Forced medications to restore competency to stand trial

After prior reversal and remand, the Fourth Circuit rules that the district court made the specific inquiries and findings in the record as required by Sell to support the determination that less restrictive alternatives to forced medication to restore competency were not available

U.S. v. Chatmon, 596 Fed.App’x 216 (4th Cir. 2015)

This case, though unpublished, provides useful guidance from the Fourth Circuit on the evidentiary foundations required to support a court order to restore a defendant to competency to stand trial through the forcible administration of medications.

Chatmon was indicted for conspiracy to distribute crack cocaine and heroin, an offense with a minimum sentence of 10 years and maximum of life imprisonment. Following submissions by his attorney that Chatmon’s condition during incarceration had deteriorated to the point that he could no longer assist counsel in his own defense, Chatmon was transferred for competence evaluation to the Butner Federal Medical Center, where he was diagnosed with paranoid schizophrenia.

The district court found Chatmon incompetent to stand trial. Chatmon was returned to Butner for evaluation of whether he could be restored to competence, where he was placed in solitary confinement. The evaluation report confirmed the diagnosis, noted that Chatmon denied having any mental illness and refused treatment, and stated there was a “substantial probability” that competency could be restored through treatment with haloperidol decanoate. The government requested Court authorization to restore Chatmon to competency through forced medication.

The district court found that the government had met the test set out in Sell v. United States, 539 U.S. 166, 181 (2003)8 , and authorized the forced medication. Chatmon appealed. In United States v. Chatmon, 718 F.3d 369 (4th Cir. 2013), the Fourth Circuit Court of Appeals reversed the district court and remanded the matter. The Court noted that the district court had made sufficient findings for the first, second, and fourth prongs of Sell, but had failed to consider less intrusive means for restoring competence. Chatmon had submitted evidence of improved behavior upon being transferred to the open population at Butner and an option of group therapy to improve competence. The Court also noted that a “court order to the defendant backed by the contempt power” is acceptable as a less intrusive means for administering drugs.

On remand from the Fourth Circuit, the district court ordered the defendant to take his medication or be held in civil contempt. The penalty was set as thirty days' imprisonment, during which medication was offered each day, but Chatmon declined it. The district court then reviewed deposition testimony addressing whether housing in Butner’s open population and group therapy could result in restoration. The doctors opined that improvements in behavior were not the same as improved competency or mental health, and that treatments other than medication could be beneficial but not by themselves effective treatment for psychosis. They stated that haloperidol was the “only” effective means to restore Chatmon’s competency. The defense offered no rebuttal to the testimony, and the district court ordered forced medication.

Chatmon appealed the district court’s new order, but the Fourth Circuit found that the record created by the district court “made careful findings” and “examined less intrusive means,” thus satisfying all Sell factors, before ordering that Chatmon be forcibly medicated.

Found in DMHL Volume 34 Issue 2