Sixth Circuit Finds Special Circumstances Preclude Involuntary Medication of Incompetent Defendant Charged with Bank Robbery

United Sates v. Grigsby, 712 F.3d 964 (6th Cir. 2013)

The Sixth Circuit Court of Appeals held on April 11, 2013 that special circumstances exist that outweigh the government’s interest in prosecuting for bank robbery a pre-trial detainee to restore him to competency. Unlike the Eighth Circuit evaluating similar special circumstances in United States v. Mackey, 717 F.3d 569 (8th Cir. 2013), reviewed below, a majority three-judge panel concluded that the potential availability of lengthy civil commitment together with the likelihood that, even if the defendant is restored to competency, he will be found not guilty by reason of insanity, greatly diminishes the government’s interest in prosecution.

Dennis Grigsby was charged with three counts of unarmed bank robbery in Columbus, Ohio, between January and March 2010. Grigsby’s attorney requested the court to order mental evaluations to determine Grigsby’s competence to stand trial and his sanity at the time of the offenses. The district court granted the motion and he was transferred to the Metropolitan Correctional Center in New York where two psychologists conducted the examinations. They both diagnosed Grigsby with paranoid schizophrenia and determined him incompetent to stand trial, but one postulated that he was sane at the time of his offense and the other that he was not. Both psychologists reported that Grigsby’s mental disease did not significantly interfere with his appreciation of the wrongfulness of his acts, but there was insufficient information about whether mental illness impaired his ability to appreciate the wrongfulness of his conduct. Neither the government nor the defendant objected to the reports’ findings and the district court committed Grigsby to the custody of the Attorney General in November 2010 for a period not to exceed four months for a determination whether he could be restored to competency.

Grigsby was then transferred to the Federal Medical Center in Butner, North Carolina and was evaluated by a psychiatrist and psychologist at the facility. They found that Grigsby had a normal upbringing, education and employment until he stopped working due to “job burnout.” He was convicted of grand theft auto, disorderly conduct, and resisting arrest in 2006; for criminal trespassing in 2007; and for resisting arrest in 2010. He served short jail sentences for these crimes. He was also charged with voyeurism and menacing by stalking, which were not prosecuted. Grigsby was in good physical health, never received mental health treatment and was not taking antipsychotic medication for his illness. He followed all of the rules of the facility, got along well with peers and staff, was not gravely disabled and did not present a danger to self or others, or to the safe operation of the facility. Although his dress and grooming were appropriate and he was oriented to person, place, time and circumstances, and denied hallucinations and delusions, they reported, however, that Gillenwater’s conversation was not linear and he displayed substantial evidence of thought disorder, including an extensive, but poorly organized, paranoid religious delusional system extending into all major functional areas of his life.

The evaluators determined that Grigsby was incompetent to stand trial. Because he was refusing all antipsychotic medications, they also requested an order under Sell v. United States, 539 U.S. 166 (2003), allowing them to medicate him involuntarily to restore his competence to stand trial. The evaluators both determined that antipsychotic medication was substantially likely to render Grigsby competent to stand trial and substantially unlikely to produce sideeffects that would interfere with his ability to assist his attorney in conducting a defense and that less intrusive therapies, such as psychotherapy would not able work. They reported that antipsychotic medication was medically appropriate and would take at least four months to be effective.

In determining whether to uphold the district court’s order authorizing involuntary medication to restore Grigsby to competence, the Sixth Circuit applied the Sell test requiring the government to prove by clear and convincing evidence that 1) an important government interest in prosecution exists; 2) involuntary medication will significantly further the governmental interest, which requires proof both that administration of the medication is substantially likely to render the defendant competent to stand trial and substantially unlikely to cause side effects that will interfere significantly with the defendant’s ability to assist counsel in conducting the trial defense; 3) involuntary medication is necessary to further the governmental interest; and 4) administration of drugs is medically appropriate for the defendant. Id at 180-81.

At the district court hearing, Grigsby conceded that the government had an important interest in bringing him to trial for the serious crime of bank robbery. Grigsby argued, however, that special circumstances existed in his case to diminish that interest. He first argued that the potential availability of lengthy civil commitment together with the likelihood that he would be found not guilty by reason of insanity addressed the government’s interest in his continued confinement.

The Sixth Circuit reviewed the Butner psychiatrist’s testimony that if Grigsby is not forcibly medicated he would remain psychotic and medical staff at FMC-Butner would request his civil commitment. In order to be civilly committed, federal law requires the district court to determine by clear and convincing evidence whether Grigsby is suffering from a mental disease or defect and poses a substantial risk of bodily injury or serious damage to property. The evidence revealed that although Grigsby was not a present danger to himself or others in the structured environment at Butner, the government psychiatrist testified that he was not necessarily fit for release into society. The district court found that the evidence was inconclusive on that issue, but the Sixth Circuit determined that the district court should have inquired further. The Sixth Circuit found evidence in the record that supported the possibility that Grigsby might meet the insanity standard at trial, if restored to competence. Both the government’s psychiatrist and Grigsby’s expert agreed that Grigsby would need to be restored to competence before a definitive determination could be made, but Grigsby’s expert testified that he suffered from a severe and chronic mental illness and likely suffered from it at the time of the bank robberies. He also surmised that Grigsby may have experienced previous psychotic episodes.

The Court further determined that the length of Grigsby’s confinement while the government attempts to restore him to competency and prosecute him may approximate the length of any prison sentence he might receive if convicted. If convicted, the government indicates Grigsby might receive a sentence of 57 to 71 months based on sentencing guidelines. Unlike the Eighth Circuit, the Sixth Circuit found the government’s analysis under the guidelines instructive because the government often uses this range, rather than the maximum possible sentence, as a basis for negotiating plea agreements. The Court therefore found this range more useful when, as here, the government advances the length of sentence as a core reason why it wants to prosecute. The Court found that Grigsby had already been held since July 2010, or 33 months. It would take at least four months to restore him to competency, plus additional time to bring him to trial, and potentially additional time to re-restore him if he loses competency during the pendency of the trial. The Court also noted that often defendants plead guilty after they are restored to competency which reduces further their period of imprisonment under the guidelines. All of these factors indicated to the Court that Grigsby may remain in custody for a period roughly equivalent to the length of any prison sentence he might serve, thus lessening the government’s interest in prosecuting him.

The Court went on to find that antipsychotic medication can burden a defendant’s fair trial rights by affecting his ability to comprehend and react to trial events. Grigsby argued that he had trial-related concerns that tardive dyskinesia and akathisia, which causes constant movement and an inability to remain still, might impair his ability to make a dignified appearance before a jury and assist his counsel in his defense. Although the Court noted that the record indicates antipsychotic medication is generally effective in restoring competency especially in patient’s with Grigsby’s positive symptoms, it also found that the government’s psychiatrist testified that 30% of patients do not respond to haloperidol and another 30% show only a partial response. He also testified that 30% of individuals treated with haloperidol develop pseudoparkinsonism, 20-30% develop akathisia, 2-10% develop acute systonic reactions, and 18- 40% develop irreversible tardive dyskinesia. Although Grigsby had never previously been treated with antipsychotic medication, and the government psychiatrist testified that other medications would be prescribed to counter the side-effects and that the medication would be changed or discontinued if the side effects continued or irreversible side-effects developed, the Court nonetheless found that the record lacked clear and convincing evidence that medication is substantially unlikely to cause side effects that will interfere with Grigsby’s ability to assist in his defense.

Based upon all the facts above, the majority of the Sixth Circuit three-judge panel hearing the appeal found that the findings of the district court supporting an order authorizing involuntary medication were clearly erroneous. The Court reversed the district court order and remanded the case for further proceedings, specifying its expectation that the district court would determine whether civil commitment is appropriate for Grigsby. A dissent was filed in this case stating that the Court majority’s analysis of the special circumstances was highly speculative as to the likelihood of Grigsby’s civil commitment, his being found not guilty by reason of insanity, his pretrial confinement exceeding any sentence he might receive, and any side-effects impairing his pre-trial rights. Compare this decision with the decision in United States v. Mackey.

Found in DMHL Volume 32 Issue 3