Commentary

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by Matthew J. D'Emic

As I sat in Saint Mathias Church in Brooklyn waiting for the priest to walk the main aisle to the door of the church and greet the coffin containing the body of Rene, I was struck by the beauty of the place. It belied the ugly truth of Rene's decision at age 24, that suicide was preferable to living with mental illness. That is what his suicide note said, found by his mother next to his lifeless body, three days earlier.

The funeral rites of the Roman Catholic Church are rich in majesty and mystery. The funeral mass, resplendent with the priest's white vestments, blessing with holy water and prayers to the saints and angels for the speedy deliverance of the departed's soul to the throne of God, is comforting and cathartic. The pungent odor of incense rising as a symbol of the mourners' prayers is powerful. It is a liturgy that seeks to explain the secret of life's suffering. It looks to alleviate the distress of the terrible finality of death, if just for one hour, recalling scriptural promises of eternal life. In this way those bereaved by loss, even the unimaginable loss of a child by his own hand, can feel hope. The child's life is changed, not ended. He is in the arms of a welcoming and loving God. Free of illness. Free of pain.

As the priest began to pray and the white pall was placed over Rene's coffin, I could not help but think how unusual it was for me to be there among the community of mourners. I am a judge in Brooklyn and Rene was a criminal defendant who appeared in my court. I was not sure that anything like this had ever happened before. Just one more example of how my role as a judge has changed since my appointment to the Brooklyn Mental Health Court.

As is well known, mental health courts seek to use the authority of the court for the psychological benefit of the accused and well-being of society by using therapeutic principals. Rather than resolve cases quickly without regard to long-term outcomes in dealing with defendants suffering from mental illness, mental health courts connect defendants to treatment in an attempt to stop future criminal behavior. That was how I met Rene.

It was a spring day when Rene was referred to the Brooklyn Mental Health Court. As he appeared before me with his attorney my attention was immediately drawn to the bizarre tattoos of celestial bodies that dotted his face and arms. He had assaulted his grandmother's neighbor with a knife, a serious charge. Evaluated by a social worker and psychiatrist working with the court, Rene was diagnosed with bipolar type schizoaffective disorder. His illness was characterized by extreme episodes, as the doctor explained, "ranging from depressed, inert and suicidal lows to hyperactive, wild, grandiose highs, to unbridled rage, lasting anywhere from hours to months." Also typical of this type of illness, Rene suffered from paranoia and auditory hallucinations. All of this was complicated by self-medication with marijuana and alcohol. The onset of the disease came at age 19, requiring six hospitalizations, an assertive community treatment team and assisted out-patient treatment order by another judge - all before he got to me on the criminal charge. As our doctor sadly wrote, the disease "thoroughly disabled him since his late teens."

Rene met the qualifications for the mental health court and pled guilty to felony and misdemeanor assault. It was agreed that if he successfully completed the court's 18 month mandate of medication, therapy and drug treatment, he would receive misdemeanor probation with no felony record. If he failed, however, he faced three years in prison. Over the next six months, Rene appeared before me 27 times.

In those six months I saw Rene do poorly and then well. He missed appointments, he made appointments. He left his drug program and was sent to rehab. After rehab he did better, but then missed two weeks of program. This lapse was the result of Rene being left alone because of a family emergency out of state. Rene became paranoid and panicky. He ran out of medication and refused to leave the house. This was quite a learning experience for a judge with no training in mental health.

At one point I put Rene in jail for a week in an attempt to get him to understand the seriousness of compliance with the court's treatment mandate. Again, he did well for awhile and then started doing poorly. The last three times I saw Rene he was doing better. In September he had a good report but did not show up for court. Rather than order an arrest warrant I decided, because of the good report, to give him a court date the following week. Later that day came the news of his suicide. The following day Rene's mother called the court's clinical director to ask if I would attend Rene's funeral.

As the Mass ended and the final blessing was pronounced I stood and faced the center aisle and watched Rene's family tearfully follow his coffin. They were as much victims of Rene's illness as he was. Taking my place behind the mourners I was greeted warmly by his mother, father and uncle. Rene's mother introduced me to Rene's younger brother and sister. She asked me to wait while the uncle retrieved a collage of photographs prepared for the wake. The grieving mother pointed each picture out and explained the family event it represented. The difference in Rene's appearance before the affects of his debilitating illness was remarkable. The family photos showed a happy teenager. No odd tattoos, no hospitalizations, no mood extremes. A happy member of a happy family. Now this mother was the living reflection of the statue of the Pietà inside the church.

A year has passed since Rene's funeral. I often think of him and his family. Although the Brooklyn Mental Health Court can boast of over 300 successful graduates, Rene is not one of them. In fact there have been other suicides. I did not anticipate any of them. Unlike the cancer patient who gives up on treatment because the physical pain is too much to bear, the suffering of the patient with mental illness is concealed and misunderstood.

When a young man dies of physical illness the church is usually packed with people sympathetic to the grief of the family. This is not always so for families distraught from the fatal effects of mental illness. There was a time when the Catholic Church denied a funeral to victims of suicide. In an act of compassion and understanding the church's position changed. Perhaps criminal justice initiatives like mental health courts can help further eliminate the stigma attached to mental illness. Perhaps one day society will treat persons suffering from mental illness like it does those suffering from physical illness - with kindness.

Judge Matthew J. D'Emic is the presiding judge of the Brooklyn Mental Health Court and Brooklyn Domestic Violence Court. He is a co-chair of the Criminal Justice Section's Alternative to Incarceration and Diversion Committee.

Comments (3)
Harry N:

I can appreciate a compassionate judge, when so many are not.
Stories like this offer hope to a society that often denies it to those who are "different".
Perhaps one day the "herd" mentality of the 85 percent in our society will indeed change.
I applaud this judge for considering the human condition and even more so by seeing that many do recover, and in all people resides the ability to do good or harm.
This is the human condition.

Good job! ..Matthew J. D'Emic, may we find more judges and even more people like you!
Harry N.

Posted by Harry N | December 8, 2009 12:09 PM
Rod Jackson:

It's often the case these days that a person who commits a minor offense that is said to be out of character is diagnosed with a mental illness and escapes punishment from the law. This can be crazy making. The person can then be subjected to a lifetime of the misery of the drugging, humiliation and infantilization. Once treated this way they are likely to become criminally crazy or die young.

My experience of prisons is that they are sensible places. Prisoners are not generally compelled to be drugged and are treated with respect.

People like the good judge help perpetuate the myth that psychosis is a medical condition. And by doing so they create the situation that people with mental illness are slightly more likely to commit serious crimes.

Posted by Rod Jackson | December 19, 2009 6:27 AM
Joanne M.:

If I could hug you i would, Judge. Thank you for what you do to help the mentally ill. Your compassion is moving. I suffer from a mental illness and have been on the dark side. That is why I am an advocate of "forced" treatment. It saved me from myself. I'm so sorry that Rene didnt make it. God bless you always.

Posted by Joanne M. | February 19, 2010 8:51 AM
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