June 8, 2014

NYC: Stabbing Case Shows Lapses in Treatment for the Mentally Ill

Daniel St. Hubert in custody in Brooklyn on Thursday. He is accused of fatally stabbing a 6-year-old boy on Sunday, nine days after his release from prison. He had not been required to receive outpatient therapy. Credit Victor J. Blue for The New York Times        

JIM DWYER, N.Y. TIMES
 
Around 8 p.m. Wednesday, a man paused at a corner in Ozone Park, Queens, and scrawled letters and symbols on a stop sign:
$Killzz
I will
BK
At the bottom he drew a smiley face, one eye winking.
A moment later, two detectives stepped up and called the man by name: Daniel St. Hubert. He was placed under arrest, and the police now believe he committed a string of shocking crimes between Friday and Wednesday morning. He was carrying a brown-handled knife in his waistband and a cellphone in his pocket, said Stephen Davis, the Police Department’s chief spokesman.

The words on that stop sign — since removed — were the last traces that the police found of Mr. St. Hubert, 27, as they tracked him from the scene of one slashing to the next: an 18-year-old woman, killed in the East New York section of Brooklyn on Friday night as she was going to meet her friends after band practice. A short distance away on Sunday afternoon, two children set upon as they rode the elevator on their way to get a treat — a 6-year-old boy knifed to death and a 7-year-old girl slashed within an inch of her life. And near dawn Wednesday, a 53-year-old homeless man on a subway platform in the Chelsea section of Manhattan, stabbed and slashed as he slept on a bench.

The subway station at West 18th Street and Seventh Avenue, where a 53-year-old man was stabbed multiple times in Chelsea on Wednesday. The victim, who was not identified, was left unconscious and bleeding. Mr. St. Hubert is a suspect in that stabbing. Credit Nicole Bengiveno/The New York Times        

Mr. St. Hubert has spent much of his time in custody sleeping. During his waking hours, his conversation has rambled, with references to Satan, but has also been coherent at times, one investigator said.
Five years ago, Mr. St. Hubert’s mother, Marie Bauzile, told prosecutors in Queens that she did not want them to proceed with a criminal case against her son after he wrapped an electric cord around her neck, took $1,000 and stole her Toyota. He was 22 years old and she already had an order of protection against him.
Her son needed psychiatric care, not prison, Ms. Bauzile told an assistant district attorney, according to Kevin Ryan, a spokesman for the Queens district attorney’s office. Nevertheless, he was charged with attempted murder, and because the crime was so violent, the case was not sent to a special mental health court, Mr. Ryan said.
 
Detectives visiting the home of Marie Bauzile, the mother of Mr. St. Hubert, in Queens. In 2009, Mr. St. Hubert beat her and wrapped an electrical cord around her neck. He was sentenced to five years in prison and released two weeks ago. Credit Uli Seit for The New York Times        
N.Y. TIMES
 
During much of his five years of incarceration for choking his mother with an electrical cord, Daniel St. Hubert was prone to aggressive outbursts and violence, assaulting inmates and correctional workers. It took three years before he was even deemed psychologically fit to stand trial.
After years of mandatory therapy designed to stabilize him, he began to show signs of improvement: In the last six months, he had citations only for minor infractions like keeping a messy cell, officials said. And the last time he was cited for violent conduct was March 29, 2013.
But there was little that New York correction officials could do to ensure that Mr. St. Hubert received the therapy he needed outside the prison walls.
 
Nevertheless, on May 23, following a standard psychiatric evaluation, he was released.
 
Once out of prison, he was on his own. If the authorities’ suspicions are borne out, within a matter of days he had come apart...
 
The numbers of inmates with mental illness have surged in jails and prisons across the country in recent years, and enormous resources are spent ensuring that they are competent to stand trial and stable while incarcerated. But as Mr. St. Hubert’s case underscores, the process of making sure they are fit to return to the community can be haphazard. Correction officials and mental health providers have to navigate between civil liberties protections and concerns for public safety, as well as the reality that the vast majority of people with mental illness are not violent.
 
For the most difficult cases, New York has more tools than do most states, including Kendra’s Law, which allows authorities to order people to receive outpatient treatment if they have a history of violence or repeated hospitalization and have rejected treatment in the past.
But there are many ways for mentally unstable people who might be dangerous to slip through the cracks. The safety net is particularly porous for those newly released from prison, experts said.
 
Daniel St. Hubert was charged Thursday evening with multiple offenses, including murder and attempted murder. Credit Victor J. Blue for The New York Times        
“Here is a person that has severe mental illness for many years, who tried to kill his own mother, who showed a propensity to violence,” State Senator Catharine Young, a Republican from Olean, N.Y., who has pushed to expand treatment for the mentally ill, said of Mr. St. Hubert. “Every single danger was present. And it’s hard to believe that no one followed up when he was released from prison.”
 
State officials say roughly 3,500 inmates with mental illness are released from New York prisons every year. Treatment for them can range from intensive to nonexistent.
 
For the most volatile cases, correction officials have the option of involuntarily committing inmates to an inpatient psychiatric facility even after their sentences have been served. Two criteria must be met: a diagnosis of a mental illness requiring care and treatment, and a substantial risk of physical harm to themselves or others because of the mental illness.

The other option available is to put them in a mandated treatment program under Kendra’s Law, which was passed in 1999 and was named for a woman who was killed when a schizophrenic man pushed her into the path of an N subway train.
 
Of the 45 states with outpatient-commitment laws, New York has by far the strongest. The state has invested about $32 million a year for people under court orders, and about $125 million for enhanced outpatient mental health services for other people who need them.
 
Christopher Capozziello for The New York Times
Michael and Barbara Biasotti's daughter suffers from mental illness and has benefited from Kendra's Law.
 
Studies have found that the orders have resulted in fewer rehospitalizations, fewer arrests, more refills of prescribed medications and more use of outpatient mental health services.
 
Even so, it is not widely applied. Since 1999, 11,700 people, many of whom are not former prisoners, have received outpatient-commitment orders; roughly 2,100 people are currently under such orders.
Dr. James Gilligan, a clinical professor of psychiatry who has conducted psychiatric evaluations for the Massachusetts prison system, said involuntary commitment was rarely used, out of what he described as an overabundance of fear of violating a person’s civil rights.....
 
Mr. St. Hubert did not fit any criteria for involuntary treatment, according to two state officials familiar with his record. They declined to say specifically why he would not qualify, citing privacy concerns, but suggested that his relatively good behavior in the months before his release would have been considered.
 
Upon release, Mr. St. Hubert was supposed to adhere to a list of conditions to be monitored by a parole officer. These included submitting to drug tests and participating in anti-aggression and anti-violence counseling. State officials said psychiatric care would have been “made available to him,” but they did not go into specifics. They declined to say if he had been directed to a psychologist or was on medication.
Judith Perry, Mr. St. Hubert’s sister, who saw him several times during the period he was free, said on Friday that — as far as she knew — her brother was on no medications while in prison or after his release.
 
Mirian Collazo sat in front of the Boulevard Houses, where the two children were stabbed. Behind her was a makeshift memorial. Credit Damon Winter/The New York Times        
 
As required, he met with his parole officer three times after his release. His last meeting was on Tuesday, two days after authorities said he stabbed Prince Joshua Avitto to death and critically wounded the boy’s 7-year-old friend Mikayla Capers in an elevator of the Boulevard Houses in Brooklyn.