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Learning how to stand trial

Doug Mattson
John HartPatients at Napa State Hospital go through mock trials in this room to help them become competent to stand trial.
ALL | GrassValleyArchive

Nevada County’s sense of security was shaken Jan. 10, 2001, when three people were slain and three others injured during back-to-back shootings at the Department of Behavioral Health Services and Lyon’s Restaurant.

In a three-day series, The Union looks at what’s happened in the year since then.

Today: How Napa State Hospital, now the home of alleged killer Scott Thorpe, gets patients back to court. Also, the woman Thorpe allegedly stalked speaks.

Friday: Families struggle with their losses, while the survivors continue to heal.

Saturday: How mental-health care has changed for patients, advocates, providers and administrators.

The place could pass for an exclusive private college, or maybe another chateau for the countless wine tasters who visit the nearby vineyards.

Hardwoods shade the boulevard, and on each side are two-story buildings of stucco and plaster, mostly offices and dormitories.

Opened in 1875, it doesn’t feel institutional, much less somewhere for the institutionalized. Then again, you haven’t reached the end of Napa State Hospital’s main entrance.

Take a right and see the 14-foot-high fence topped with another 2 feet of razor wire. The fence forms a 1.6-mile perimeter. Guards keep watch from 10 observation booths – nine of which are staffed 24 hours a day.

There are motion sensors and “14 omni-dimensional cameras that could pick up a dime on one of these roofs out here,” said hospital executive director Dave Graziani.

“The perimeter is secure,” he said. “I feel safe that people are not getting out of there.”

Somewhere in there lives Scott Harlan Thorpe, the Smartville man accused of fatally shooting three people and wounding two in Nevada County on Jan. 10, 2001.

If he’s like most patients, he won’t try to flee. Patients at Napa are judged only low to moderate risks for escape. The only escape since the fences went up, in March 1999, lasted 12 minutes. That person was being escorted to a medical appointment.

Now basic medical services are provided on the inside, where more than 850 seriously mentally ill men dwell. Of those, Thorpe is among 214 patients in Program V – those facing criminal charges but deemed incompetent to assist in their own defense.

They receive medication, therapy and schooling on the legal system so they can be returned to face felonies ranging from theft to murder.

“Our main focus is to get them back to court,” said Ray Reaka, Napa’s nursing coordinator for the legally incompetent.

Staff won’t discuss Thorpe or even acknowledge he’s there, because of patient confidentiality. But a hospital tour offered a glimpse into his daily routine, and the program that provides his only channel back to Nevada County.

Six in 10 in the program leave the hospital within six months, Reaka said. Eight in 10 are out within nine months. The others can stay up to three years, after which they could be held indefinitely through a civil court process.

Thorpe was guaranteed at least an 11-month stay in November, when a staff psychiatrist reported that he needed another six months of treatment, that he was still delusional from schizophrenia.

A guard with a metal-detecting wand gives visitors the once-over on their way through a trio of gates controlled by another guard in a glassed-in box.

“Good thing you’re not wearing beige,” Reaka joked.

What he meant became more clear on the inside.

Napa patients are outfitted in beige – jackets, shirts, pants, even shower shoes come in the unhappy color. Beige-clad groups chatted or strolled the hospital grounds as Reaka led the way to Program V, where staff was preparing for the most crucial stage of each patient’s stay – the mock trial.

Incompetency, by state definition, means a defendant doesn’t understand the nature of his charges or can’t rationally assist his lawyer in his own defense. Both standards applied in Thorpe’s case, said the doctors who interviewed him.

Mock trials get patients to understand the court process. They learn legal jargon and the nature of their charges. Psychologists, social workers, nurses and therapists are cast as judge, prosecutor, clerk and bailiff, while the patient plays the defendant.

“It’s show time. We try to replicate a court setting as best we can,” said Dr. Jim Jones, a hospital psychologist who puts his Shakespearean theater experience to good use as judge.

“It’s not just memorizing facts about the case,” he added, “but do they really understand what ‘incompetent to stand trial’ means, what ‘schizophrenia’ means?”

Said Reaka: “It’s very stressful for people because they have a lot of people watching. You’re performing for people in a large room. Some people say it’s probably more stressful than real court.”

Reaka sat in the back of a second-floor room as 19 beige-clad patients filed in. They varied in age, race and degrees of alertness. Some were expressionless, others faintly interested in the back-row visitors.

All stood when the make-believe bailiff read her opening line: “The court will come to order.”

The defendant was John, a lanky, long-haired figure with a goatee, who gently swayed in his chair while bouncing a leg. He’s a recovering heroin addict who’s spent time in San Quentin Prison, but otherwise calls San Francisco home.

His narrative was scattered, which is common for someone with schizo-affective bipolar disorder. But he could explain why he ended up at Napa. He allegedly violated probation by getting into a domestic dispute and failing to appear in court for a ticket issued to him for selling secondhand clothes on the street.

Dr. Jones, wearing a black robe, was impressed.

For most patients, he said later, “I think the most prominent weakness would be not having a full understanding of the information contained in the police report.”

But John’s outlook on his medication, therapy and even his diagnosis had worried Jones and other staff members.

“I don’t feel I have a mental illness,” John explained. “I feel I was in a bad environment that caused me to snap.”

Asked how he’ll regulate his medication back on the streets, John said he’ll probably rely on herbs and stay clear of heroin. And again, he insisted, his problem was his living situation.

“Maybe I’d be able to get a little place with a front yard so I can settle down or something,” John said.

During this exchange, a patient in the back row repeatedly crouched and muffled his laughter. He would sit up, look around, and then laugh again.

“He was probably hallucinating,” Reaka said later.

John’s mock trial was on Dec. 11. He eventually was found competent and returned to San Francisco authorities after he honed his understanding of the legal system and need for medication.

The hospital doesn’t keep numbers on how many people succeed or fail on the streets. Some, after getting their day in court, return to Napa after being found not guilty by reason of insanity.

Tracking all the patients would be monumental, given the many jurisdictions involved, staff members say.

“It would be great information to have, but it just doesn’t happen,” Jones said.

Patients must clear several hurdles before getting to a mock trial.

In their living units, they attend group sessions on symptom management, medication management and problem-solving. All the classes, Jones said, center on the question: “How do they get help if they feel mentally ill?”

The living quarters aren’t much brighter than the beige outfits, but they’re clean and the patients walk around easily.

Beyond their bedrooms – sized for one, two or four patients – they have rooms to make art, watch TV and play table tennis. There’s also a small law library.

Some mumbled or smiled for no particular reason while walking across the peach-and-white tiled hallway.

Likewise, the staff feels at ease, despite the violent pasts of some patients.

“As you get more experience, you’re more comfortable being around these guys,” Reaka said. “A lot of people are motivated to get out of here, so they behave themselves pretty much. They don’t act out a lot. They’re pretty high-functioning once they’re stabilized.”

Not all patients are eager to leave the hospital, given that some face the prospect of prison. Patients who fake their illness, or lack of progress, are called malingerers.

Chief, the mute character in “One Flew Over the Cuckoo’s Nest,” is analogous to one of Reaka’s examples.

“A really good one we had was someone who wouldn’t talk,” he said. “He started smiling at stuff we were saying, so we started to pick up on that. After years in training, you learn what people look like when they’re distressed with mental illness.”

Some patients, as they escape their delusions and clear their minds, come to first-time realizations about the crimes they’ve committed. The epiphanies are unpredictable.

Deep depression and sorrow can ensue.

“I’ve had some people have committed heinous crimes, murder, who have just shown a sadness for what they have done,” Jones said. “There are some clients who don’t show remorse, but you never know who that will be.”

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