Inside the Mustard Factory

by Bill Blum

In the spring of 1911, a novel legal forum for the mentally ill held its first civil commitment hearings on the outdoor porch of a county hospital in Los Angeles. Back then they called it the "insanity court," and as the Los Angeles Times observed, it represented "one of the most beneficial deviations in handling demented persons. ..."

The court survived, even if it didn't exactly thrive, and by the 1920s it had a more permanent home in the hospital's basement as the Psychopathic Department of the Superior Court, then later as the Psychiatric Court, and later still as the Mental Health Court. Now, after almost a hundred years, two judges and a commissioner handle an expanded menu of civil and criminal mental health cases from a converted mustard factory in a high-crime district just northeast of downtown. The court has been operating there since 1974.

You can get a pretty good idea of just how tough the light industrial neighborhood is from the chain-link fence that surrounds the courthouse parking lot. In spots, it rises a good twelve feet from the blacktop and is capped by hoops of razor wire.

The courthouse itself is easier to miss. A standard-issue brass sign identifies the two-story brick-and-cinder-block structure as a branch of the superior court, but the plaque is hidden behind yet another steel-mesh fence.

"We like to keep things low key around here," Timothy Dowell, the court's longtime administrator, told me with a chuckle when I visited the facility last year. Until his retirement in June, Dowell kept a photocopied page from a Thomas Brothers book of maps affixed to his office bulletin board. "Here," he said, pointing to an asterisk penned on the page, "is where a police officer was shot. And here is where that motorist who took a wrong turn late at night was gunned down. We're smack in the middle of 'Avenues' territory," he added, referring to the notorious Avenues street gang.

An X-ray screening station at the building's main entrance leads to a large waiting room filled with rows of old, hard plastic chairs. A few vending machines stand at one end and an institutional-style TV hangs from a wall bracket. On any given day, the big room fills with lawyers and conservators, plus a few low-security litigants - gaunt-looking men (for the most part) outfitted in baggy pants and worn, thrift-store flannel shirts who slowly pace back and forth, seemingly deep in thought, under the watchful eyes of state and county counselors as they wait to be transported back to their respective mental health facilities. A panel of psychiatrists is on standby for on-the-spot mental health evaluations. An adjoining mini-jail, meanwhile, holds the more dangerous and delusional criminal defendants until it's time for their cases to be heard.

The hearings themselves take place behind thick steel doors in one of three rooms - Department 95, 95A, or 95B. Department 95, the oldest unit, handles the criminal side of the court's docket. Civil cases heard in 95A and 95B include everything from conservatorships to habeas writs challenging 14- and 30-day psychiatric holds under the Lanterman-Petris-Short (LPS) Act (Cal. Welf. & Inst. Code §§ 5000?5559).

One morning last March, I sat in Department 95 to observe a competency proceeding involving a trim, square-jawed 25-year-old man I'll refer to here as Ricardo. Dressed in a blue jumpsuit, his head shaved and his face expressionless, he'd come straight from the county jail, where he'd been held for nearly four years since being charged with murdering a man in a gang shooting. The crime carried a prison sentence of 25 years to life, plus enhancements for gang affiliation and gun use. However, at his preliminary hearing in 2007, Superior Court Judge Maria E. Stratton questioned Ricardo's mental competence to stand trial. In accordance with statutory procedures, the criminal proceedings were then stayed and the case was transferred to Department 95.

Throughout the fall of 2007 and the following winter, Ricardo was evaluated by four court-appointed mental health experts - two from each side - who examined and tested him, only to arrive at equally divided opinions. Then, after a lengthy delay occasioned in part by the replacement of one doctor, the case once again came before Judge Stratton, who by then had moved over to the Mental Health Court, where she had become its on-site supervising judge. Of course, Ricardo's case could easily have been bounced to another judge if, say, the prosecutor or Ricardo's lawyer had raised any objections because of Stratton's past involvement. But since none were forthcoming she set the case for trial, which got underway last November.

Over the next four months, Stratton heard six days of testimony from the experts. The testimony was often dry and clinical, recounting in detail the work each doctor had performed, culminating in their ultimate, conflicting opinions.

If Judge Stratton were to find Ricardo incompetent, he would be committed to a mental institution. However, if after three years he was not restored to competence (Cal. Penal Code § 1370(c)(1)) the court would either have to return him to the criminal justice system, release him, or initiate conservatorship proceedings for extended treatment under the LPS Act (Cal. Penal Code § 1370(c)(2); see also In re Davis, 8 Cal. 3d 798 (1973)).

Considering all the possibilities, then, a finding of incompetency was the best outcome Ricardo could hope for.

According to the Administrative Office of the Courts, the Mental Health Court is the only courthouse in the nation that deals exclusively with mental health matters. And since all such cases in Los Angeles County come here, it ends up authorizing about 30 percent of California's involuntary commitments.

"Essentially there's Los Angeles, and then there's the rest of the state. It's a world unto itself," says David Meyer, a former county public defender who worked for about a decade in the Mental Health Court. On the plus side, having one specialized court do this work provides a level of expertise that the county wouldn't otherwise enjoy. On the downside, though, litigants often face long delays due to backlogs, not to mention time-consuming commutes.

To alleviate these problems, the state could create fully functional branches throughout the county. But that would require money - lots of money - which simply isn't available. And so, for the next few years at least, the state Judicial Council - which controls statewide court construction - foresees a continuation of the status quo.

Meanwhile, the existing facility is clearly showing its age. Just last winter, heavy rains set off a roof leak that flooded one bench officer's chambers and a file room. The courthouse also suffers from frequent graffiti attacks and occasional rat infestations. "There's a sort of bunker mentality that's set in," observes William Hodgman, head deputy of the district attorney's Target Crimes Division who is also in charge of the DA's psychiatric unit. "Everyone works hard at working together," he says, "but hopefully when funding is available, improvements will be made."

When that will happen is difficult to even guess. In recent comments, the presiding judge of the Los Angeles Superior Court, Charles "Tim" McCoy, made it clear that he believes any available funds generated through bond sales should be devoted to maintaining current court operations rather than taking on new construction projects. Even more distressing: As a result of state budget cuts, McCoy was forced this spring to lay off 349 court employees. And unless new revenue sources are found, he warns of an additional 500 layoffs in September and 530 more in 2011. All told, as many as 180 courtrooms across the county could go dark.

So far, the layoffs have yet to hit the Mental Health Court very hard: It only lost one part-time clerical position. But insiders worry about the impact of a second or third wave of reductions. "Although no judges will be laid off," Judge Stratton ventures, "the court could lose one of its three courtrooms, which would mean moving a bench officer to a different location."

Were that to happen, an already bad situation would grow immeasurably worse. "The courts and many public services in general are already a disaster due to underfunding," charges Meyer, the former public defender. "If one of the mental health departments were closed, people would be denied vital services and the disaster would intensify." Especially hard hit, in his estimation, would be conservator and other civil proceedings. Meanwhile, criminal-law matters such as competency determinations would be plagued by even greater delays.

Stratton's department currently supervises more than 4,900 mental competency cases, both pending and with existing commitment orders. The vast majority of these get resolved on the basis of written psychological reports. And about 40 percent of the time, she finds the litigant mentally incapable of standing trial.

Working as hard as they do, Stratton and her colleagues rarely find the time to go out to lunch, although, as the judge jokes, that's not much of a sacrifice when the finest nearby dining option is a King Taco. Needless to say, some judges view the Mental Health Court as a hardship posting, and in the past the local administration has had to draft candidates with the apparent understanding that they would get priority consideration for more choice assignments once their two-year stints are up. But Stratton, whose chambers are cramped and windowless, actually volunteered for the job after serving on the bench downtown. "I wanted a new challenge," she explains. "This is a fascinating assignment. After spending two years here, you get an extraordinary feel for the many different ways mental illness is addressed, both civilly and criminally, in the legal system."

The Mental Health Court is remarkably good at what it does, she adds. "We have a very low staff turnover, and everyone here - from the clerks to the lawyers - is hip to the special problems of our litigants. No one is judgmental that they are sick. The work we do also takes a tremendous burden off of other judges throughout the county" who would otherwise be required to pick up these cases. Indeed, she finds the work so important and rewarding that she signed on for at least an extra year.

As I settled into my seat for Ricar- do's hearing in March, I could sense the tension. Ricardo had spent the better part of four years behind bars in a kind of legal limbo. There is no statutory time limit for holding a hearing on a defendant whose competency is in doubt. Although defendants who are later convicted receive credit for pretrial custody, the only test for determining when a competency issue must be resolved is reasonableness. (See Jackson v. Indiana, 406 U.S. 715, 738 (1972); Hale v. Superior Court, 15 Cal. 3d 221, 225 (1975).) And in Ricardo's case that issue was now largely moot.

Judge Stratton opened the proceeding by complimenting the lawyers on both sides for their performance and effort. She then quickly summarized the evidence, and announced her ruling. Ricardo, she declared, was incompetent to stand trial. The entire proceeding lasted less than ten minutes.

Apparently, Ricardo understood the ruling. His shoulders relaxed, and for the first time I saw a smile crease his face as he shook hands, first with his lawyer and then with his court-appointed Spanish interpreter. Ricardo's mother and sister, also in attendance, rose and walked to the counsel table to embrace him. Even the prosecutor seemed satisfied with the result. At that moment, at least, the bunker that is Department 95 was a happy place.

That same session, Stratton issued an eight-page, single-spaced document. In it she noted that though Ricardo lacked an Axis I mental illness such as depression or schizophrenia, as defined by the Diagnostic and Statistical Manual of Mental Disorders, he was nevertheless developmentally disabled, and therefore "unable to understand the nature and purpose of the proceedings against him and to assist counsel with his defense in a rational manner." The judge observed further: "Competency means more than sitting quietly and acquiescing to defense counsel. It means to actively participate by contributing meaningfully to the investigation and development of relevant factual issues and being able to understand explanations of why certain legal strategies are employed or discarded."

Of course, whether or not Ricardo will remain legally incompetent is another question. Unlike the pretrial determination process, strict guidelines apply once a defendant is found incompetent and sent to a mental institution. A defendant committed to a state hospital or developmental center must be evaluated and treated, and the facility must document his progress in a report to the court within 90 days of the commitment order, and at specified intervals thereafter (Cal. Penal Code § 1370(b)(1); In re Mille, 182 Cal. App. 4th 635 (2010)). The committing court retains jurisdiction over the case, subject to the three-year limit on initiating a conservatorship or returning the defendant to the justice system for trial.

If Stratton stays in Department 95 long enough, she'll monitor Ricardo's progress through the end of his court-ordered treatment. If not, her successor will step in to fill the need. Either way, the Mental Health Court will chug along.

In Los Angeles, when questions of mental competency arise, they are resolved in a former food processing plant.

Bill Blum is an administrative law judge and freelance writer in Los Angeles.

---