attack him he asked me why, and I said something to the effect of, "This is for sexually abusing me 20 years ago," which he denied at the time, then.
While you were killing him? Yes.
This was seven years ago.
Between now and then, was there a time when you came to realise that you'd done something terrible? Yes, it took me several months to come to that realisation.
Was that an emotional realisation? There was emotion attached to it, certainly.
What kind? It was kind of amuted dejectedness.
I no longer believe that he physically or sexually abused me.
How long have you known Jonathan, Dr Borack? Two years.
Two years? Mm-hmm.
And what kind of progress would you say he's making? I think he is making very good progress.
What we've been primarily working on is helping him to access and express his emotions, because that kind of connection to other people and support is what'll be protective against there being any kind of a relapse.
What is your diagnosis? Schizophrenia.
Schizophrenia.
Yes.
What does that really mean? That term, schizophrenia? Well, it means It's a disorder of thought.
That the cognitive style, the perceptions, thinking, are improper, not connected to reality, distorted.
And the slight lack of an ability to express emotions, is that considered to be part of schizophrenia? Yes.
Indeed it is.
In Jonathan's case I believe that it's partially his upbringing and his personality.
It could also possibly be a little bit an effect of the medications.
It would sort of flatten him a little bit.
Were you raised in a family that was a little bit emotionally constipated? We didn't communicate a lot within the family.
Um I told Dr Borack that I was probably 18 years old the first time somebody asked how my day was.
Did you love your father? UmI believe I did, although we were certainly having problems with our relationship in the several years prior to my killing him.
Yes, we'd had challenges before that, but I was not aware of them.
It may sound really perverse, but part of me just wants to see more grief, and Is that the wrong thing for me to feel? It's an understandable feeling, and I think that this is part of why it's so important for us to develop this in him, because this is also how he would appear and present to evaluators and to the court and maybe to the public in general.
And the immediate impression one could gather is that he doesn't care, he doesn't have feelings, he's cold-hearted, but none of that is true.
I don't suggest that it isn't there, just that it doesn't It's less visible than one might wish, given the seriousness of the things that we've been talking about.
Treatment at the hospitals involves a timetable of classes and therapy So then, reach for the heavens, hope for the future, what is he encouraging all of us to do? Never give up.
but for them to be effective, patients' symptoms need to be under control, and that means a regimen of psychoactive medication.
Lithium, 300 milligrams.
It's for my mood.
Minocin, 100 milligrams.
40 milligrams Prozac.
Depending on their progress, patients are assigned a movement level from one to five, which dictates where they can go.
Those who are doing well can take hospital jobs.
It's another way to prepare them for the outside world.
At Kosar, one of Summit's sister hospitals, Eric was delivering comfort items.
Do you do this every clay? Every week.
Once a week? Yeah, once a week.
Can you show me what's in one of these bags? Sure.
So, first of all, this.
This is a soft animal.
They like to cuddle with these and Who does? The ladies, and some of the guys.
For what reason? Maybe agitated or upset.
Would they share it, or would that become one person's toy? One person.
One person.
Unfortunately we're not able to share things with each other.
Why? Contraband.
Some contraband, stuff like that.
This is interesting.
Yeah, there's a squeeze ball.
Those are for with when patients are upset too, and they need to calm down.
Do you have anything like these stress toys? Do you use any treatment like this? Do I have them? No.
No, Louis, I I'm not saying I'm better, I've just gotten past being angry and lonely.
I have a female friend that I'm involved with and Here on the unit? Not here on the unit, but outside, in the community.
And we date, we've been dating for a long time.
She comes to visit me.
Your emotional needs are being met.
Yeah.
Can you have physical contact? Yes, but not intimate.
Not intimate.
Hugs? Yeah, hugs.
I'm here.
OK.
So it just goes in here, with some of the other ones in here? Yeah.
Bubble mixture and socks See, this is other stuff that we have too.
Yeah.
What privilege level are you on? I got level three.
Level three.
Yeah, level three consists of going in the mallway, this end to that end.
Can you go outside? No, that's what I'm saying, I can't go outside, only through here.
Not even supervised? Well, not yet.
As soon as I get level four, then I'll be able to go out into the community.
And how long Not by myself, but with staff.
And how long did you say you'd been inside? 14.
14 years? Yeah.
And you still haven't made it to level four? I did, but the situation prevented me from staying over there and I had to move over here on K2.
I guess we'll say bye-bye now.
Thanks a lot, Eric.
You're welcome.
Until the next time.
All righty.
At Summit, those with the highest movement levels tend to stay on Unit K.
Hey, Corey.
Remember I mentioned to you going over your risk assessment? A patient named Corey was meeting his psychologist.
Back when you lost your mother, and you were dealing with a good deal of depression, you had expressed very clearly that you didn't have much interest in leaving the hospital.
Since that time, you've made a good deal of what we think is progress.
Do you still have concerns about, you know, "Can I make it on my own? How can I make it "without the supports I've had in place for so many years now?" I look forward to leavingnow.
But I'm not in any rush.
You're not in any rush? No.
Why do you say that? I do worry about what I'm going to do when I get out there.
Being able to take care of myself.
I'd like to think I've learned a lot since I've been here, though.
Yeah.
We see you as being very capable.
I mean, clearly you're intelligent.
But I think functionally you're much more capable than maybe you can recognise yet.
You see yourself ultimately living in an apartment maybe all by yourself and handling things like? Sounds lonely.
It does kind of sound lonely.
It does kind of sound lonely.
Uh-huh.
But are you going to stay kind of sequestered away in this apartment? I wouldn't want to live that way.
No, you wouldn't.
No.
What I'd imagine, instead, is that you would be meeting people in the process of getting back in the community.
Mm-hm.
Home, sweet home.
I visited Corey's room with nurse manager Cheryl Milstead.
What led to you being institutionalised? I was arrested.
For? I assaulted a police officer.
Can you talk about how that happened? My girlfriend had cut herself, slashed her wrists.
In a suicide attempt? Yeah.
And I wasn't stable at the time, and I thought there was a conspiracy happening, so I got angry with the woman at the hospital, and she called the police, told them I had threatened her at the hospital, so they came around to arrest me.
But I had heard a voice that night, telling me that I needed to commit suicide when the police came.
And I had a weapon, it was an iron fire poker about this long.
From your house? From my house.
I had it with me when the cop came to the door, I showed it to him.
I hit him in the arm with it, not all that hard, cos I was hoping he'd shoot me and kill me with his gun, but he shot me in the leg.
I didn't know what to do, so I hit him in the arm again.
He shot me in the leg again, and again.
And I was just standing there with three gunshots in my legs thinking my plan had just completely failed, cos I was still alive.
And the next morning I wake up and I'm on the news, on Martin Luther King Jr Day, on TV.
For what? For assaulting a police officer and getting shot, you know.
You made the news? I made the news.
How did that make you feel? I was proud of myself.
Why? Cos I thought it was going to change the election.
I thought Obama was going to get elected because of me, and it was going to be a great thing for the country.
Why did you think that you being shot would lead to Obama getting elected? Because the police shot me on Martin Luther King Jr Day.
And that's just not a good day to shoot somebody.
And Obama was black, and I thought it would work.
It all sort of made sense.
I guess there is a sort of logic there.
What do you think, Cheryl? If you look over here, you see this poster that says, "Darkness cannot drive out darkness.
Only light can do that.
" I look at that every day and think about that night that I got shot.
And there's no way to know if it made any difference at all.
I don't imagine that you getting shot by the police officer made any difference to the outcome of the election.
It's insane to think that it did.
You can see that now? I can see that much, yeah.
Would you agree with that, Cheryl? Yes.
And when you hit the police officer with the poker, how hard did you hit him? Very lightly.
On the arm? On the arm.
You didn't hurt him? No, I think I did hurt him, though.
You did hurt him? Yeah.
How did you hurt him if it was very light? Well, after he shot me three times I hit him again.
Harder? Harder, yeah.
Where? In the head.
Was he hospitalised? Yeah.
Yeah, I don't think he works for the police any more either.
I feel really awful about it.
Morning, John.
Morning, how you doing? Not too bad, thanks.
How are you? I was back at Unit.]
for Jonathan's monthly treatment team.
Morning.
Jonathan, how are you? Leading the meeting was Jonathan's psychiatrist, Dr Rukseniene.
Well, first problem on your plan is mental illness.
Having made good progress, he was being considered for a higher movement level.
We talked with the team about your level.
Mm-hm? And the team decision is to start process for level five.
Oh, good.
OK? Now we need to discuss what you would do on level five, and you know, we focus on therapeutic groups.
Yeah.
So if your mom comes to visit Mm-hm.
maybe you could go out to have a lunch with her.
Yeah, that would be good.
OK.
All right.
Well, anything else, Jonathan? No, I don't think so.
All right, thanks for coming.
OK.
Bye, Jonathan, thanks for coming in.
OK.
How did that go? I think it went well.
Yeah.
You seem pleased.
Yeah.
I don't think he was super-surprised.
I think he was hoping for and figuring maybe, and so it wasn't like this wonderful shock to him.
I mean, he is doing very well.
Clinically, no symptoms, other than negative symptoms.
Yeah.
Negative symptoms, meaning? Meaning deficit symptoms.
You know, his face is not moving when he talks, he doesn't make hand movements, head movements.
It's quite a challenge, you know, to develop that in somebody when it is quite possibly a symptom that won't go away.
Negative symptoms are very difficult, correct, Dr Rukseniene? They're the last to go, and sometimes they don't.
And he did make improvement, actually.
Yeah.
I mean, like, from just reading the records Yeah.
But it's still there.
It's still there.
It was a big day on the unit.
After five years at the hospital, a patient named William had been approved for conditional release, and was leaving.
I'm a guitar player.
You are? Yeah.
What do you play? I play blues rock.
I was doing a TV deal with Channel 12 where I preached the gospel.
On TV? On TV.
You had a TV job? I had a TV job.
Like me? Yes.
Are you kind of a celebrity? In a sense.
Do people recognise you? Yes, they do.
How long have you been here? Well, I've been here about five years.
What diagnosis? Schizoaffective bipolar type disorder.
Mm-hm.
So what happened? I was in my car, speeding.
I was causing traffic jams, I was going through red lights, I was going through stop signs.
I could have killed somebody.
Why? Why were you doing it? I felt that Wright-Patterson Air Force Base was watching me from space.
Is that a local Air Force Base? Yeah.
In Dayton.
You thought they were watching you for a reason? They thought that I was the Mahdi.
The Mahdi, which is the Muslim messiah.
I was so powerful I thought I was God.
I thought I could do anything.
I thought Benjamin Netanyahu was in Israel watching me.
I thought I was psychic and that I could communicate with anybody I wanted to with my mind.
And he told me to speed, so I sped.
Netanyahu did? Benjamin Netanyahu told me to speed, so I sped.
So you had a lot It's kind of funny now, is it? It's funny now because it's absurd.
Doesn't make any sense.
There was a lot going on in your mind.
Still a lot is going through my mind, but as far as I know, I'm well.
Well, William, you ready to go over your medicine? Yes.
All right.
If you feel you ever get stuck and you need more information I'll certainly have time to study this.
What is that? Especially when I get my own place.
Do you know what that is? That's documentation concerning my medication, so what they do and what they are.
It's a thick document.
Gosh, I know.
It's a lot of background on Lot of medication.
what they do for you.
So can you tell me what this one says? How often you One tablet three times a day.
OK.
This is for the side-effect, OK? Helps with involuntary movements.
This is to treat your manic-depressive disorder.
I got you.
You got me? Show me where the psycho The mood stabilisers and the anti-psychotics, those two are the ones I'm concerned about.
OK.
You want me to show you on the paper or you want me to show you with the medicine? Which is easier for you? I want to talk to Dr Rukseniene.
Dr Rukseniene? Mm-hm? I'm feeling low.
Feeling low? Low, low, low.
Low.
Why would you feel low? Theology.
Theology.
When I feel like God is pleased with me, I'm happy.
But when the blasphemous thoughts go through my mind, it brings me down.
Brings me low.
In two seconds from here, I may feel like a million bucks.
But, uh It sounds like manic behaviour, bipolar condition.
Maybe it is.
I think it is because I've been in here so long.
Have any thoughts to hurt yourself? No.
How about anybody else? No.
William, what will happen if you stop taking your medicine? I relapse.
I plummet back into insanity.
Which I do not want to go through ever again.
It's ruined my life.
I could've been married with a family by now, but instead, I'm in here at Summit.
The medication that I'm taking has been prescribed by the city, and I will take them as prescribed, because that's what I have to do.
You ready? Yeah, I'm ready.
OK, good luck.
Good luck with everything, William.
See you later, everybody! I'll see you.
Good luck.
Amen.
Stay out there.
I will.
Cool.
You'll be all right.
I know.
The last time I see you.
How did that go, from your perspective? Well, you probably noticed how anxious he was.
What was, you know, going through my mind, I mean, does he show any signs of psychosis or mood instability? Those were his main Mood instability? Right.
I didn't hear anything psychotic, actually.
When he was talking today, he was not talking about being a Messiah or And he was not talking about telecommunicating with others.
If you'd heard something that seemed to you like psychosis, what would you have done? I would hold the discharge.
Hold the discharge? Even though that would have been a huge blow for him? Yes.
But you were ready to do that? I was ready to do that.
Did it cross your mind? Um Well, I mean, I obviously was thinking about it, yeah.
If you get three of a kind, what do you do? You put them down.
All of them? Yes.
I was with one of Unit J's handful of female patients, Judith.
We were playing a game called Tunk.
So you win that hand.
That's one for you.
You know how to shuffle? I can do my best.
I play bridge with a bunch of people, and they said that officially, you're only supposed to shuffle them three times, but I don't find that enough.
Oh, really? Do you play bridge in here? At visitation.
My friends usually visit once a month.
And have you been here a while? Over five years.
Was there an incident that bought you here? Yes, they said I stabbed a woman on the bus with a pair of scissors for the nursery school.
Children's scissors? Mm-hm.
And they said I stabbed her and that with those pair of scissors.
Do you say that you didn't do that? Yes.
I do.
Were you there? I was there, and those were my scissors, but I didn't stab her.
All I know is they were laying on the bus floor.
What diagnosis do you have? Depending on the psychiatrist who's doing the evaluating, either paranoid schizophrenia or schizoaffective.
When did you first get diagnosed? The mid '70s.
With schizophrenia? Correct.
And do you feel that you do have that? No.
That's one of the impediments for me getting out of here.
So what privilege level are you at? Three.
I get to go out for leisure time.
But you can't leave the hospital.
Correct.
Would you like to be able to do that? I would like to be just discharged like they know I should be, but it's very embarrassing for a number of powerful people.
How do you like it here? I don't.
The treatment is abysmal.
Do you accept that the treatment team and the personnel here are doing their best to help you? No.
They're doing their best to help themselves.
Shall we play one more? OK.
Is that all right with you? Sure.
It was Sunday, and for many of the clinicians and psychiatrists it was a day off from the hospital.
But not for the patients.
Hi, Jonathan, how are you doing? Good, thank you.
You? Good to see you.
Not too bad.
Are you having a good Sunday so far? It's decent.
Weekends tend to be a little slow around here.
Is there a reason why you can't get a drink with caffeine in it? They changed the policy a few months ago.
Caffeine is allowed on weekdays before noon, but not in the machines or afternoon.
Why is that? Well, the justification was something like It was claimed that over-caffeination was causing too many codes and Codes? That you hear over the announcements.
Uh, incidents of violence, maybe.
You know, it's disappointing, cos I do like toself-stimulate using caffeine.
I guess I'll just get water for now.
Is that what you're getting? It's close to water, yeah.
Zero-calorie pop.
Can I see your badge? Oh, yes.
And that's you? Yes, that's before I lost about 40 pounds.
I think I was eating from stress.
I was still delusional, I didn't accept that I had a mental illness.
Really? I still felt justified in my acts and I felt like the NGRI plea would dismiss what I felt were justifications for killing my father.
Since meeting Jonathan, I'd found out more about his crime.
His father had been a much-loved professor of history in a small college town, and the killing shocking in its gruesomeness.
One newspaper reported 40 stab wounds.
I was struggling to square the Jonathan that did that with the one I knew.
You were saying that you were still basically, I guess, somewhat disordered in your thinking through the trial.
How did it come about that you feel you began to see things more rationally? Well, the medication may have had something to do with it, but I think a lot of it was just getting a consistent message in individual therapy.
It was challenging.
I mean, that meant that I had done something very wrong, and that was hard to accept.
It's hard to accept that one has had false beliefs.
If something like that were to creep up on you, either because your medication stopped working or because of increased stress or something else, you feel as though you would be able to recognise it? Certainly, yeah.
How? Well, I think I can recognise signs of paranoia.
The conclusions I came to about my father were not very quick.
They tookprobably years.
If I did start to suspect that somebody was hurting me or plotting against me or trying to drug or poison me, um, I can recognise that that's sufficiently unlikely as to probably require some attention.
Good.
I mean, it's a pleasure talking to you, Jonathan.
Thank you.
It's healthy for me to have some experience talking to someone who's not part of the medical profession.
You think so? Yeah.
In what way? You ask some questions that I may not have thought about much before.
You asked me did I love my father, previously, and I gave you an answer, something like, "Well, I may have loved him but didn't like him very much.
" I don't think I'd been asked that before, so I thought about it a little bit, and if I were asked that again my answer would probably be something like, earlier on in life, yes, I did love him, but as the illness progressed we grew more distant.
Are you able to love him now? Oh, I'm able to miss him now.
Yeah.
Seems to suggest that you did love him.
Maybe so, yeah.
Yeah.
Word had got out about my chat with Judith.
I was surprised to learn she had some of the most pronounced symptoms of psychosis of anyone on Unit J.
I arranged to talk to her again, this time with Dr Rukseniene sitting in.
Hi, Judith.
Hello, Louis.
Nice to see you again.
Thank you.
Nice seeing you again too.
So, how you been? My sister came Friday night.
We had a good visit.
And I told her about the BBC being here.
I think it's very exciting.
I'm glad to have the chance to dispel some of the myths about mental illness, even though I say I'm not mentally ill.
This came up when we played cards, didn't it? That you don't believe you are Mentally ill.
You don't believe you are mentally ill.
Is it OK for you to sort of agree to disagree about whether Judith has mental illness? Well, I think I think we do disagree, right? I know.
And, erm You know, we discuss that in treatment team.
All the time.
All the time.
That's one of my goals on my treatment plan.
To verbalise that I'm mentally ill.
And how are you doing with it? I won't do it.
Because I'm not mentally ill.
I'll tell you the last thing at the beginning, that I say I'm the real Jesus Christ and I am female, so you see the hard road I've had to hoe to convince people of that.
But I say that I lived at the same time as the Jesus of the Bible and was Jesus Christ back then, but when they wrote the gospels they confused Jesus and Jesus Christ together.
That didn't come up when we played cards, did it? No.
You mentioned that Dr Rukseniene is very professional.
Yes.
But not therapeutic.
So there's a positive and a negative for you, Dr Rukseniene.
Well, I mean, I enjoy talking with Judith.
Mm-hm.
You've said that before, that I'm very pleasant to talk with.
Very pleasant.
And Judith, you said that you were prepared to stay here in the hospital all this time.
No, I didn't, Doctor.
No? I know you threatened me with it.
It's a possibility, though.
Mm-hm.
Well, no, it's not even a possibility any more.
How come? Because the truth is going to come out.
Was that an emotional experience for you? I mean, I heard all that before.
It's weird, isn't it? Cos you have to sort of honour your sense of what reality is, but also her sense of what her reality is, and she disagrees with this, but she has an illness.
Well, from a clinical perspective there is no doubt.
On some level she might even understand it, because she's taking medicine.
Even though it is court-ordered.
Without insight into the fact that she is mentally ill, Judith is stalled in her treatment.
Considered incapable of facing trial, she could be detained for the maximum term her charges carry - eight years.
Don't these enchiladas look delicious? Amazing.
That looks tricky.
'Back with Corey.
' Is it OK? It's great.
Having made good progress in treatment, he was about to see his forensic review team, or FRT.
Hey, Corey.
Hi, Dr Borack.
How you doing? Very good.
They would be assessing him to see if he was ready to be sent before the courts with a recommendation for conditional release.
We read some very good things about you and talked with your treatment team and they said some very good things about you.
That's exciting.
Do you know what your diagnosis is? Paranoid schizophrenia.
Have you ever had paranoid thinking? Oh, sure.
OK, so before your treatment, you Yeah.
Do you have those kind of thoughts now? No, no.
OK.
I do still hear some voices, though.
I definitely see things.
What kind of things? Like, in the air, I see things in the air.
Like, lights flashing and stars shooting around.
OK.
Is that, like, happening now, or just? Yeah.
OK.
All right.
All the time.
How do you deal with that? I just try to get used to it, really.
And I hear voices too, I just try to get used to them.
OK.
Do you ever do what the voices tell you to do? Yeah.
Like what kind of things? Oh, I don't know.
I don't know.
If it's clearly a bad idea I won't listen to them.
OK.
Like, if it was to hurt myself or something like that.
OK, hurt self, or what about other people? Yeah, I wouldn't ever want to hurt anybody else.
OK.
I know they're not real.
OK.
Well, I guess that's all we've got.
Right.
Thank you, Michael.
Thanks, Corey.
Nice meeting you.
Nice meeting you.
In terms of the spectrum of patients that come to these assessments, where did he sort of score? Where did he fall? Oh, very good.
Very high? I would say, compared to many of the ones we evaluate.
He does admit to having still some residual symptoms.
Mm-hm.
Which adds to his credibility.
Yeah.
Slight concern about his statement that he does he'll do sometimes what the voices tell him to do.
However, he was pretty clear that he wouldn't if it was a bad idea, something harmful.
So it sounds like you're basically giving him the green light at this point, as far as the two of you are concerned.
Yeah, that's how I feel.
Would you say that? Yeah.
I think you aced it.
Yeah, I do too.
That's my dad right there.
Wow, that's It's at Indian Mound.
Did you get on pretty well with him? Oh, yeah.
What was he like? Real kind man.
Who's that? That's my mom.
There I am.
That's you as a baby? Yeah.
With my mom.
And was your childhood pretty happy? Oh, yeah.
Definitely.
These are great photos.
How old are you, Corey? 31.
And how old were you when you first realised you might have mental health problems? I'm not sure.
Uh, first time I was in a hospital I was 14, but I didn't think I had a problem.
I just couldn't sleep, I wasn't eating, wasn't making sense when I talked.
Was there any family history of illness like that? Yeah.
On which side? My dad's side.
And what about the future? I want to be a good influence on the world.
I want to make the world a better place, even in a small way.
That's all I can really hope for.
It just makes me have a lot of urge to leave the hospital and do something like Like I have a second chance, another life now.
Second life to make a difference.
That's all.
I was taking a break from the hospital with an appointment to see William, the ex-televangelist, accompanied by his mother, Beverley.
Bill? He'd now been outside for a month.
He was staying at a hotel on the outskirts of Dayton.
How you doing? Can we come in? Sure.
Come on in.
Welcome.
It's your medication that you're waiting for, they deliver it every day, is that right? Oh, my goodness.
Think my prayers are answered.
That may be somebody else.
Oh, hi.
Oh, hi.
Oh, my gosh.
Oh, my goodness.
Now this is a show.
My dad's on camera now.
Oh! Jesus, I didn't mean Come on in.
No, you can come on in, Bill.
He's the real mental patient right there.
He's the culprit.
Here.
How you doing? Good morning.
I'm kidding, I'm kidding, he's not.
No, I get it.
I'm Louis.
Bill.
Bill, nice to meet you.
Good to meet you, Louis.
You're up from Mexico? Yes, correct.
In your view, how's William doing? Well, he's doing OK.
Uh, personally Hey, this is really a coincidence that everybody comes all at once.
Everybody at the same time.
Now these are my morning meds, right, Bryan? Yep, the yellow ones.
Yeah.
So basically, you or someone comes every day to deliver William his meds? Mm-hm.
Makes it a lot easier for him.
And then for how long does that service continue, do you know? Depends on the client.
Depends on what their needs are.
If we have court orders, with some, it can be as long as the court wants us to.
See you this afternoon, Bill.
We will be by tomorrow.
Same time? Till then, you take care.
Thank you.
I'll see you later.
You round up the list of the meds that I'm taking on those bubble packs.
Yeah, yeah.
I'm taking Zyprexa too.
Yeah.
And Haldol.
Yeah, I know.
Both anti-psychotics.
I know.
Plus the mood stabiliser, the lithium.
What point are you making? That it's a lot? It's a lot.
It's a lot.
You're doing a great job.
I don't know.
I got some issues.
I shouldn't say that.
My life is rich, I'm doing well, I'm in my right mind, I'm aware of that.
I know my warning signs.
I know when I'm about to relapse.
Before you went to Summit for the car chase, had you been hospitalised before that? Many times.
Many times? Since the age of 17 years old, 18 years old, I've been hospitalised several times, I've had six mental relapses.
What happened when you were 17? Gosh, I can't remember now.
I just, erm Oh, I thought that there were Hindus or Muslims after me.
When you were 17? Yeah, I thought the Muslims were after me.
No, I can tell you.
I'll never forget it.
How do you remember it, Beverley? I remember the school calling.
This is hard.
I don't want to share tears, tears are a sign of weakness.
The school called and they said, "Your son is acting different," and I said, "How different?" And they said, "He thinks his dad is on the lawnmower mowing grass.
" He was paranoid, so I took him to a hospital to have them check him out and they said he was very ill, and then it kind of went from there.
I remember he said to me, he said, "Mom, you've never wanted to admit.
" Admit what? That he's mentally ill, or a schizophrenic, and I said, "You know what? And I never will.
" I said, "Do you want me to admit that I gave birth to a nut?" And he said He looked and he thought about it.
He never said another word.
He does fire differently, when he gets nervous, than the rest of us.
He has lost control.
But you're taking a nasty divorce, you're taking 16 or 17 hits of LSD to mess up the brain at age 12 or 13.
That's what I was going to say.
I was So I cannot say And I've said to the doctors, "Show me.
Show me his brain.
"You prove to me that it's different than all of ours.
" They can't do it.
Before I had my first relapse, before How old were you when you started taking LSD? I was young.
I was just a boy.
How old? 16.
15.
Lead the way.
Your house looks great.
Who wrote this? You? I did.
What is it? A diary? I wrote a story for the whole year for him up to age 18.
Ha.
Haven't seen these in a long time.
It says 18th birthday, you enjoy watching TBN - Trinity Broadcast Network Uh-huh.
and Benny Hinn, sometimes too much.
So that's interesting, that he was watching too much evangelical TV.
Yeah.
Does that ring a bell? When he was in the 12th grade, yeah.
When he was 18 or so? Yeah.
I was inspired by evangelism.
TV evangelism.
Do you think there's any way it was related to the onset of the mental illness? It's the other way round.
Go on.
I was exhibiting signs of madness, illness, for about a year.
When I stabilised, I realised what happened to me, and I just felt compelled to sort out my life.
I also felt led to be a preacher but I said to myself, looking in the mirror at myself, that "You don't have the ability to be a preacher, you just can't do it.
" The truth is I did.
I made myself known in the community.
I have tremendous faith.
Faith of 1,000 saints.
There's only one way to heaven and that's through Jesus Christ, and Jesus Christ came and split time as I said, and that's the message of Christmas.
This is me in my prime.
This is? Well, this is me when I'm a boy, I'm just a young kid.
In my life I've had four ministries, and they all have different names.
Are you enjoying it? Yeah, little bit.
We have denied God.
Yet we think we have all the answers, we have the answers for a perfect society, yet we can't solve our marriage problems or our social problems, we can't solve our crime problems.
In the beginning he came and he was born to redeem humanity.
The second time he comes, he will come to reap the harvest.
'When I was doing that I was an amateur.
I was just a kid.
' I'm 36 now, I can put on a show in front of a church and be fine.
I guess that's my calling.
God says believe in me, trust in me.
I am the God that can redeem, I am the God that can restore, I am the God that can lift you up.
I am greater than death and hell.
I redeemed humanity through the power of my word, the power of my spirit.
Receive me, my friends.
That's what God says.
For the hospitals, discharging patients involves a delicate balancing act, weighing their faith in recovery against the very real dangers of relapse.
In 1989, a patient on a weekend pass stopped taking his medication and shot and killed two strangers in a bar.
Hey, Eric, can we come talk to you? The patient's name was Eric - the same Eric I'd met handing out cuddly toys and toiletries.
Hi, Eric.
Good to see you again.
Good to see you too, Louis.
I'd arranged for another visit, this time with his social worker.
When we last spoke you were delivering comfort items in the cart, do you remember? Yeah.
And you were level three at that time.
Yeah, I'm level three right now.
And you're still level three.
But you'd spoken about a wish that you had to get more movement, isn't that right? Yeah.
So can you tell me a little about how that's progressing? Well, I'm in treatment now.
And, um, I'm trying to work towards the process of going back to court for a level four.
Mm-hm.
As I understand it, it's quite a sensitive case.
Would that be one way of characterising it? Yeah.
Mm.
For the hospital I can see, you know, you're rooting for Eric and you're rooting for him to progress through the system and to be given the level of movement that he deserves, and at the same time there's this terrible incident in the background that has to be taken seriously.
And that's why increasing movement is difficult.
So when we talk about holding back on the movement, we're talking about you being safe and the community being safe.
Sometimes it is depressing and other times I excel where I want to, in breakthroughs and my illness and stuff like that.
As far as your illness, do you feel Do you feel that's under control now? Now? Oh, sure, yes.
Very much.
Would you agree, Cathy? Um, I would say you're stable and I would say that you've grown a great deal.
I also see you as a human being Mm-hm.
Yeah.
And you're trying to push forward and you live in an environment that at times is unstable.
And when you've lived here as long as you have, I think it's normal to become frustrated and sometimes say things.
With me pursuing my level four again, we were going for it, and I had a couple of incidents and the hospital - my treatment team at the hospital - felt that we shouldn't go back at this time and go to court to try to advocate for this level four because I had a couple of incidents that happened.
Recently, do you mean? And how recently was this? Well About a month, maybe.
About a month.
It was about a month.
And it was verbal.
Yeah, it was verbal.
There was a verbal incident? Mm-hm.
In the hospital? So was it viewed as a little bit of a wobble? You know, a tiny setback? Yes.
It's a bump in the road.
And we have to be so careful.
How do you see the next few years panning out for you, Eric? I can be in line for another risk assessment in about a year or so.
And within that time I'm going to try everything within my power to do what I need to do in order to make that happen.
You haven't given up on the idea of getting out? No.
No.
No.
What is it that you'd want to convey to the people on the outside who might know about what happened, about the crimes, who might be afraid of the idea of you being released? There's nothing I can say to probably make them feel better at this point now, and in the future, it's not about what I say, it's what I do.
Do you feel guilt over what happened? No, cos I was not guilty.
I mean, it happened, but I wasn't in my right mind, it wasn't my actions of wanting to do that, it was my illness.
OK, thanks, Eric.
Bye, Louis, thank you too.
Thank you very much.
See you later, Eric.
Do you think there's a little part of him that maybe feels or suspects he's being strung along a little bit? I think that's where the anger comes in.
Mm-hm.
When he got so angry with the team for saying If we're going to wait a year, that's a long time to wait to go back to ask for a level where you have supervision in the community with a staff person or a case manager.
Just to get out of these walls.
Yeah.
While supervised for a few hours.
So that's a year.
The fact that he's done something like that once, albeit 25 years ago, does that mean potentially he could do that again? There's always the potential, if someone has done something, for it to happen again.
However, our task is to teach people the importance of staying on those meds, really using those mental health services.
And if the symptoms start to flare, he'll be able to reach out and say, "Something's not right.
" That's our task.
It was Jonathan's turn to face the forensic review team.
How you doing? Good to see you again.
The young man who'd killed his father would be facing two clinicians to see whether he might be ready for unsupervised trips into the community.
Tell us a little bit about level five and what you would do on level five.
OK.
We're requesting passes to the public library.
And a pass to church on Sundays, and also to be able to go out to lunch with my mother when she visits, which would be good.
I told her we're requesting that and she cried.
I guess it was emotional for her.
What triggers do you think would be out there for you? Things that could set you back or throw you off track? Um Stress can be a trigger for recurrence of symptoms, I understand.
Any particular kind of stress, or what? Er It would be stressful for me if someone says, "Hey, I heard about you, "and I don't want you to Around my family," or whatever.
Mm-hm.
Yeah, that would be stressful, but something I've already dealt with on at least one occasion.
And think I'd be able to handle fairly well.
Well, we appreciate you coming and talking to us here today.
OK.
And if you don't have any more questions, that's it.
All right.
Thank you for your time.
Thank you.
How did that go? I thought it went well.
I would be very comfortable recommending that he gets a level five.
Yeah, I don't see a problem with that at all.
This is not now by any means signed off in the full sense.
It still has to go to court, is that right? Yes.
Could the judge still say, "Well, it's still not good enough"? Yes.
Judge can do whatever they want.
If it's a high-profile case especially, if it's viewed as sensitive and controversial.
Yes.
And I guess there's another point that somehow people who get off because they're deemed not guilty by reason of insanity are somehow getting away with it.
People that are found not guilty by reason of insanity don't just walk.
They're under the thumb of the court for the maximum penalty if they were convicted.
Jonathan'll be under the thumb of the court for the rest of his life.
Are you doing a post-game debrief? Oh, little bit, yeah.
How do you feel? I think it went OK.
Yeah.
Yeah.
I've been through a few of those before so I had a sense of what they were going to ask.
You take an interest? Obviously.
You know, that's our project.
Oh, yeah.
Yeah, so I think it went We, you know, we cheer for you.
You said, "We cheer for you?" Yeah.
From the stands.
Because you're proud of Jonathan and the progress he's made? Absolutely.
And you feel he's got a good heart.
Can we say that, or did I go too far when I said that? No, I think you hit it.
Yeah.
What do you think about that? It's good to hear.
Thank you, I find that encouraging.
Yeah.
Thanks, Louis.
With Jonathan seemingly on the verge of a small victory, I found myself reflecting on the sadness his illness had bought into his life and his family's.
After more than a month at the hospital, I'd come to see it as a place of hope, tempered by an awareness of the limits of what medicine and caring can do.
Here, the most humane impulses, to help and to heal, exist in a tension with a fear of risking more lives and more crime.
Next week, I'd be going deeper inside the forensic world, getting to know patients whose personalities make them more difficult to treat I have narcissistic, attention-seeking and a little bit of antisocial.
and exploring the blurred line that defines what we consider insanity.
You OK over there, Charles? Yeah, I'm just playing crazy.
I'm not really here, I'm just playing, yeah.