IN RETROSPECT, ONE WONDERS IF it was the crime that got Isaiah Doyle sentenced to death or his behavior on the witness stand. His attorneys tried to convince him not to testify at all. They feared that anything he said would end up doing more harm than good. In the end, Doyle didn’t take the stand until the sentencing phase of the trial, a day after the jury had found him guilty of killing a convenience store clerk during a 2005 robbery.
His attorneys were right to have been worried. He had spent much of the trial sleeping, sometimes snoring loudly. When he wasn’t sleeping, he was disruptive, tearing up sheets of paper from the legal pads on the defense table, playing with evidence, and “laboriously copying out sections of a book onto multiple sheets of paper.”1 His mental state had deteriorated over the course of the trial; even during the trial, his attorneys noted that he was unable to provide them meaningful assistance.
His statement on the witness stand was predictably disastrous. On the night of the crime, Doyle and a friend robbed two convenience stores near New Orleans before coming to the third, where, after demanding Kool cigarettes and the money in the cash register, he shot and killed the clerk, the twenty-six-year-old daughter of Korean immigrants. According to the friend he was with on the night of the murder, Doyle was also high on a mix of cocaine, heroin, and Xanax.
“I wouldn’t care what decision [the jurors] made,” he said. “I have no conscious [sic]. I wouldn’t care. I hate everybody that’s up there right now, especially him over there [the jury foreman]. I wish I could cut his head off.” He told the court that not only was the clerk’s murder not an accident, but that he wasn’t sorry for what he had done: “I would like to say that I have no sympathy or empathy for [the clerk] or her family.… I have no conscious [sic]. So when I go back to the dorm and I lay down I don’t think about it ever.” He ended by directing his anger to the jury itself: “If I had a AK-47 I’d kill every last one of you all with no problem. I have no remorse for what I have done.”2
It took the jury just two hours to decide that Isaiah Doyle should be put to death. According to newspaper reports from that day, Doyle showed no emotion as the verdict was read. His mother, who was in the courtroom that day, burst into tears and had to be helped from the room.
Lost on the jurors was that Doyle’s chilling performance was almost certainly a further manifestation of the severe mental illness he had his entire life. As one of his attorneys told the court, Doyle “has a long history of mental problems that stretches from the time he was a baby until his sitting in the courtroom.” The attorneys also noted that he had a developmental disability, had spent time in a psychiatric hospital as a teenager, and had substance use issues—he had overdosed three times in the years before the murder.3
The jury’s decision to sentence him to death in spite of all that went against hundreds of years of history that said a person with severe mental illness shouldn’t be put to death. In the same eighteenth-century treatise on English common law where he explains why a person must be sane to be put on trial, legal scholar William Blackstone argues that a person who is insane should also not be executed: “[I]f, after judgment, [the defendant] becomes of nonsane memory, execution shall be stayed: for peradventure, says the humanity of the English law, had the prisoner been of sound memory, he might have alleged something in stay of judgment or execution.”4
In 1986 the US Supreme Court, in Ford v. Wainwright, upheld the notion that people with mental illness should not be subjected to capital punishment. Alvin Ford was a man from Florida who became very paranoid and was ultimately diagnosed with paranoid schizophrenia after his conviction in the 1970s of first-degree murder. The Court ruled that executing somebody who is too insane to understand why he is being put to death violates the Eighth Amendment: “It is no less abhorrent today than it has been for centuries to exact in penance the life of one whose mental illness prevents him from comprehending the reasons for the penalty or its implications,” wrote Thurgood Marshall in the decision. Among other things, Marshall went on to say, there is little point to killing somebody who doesn’t understand why he’s being killed: “[T]he execution of an insane person simply offends humanity.… It provides no example to others, and thus contributes nothing to whatever deterrence value is intended to be served by capital punishment.”5 In practice, though, the Court left it up to the individual states to decide how insane is too insane to be killed. And unlike other areas of capital punishment, the law remains remarkably unclear on it. (The 2005 decision in Roper v. Simmons ruled it unconstitutional to execute juveniles, and the 2002 decision in Atkins v. Virginia deemed it unconstitutional to execute a person with developmental disabilities, although just how to define a developmental disability has also been left to the states to determine.) What remains is what one longtime capital defender told me, a standard of “too sick to execute” that is impossible to meet. Indeed, about half of the people executed between 2000 and 2015 had been diagnosed with a mental illness or substance use disorder at some time in their adult lives.
Many crimes that get defendants sentenced to death are grisly, so grotesque as to make the perpetrator seem almost inhuman. Isaiah Doyle’s crime was terrible. But in stark contrast to those other capital cases, his hardly stands out. Certainly there are many in our prisons who have committed murder in the course of a robbery and were not sentenced to death.
It is hard to find more visceral proof of our ambivalence or, worse, antipathy toward people with severe mental illness than our continued readiness to sentence so many of them to death. The picture that accompanied every story about Doyle in the New Orleans Times-Picayune was his mug shot. It’s a picture that speaks to our fear of young African American men: large indistinct tattoos on both sides of his neck, heavy-lidded eyes looking slightly sideways. But it’s what he did in court—acting out, showing no remorse, and most of all, threatening the jury—that speaks to our culture’s collective fear we have of people with mental illness: they will somehow attack us personally.
As with other questions relating to sick people in the criminal justice system, our way of approaching people with mental illness who have been sentenced to death is deeply contradictory. On the one hand, states (or, in some cases, the courts) are finally recognizing that, as with other parts of their prison populations, death row cohorts include growing numbers of people with mental illness. (The years that people now routinely spend, often in solitary confinement, waiting for their cases to be resolved cannot be good for their mental health.) But instead of addressing the cases themselves and whether the punishment is appropriate, states are simply expanding mental health services for the condemned. In 2014 California began construction on an inpatient psychiatric unit for men on death row. A judge also ruled that all 720 men on death row at San Quentin must be screened for mental illness. “This is the only place on Earth where you’d be talking about building a psychiatric hospital for condemned prisoners,” one law professor told the Los Angeles Times when it was announced. “It is a measure of American greatness and American silliness at the same time.” A cartoon that ran in the paper sums up the absurdity of the situation well. With the caption “Under court pressure, California is building a psychiatric care hospital at San Quentin prison to provide long-term mental health care for Death Row inmates,” the cartoon depicts a classic psychiatrist’s office where a man in prison scrubs, handcuffs, and leg shackles lies on an analyst’s couch. Visible behind him are cell bars and a view of the electric chair. “Why so depressed?” the bearded therapist asks.6 We are also a country that is willing to send people with mental illness to their death but insists on restoring them to competency first; a person on death row who attempts suicide will be patched up before he is killed by the state.
It sounds facile, but the most obvious way to stop executing people with mental illness—or threatening to execute them, for the average length of stay on death row is now at least twenty years—is to abolish the death penalty. In fact, although its end may come too late to save Isaiah Doyle or the many others with mental illness still on death row, it appears that it is finally on the wane in the United States. California has not executed anybody since 2006. Before Isaiah Doyle, nobody had been sentenced to die in Jefferson Parish in years. A look at the geography of death sentences makes clear that a very few jurisdictions—and their district attorneys and judges—are responsible for the vast majority of death sentences in the United States today. Barring abolishment, a US Supreme Court decision that clearly outlines the parameters for giving the death penalty to a person with mental illness—much as it did for juveniles—would be a relatively easy fix, although there would presumably still be arguments about what constitutes sick enough and trying to decide who is, in fact, sick versus who is malingering. (The prosecutors in Isaiah Doyle’s criminal case continued to argue to the end that he was “crazy like a fox.”)
Of course, as disturbing as their cases often are, the people with mental illness on death row remain only a small part of the large and growing population of people with mental illness who we routinely lock up. But the death penalty cases are important in another crucial aspect: in their extreme punishment, sanctioned by juries, they provide powerful evidence of our views about mental illness and crimes more generally. As Austin Sarat, a professor at Amherst College who has studied the death penalty extensively, told me, “The issues in capital cases are different only in degree, not in kind. The same kind of problems that plague the mentally ill throughout the criminal justice system show in the death penalty system.”
Finding a way to stop the incredible growth in the number of people with mental illness we shunt into the criminal justice system is obviously complicated. The approaches outlined in the last chapters of the book are certainly moves in the right direction: training police to respond in a more sympathetic, health-care–oriented way; building diversion programs to get people out of the system when they do get caught up in it; or making it easier for people to get mental health care. Should those steps fail and people end up in the criminal justice system anyway, it’s clear that jails and prisons need to be better equipped to take care of those people, whether by creating housing that allows them to stay apart from the general population or by hiring more health care workers.
What really needs to happen, though, is what psychiatrist George Stevenson called for more than a half century ago in the New York Times: a new way of treating people with mental illness. Both the official mental health care system and the de facto one, the criminal justice system, need to be completely overhauled. On the one hand, our awareness of the shortcomings in both suggests that the chances for comprehensive reform are higher than they have been in years. At the same time, there are also worrying signs that, instead of taking on this difficult task, we are getting further mired in the status quo and setting ourselves up to repeat the mistakes of the past once again.
This isn’t the first time we have been on the cusp of dramatic reform. In the mid-1940s, driven in part by the news and other reports coming out of psychiatric hospitals, states began a frantic drive to fix the mental health care system. In 1945, for example, New York ordered its hospitals to hire more psychiatrists and other mental health staff and to provide more treatment to their patients. It also commissioned a study by Columbia University to look at all the New York hospitals. Kansas, California, Missouri, Maryland, and other states examined their mental health care systems and found them lacking. A 1950 study by the Council of State Governments recommended, among other solutions, the construction of new facilities to help reduce overcrowding in hospitals.7 All of these reforms make considerable sense, even today. Had we resolved the problems then, it’s possible we might not be where we are now.
We have begun to understand, again, that jails and prisons are not appropriate places for dealing with mental illness. Yet the push continues to medicalize criminal justice in response to the criminalization of mental illness, often at the expense of diverting people out of the criminal justice system or of keeping them out of there from the beginning. One of the latest developments on that front—and the most expensive—was the offer from the Alabama Department of Corrections, in response to the class-action lawsuit over its treatment of prisoners, to find millions of dollars to build four new prisons, facilities that would allow the state to provide better mental health care to its prisoners. New York City has begun to talk seriously about closing Rikers Island, but only to replace it with new jails. We have known for more than two hundred years that keeping people with mental illness locked up in jails and prisons does little but make them worse. We know how to lock up masses of people. Now we need to figure out how to treat them.