Charges dropped against man with severe mental illness, but questions remain about Delaware's psychiatric care system
Delaware’s Department of Justice agreed this week to drop its case against a New Castle County man charged with assaulting a staff member at the Delaware Psychiatric Center – a case that has raised questions about the state’s handling of people with severe psychiatric disorders.
The man at the center of the case, who Delaware Public Media will refer to by his initials, ST, had been in custody at the James T. Vaughn Correctional Center in Smyrna since 2022, where he was transferred after the incident at the psychiatric center.
But practically every party involved in his case agreed that a prison was not the most appropriate place for ST.
“Even if [ST] is at his lowest point – in the worst-case scenario – he can’t be held at Vaughn forever,” New Castle County Superior Court Judge Danielle Brennan remarked at a status hearing on ST’s case last month.
ST’s case began with a 2014 arrest for walking shirtless along I-95 in Wilmington. He was charged with two misdemeanors – one for walking on a highway without a light – and felony possession of cocaine; a court eventually determined that police had misidentified ST’s antipsychotic medication as cocaine, and the felony charge was dropped seven years later.
He was promptly released on his own recognizance, after which he fell into a downward spiral. Two days later, ST was arrested again for stealing a $1 drink from a Wilmington corner store while armed with a brick – an incident that incurred a first-degree robbery charge.
But trying and convicting a person with a persistent and severe mental illness is not straightforward.
In ST’s case, the arrests landed him in what Delaware Mental Health Court presiding Judge Andrea Rocanelli called a “revolving door of commitment, discharge from commitment... substance abuse, crime and incarceration,” fueled by what ST’s defense attorney and other mental health treatment advocates characterize as a failure by the state to provide an appropriate level of long-term care for people with severe mental illnesses.
Though ST was convicted of multiple felonies and sentenced to 20 years in custody, his sentence was suspended in favor of treatment at the Delaware Psychiatric Center (DPC), which theoretically offered an opportunity to provide ST with the medication and therapy needed to manage his mental health challenges.
According to those who treated ST, he was at his most stable – “radiat[ing] exuberance and self-assurance,” Judge Rocanelli wrote in a December 2020 opinion – while in a psychiatric hospital setting.
But the Department of Health and Social Services, which oversees DPC, has consistently argued that it should not use the center for long-term inpatient care. The agency cites a landmark 1999 US Supreme Court decision known as Olmstead v. L.C., which – among other impacts – stipulated that treatment for people with mental illnesses “should be provided in the setting that is least restrictive of the person’s personal liberty.”
The Olmstead decision, along with a subsequent investigation of the DPC by the US Department of Justice, prompted Delaware to develop community-based mental health treatment options and shift away from institutionalizing people with mental illnesses.
But the state took its reforms a step further, interpreting Olmstead as prohibiting long-term inpatient psychiatric care and transforming DPC into a facility for stabilizing people experiencing crises and gradually re-integrating them into the state’s community-based treatment programs.
While the state’s reaction to the Olmstead decision “addressed institutionalizing too many people,” Rocanelli wrote, “Delaware now fails to provide a humane institutional setting for those few citizens who need long-term inpatient treatment.” DHSS did not respond to requests for comment on its interpretation of Olmstead.
In the view of several current and former state officials who have followed his case, ST is one of those rare Delawareans in need of longer-term care. Instead, over the half-decade ST spent at DPC, the agency focused its efforts on his release, placing him in a community supervision program and attempting to manage his symptoms in an outpatient setting.
But ST’s mental health did not improve under community supervision; instead, his crises appeared to worsen, culminating in a 2019 incident in which ST ran away from his supervision team while on a weekend pass from DPC. When police eventually found him, ST told the officers to “shoot him.”
That incident landed ST in the custody of the Department of Correction facing a 17-year prison sentence; according to the court, while long-term incarceration was “problematic” in ST’s case, it was the only remaining option to provide structured, inpatient mental health care.
The state eventually dropped its original charges against ST – albeit without holding a hearing on whether he was competent to stand trial – but ST is no longer cycling between DPC and community custody. Instead, he may now cycle between prison and DPC, which has previously contended that it was not equipped to manage his violent episodes.
ST’s latest status hearing, where DHSS outlined its plans for his latest return from prison to the psychiatric center, centered on how the facility should accommodate a person who experiences violent psychoses.
“We’re starting this process all over again,” said Judge Brennan. “Let’s assume that some days are good days and sometimes we’re going to have a hard time.” If the state dropped the charges against ST for last year’s assault and returned him to DPC, what would happen if he once again had a violent episode?
“The bottom line is that if [ST] assaults a staff person and they want to call the police and report it, that is what is going to happen,” said Deputy Attorney General Valerie Farnan, who represented DHSS at the hearing.
As a precautionary measure, Farnan explained, DPC had begun outfitting a unit in their building to house ST in isolation from other patients, complete with additional security and video cameras.
So far, she added, DPC has struggled to find enough security staff for their facility; adding an extra security detail for ST will be especially challenging.
According to Farnan, DPC deems those security measures necessary because it views ST as “an outlier in terms of violence and aggression.”
But Robin Timme, the former chief psychologist for the DOC who has followed ST’s case since 2014, told the court that the DPC should be better-prepared to manage violent psychiatric symptoms – a task he argues is a core part of the facility’s responsibility.
“What if there is a psychiatric emergency?” he asked. “Is it seen as a criminal act? Or is it seen as a symptom of that psychosis, which we've all agreed that it is. We're dealing with a hospital that is saying that due to security limitations, they cannot handle psychotic aggression. That is a major problem.”
ACLU of Delaware Legal Director Dwayne Bensing agrees, contending that ST may not be as unique as the state suggests.
“We don’t know how many people there are,” he told Delaware Public Media, “but we believe there are several people trapped in the cycle of DPC being unable to deal with violent symptoms of severe mental illnesses and dealing with those by filtering people right back into the criminal justice system.”
Bensing also raised concerns about placing ST in isolation at the psychiatric center, which he argued may constitute a civil rights violation.
“We can’t just say, ‘this person is very difficult, so we’re going to put them in a holding cell, isolated, and only let them receive meals three times a day and sunlight for an hour,” he said. “That’s not a constitutionally viable option.”
Despite the additional security measures, Farnan told the court that DPC will ultimately still “be working towards [ST’s] discharge,” though the exact logistics of that discharge remain unclear.
ST, who only spoke briefly at the hearing, suggested that he might fare well in a private out-of-state hospital; other possibilities include a return to community supervision and wrap-around case management.
That suggestion also drew some skepticism from Timme, who cautioned the court about the “extreme focus on discharge planning and readiness” in a case as delicate as ST’s.
For now, the state is moving forward with its plans to return ST to the psychiatric center. Meanwhile, civil rights groups are searching for any other Delawareans who may be trapped in the same cycle, setting the stage for a possible civil rights lawsuit.