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The Colorado Mental Health Institute houses about 200 criminally committed patients, sent there by a judge. Also in the forensic unit are 87 patients under civil commitments or who are defendants undergoing psychiatric evaluations.

There are 194 patients in the general population. They include people in the geriatric, adolescent and medical surgery units.

The state has already paid $2.5 million for architectural plans for a new $49 million forensic facility, but funding was scrapped this year because of budget concerns. Construction is scheduled to begin July 1, but the project awaits funding.

Ten percent of all patients are women.

The institute has about 900 employees. Of those, 342, including 13 psychiatrists, are in the forensic unit.

Its budget for the 2001-02 fiscal year was $58 million, most of it state funding.

It is the only mental institute in the state that treats the criminally insane.

The average cost of housing each forensic patient is $127,000 a year..

Inmate Insanity

11 Nov

Inmate ‘insanity’
Denver Post ^ | August 25, 2002 | Kirk Mitchell
Posted on 8/25/2002, 2:56:39 AM by sarcasm

Sunday, August 25, 2002 – PUEBLO – At least 11 residents of Colorado’s main facility for the insane share a remarkable characteristic.

According to their psychiatrists, they are sane.

Medical records show they and at least three others who have been released faked or wheedled their way into an institution meant primarily for people who, under state law, are “incapable of distinguishing right from wrong” when they steal, rape, kill or commit some other crime.

These 11 patients cost state and federal taxpayers about four times more than if they were in prison – about $1.4 million a year.

But the price of sending sane people to an institution for the “diseased or defective of mind” goes far beyond dollars.

Some of the sane patients in the Colorado Mental Health Institute prey on the truly disturbed residents.

Others escape from the facility, which is less secure than a prison, and commit more crimes.

One patient was released more quickly than he would have been from prison, and killed a father of four.

These conclusions are based on a review of court records; interviews with patients, doctors and staff; and hospital records that 11 patients contacted by The Denver Post allowed the newspaper to examine. Records show that since 1988, at least three other patients who faked mental illness to enter the institute have been released.

State officials don’t dispute that the sane are among those locked away in the Pueblo facility, which on Friday housed 481 patients, about 200 of them committed by a judge after they were charged with a crime.

Ten years ago, mental-institute officials concluded that 27 of 101 patients sent there over a five-year period shouldn’t have been committed because they knew the difference between right and wrong, even though some had a mental illness. No follow-up study was done to determine whether they were released.

Former institute Superintendent Robert Hawkins said before his death in July that sane patients represented a small percentage of the institute’s population. State law compelled him to keep patients in the mental hospital even when they were found to be sane, he said in an interview before his retirement in June.

Because they might commit more crimes, he said, they were deemed dangerous and couldn’t be let out.

“The hospital has absolutely no reason to want to retain them here,” Hawkins said. “However, the hospital will not assert to the court that these persons will not re-offend when all evidence is to the contrary.”

But Ron Honberg, legal director for the National Alliance for the Mentally Ill, said institutions for mentally ill patients shouldn’t become a pseudo-prison for criminals. Sane criminals should be separated from vulnerable mentally ill patients or be released, he said.

“It sounds like the state is trying to solve a broader social problem through the hospital,” Honberg said.

Denver lawyer Kathleen Mullen, who filed a class-action lawsuit against the institute in 1999, said doctors hold sane patients because they are worried about political fallout if patients are released and commit more crimes. They are warehoused even though they haven’t committed a violent offense in decades.

“They won’t release anybody, because they are so scared of their shadows,” Mullen said. Instead, hospital administrators “treat them as though they are insane.”

Not all get out quickly

The problem starts in Colorado courtrooms, such as the one in Montezuma County that Jimmy Nieto walked into in 1994.


A convicted sex offender, Nieto, then 20, was charged with having sex with a 15-year-old girl.
Nieto said he was told by his attorney, Guillermo Garibay, that he would serve less time in the institute than in prison. At the institute, Nieto and his grandmother said he was told, he could attend college and receive drug and alcohol treatment. Garibay said he doesn’t recall that conversation.

“He made this place look really good,” Nieto said. That he wasn’t mentally ill didn’t seem to matter, he said.

Nieto and his grandmother, Shirley Hill, said the attorney assured him that he would only have to stay one to two years at the institute. Garibay denies that.

“That’s not something I would tell him or anybody,” Garibay said. “I didn’t expect there was going to be any miraculous cure.”

Garibay said his client had a bicycle accident that caused brain damage, affecting his impulse control.

Two psychological reports presented to the court said Nieto was not mentally impaired.

“It is my opinion that Mr. Jimmy Nieto did not suffer from a mental disease or defect at the time of the alleged crimes,” Dr. John Hardy, a court-appointed psychiatrist, said in one of those reports, dated Dec. 10, 1993.

Nevertheless, in early 1994, Nieto cut a deal with then-District Attorney George Buck that stated Nieto had sex with the girl because he was psychologically impaired – a finding that qualified him for the Pueblo institute.

Buck, now a lawyer in Cortez, said in an interview that he didn’t recall why he agreed to the plea. But he added that the 15-year-old and her family would have been consulted and that he tried to avoid the trauma of forcing a sex-offense victim to testify.

On April 18, 1994, District Judge Grace Merlo cemented the deal by finding Nieto not guilty by reason of impaired mental condition. She committed Nieto in 1994.

Merlo, who is retired, said she recalled the case but not why she accepted the agreement.

Like all people sent to the Pueblo institute, Nieto went for an indefinite period – one day to life.

Colorado’s approach is common. But at least 17 states place people in mental institutions for an amount of time that varies with the nature of the criminal offense, said Honberg, the Alliance for the Mentally Ill official.

The number of states that use specific time periods is growing, he said, and one state, Virginia, limits to one year commitments for people whose crime was a misdemeanor.

Psychiatrists and staff members at the Pueblo institute said they are puzzled why Nieto is there.

In a July 30, 1997, memo, Nieto’s institute psychiatrist, Dr. Elissa Ball, said that during a meeting about Nieto’s care, institute staff members said Nieto shouldn’t have been found mentally impaired.

“He certainly doesn’t have a mental illness,” Ball told The Post.

Nieto has spent three times longer in the institute than he might have in prison, where he would have been eligible for release in 1997, said Department of Corrections spokeswoman Alison Morgan.

Easier to escape

Keeping those who fake mental illness – malingerers – at the institute has not always kept the public safe.

Patients deemed not responsible for their crimes are in an institution designed to cure and rehabilitate rather than punish. The hospital is not enclosed by a fence. It isn’t as secure as prison. Patients often earn the right to cross institute grounds alone or leave the complex to work or attend therapy.

When patients, including the sane criminals, leave the institute, they sometimes don’t return.

Of the known 14 current and former patients who faked their way into the institute, 11 escaped, and five of them committed new offenses while they were out.

On May 8, 1979, a year after serial rapist Darrell Jones, 44, was committed on what a report by an institute psychiatrist called “fabricated psychotic symptoms,” he walked into a house two blocks off institute grounds and raped a woman who was eight months pregnant. He was found guilty of rape and sentenced to prison.

Keith Simpson, whose institute psychiatrist says he has no psychotic symptoms, was committed several years after robbing an Aurora convenience store in 1989. He escaped twice. The first time, on May 5, 1990, he ordered a cab driver to take him to Denver, saying he had a gun in a sack.

The second time, on Dec. 11, 1990, Simpson escaped from the institute during a ward dance, shoved a woman out of her car and drove the car through a garage door and into a telephone pole. Voices commanded him to make both escapes, he said. Psychiatrists didn’t believe him. In 1992, he was convicted of kidnapping and escape and served two years in a Colorado prison for the crimes.

Then he was returned to the institute. Simpson, now 48, was released in 2000.

After Kneka Knoke escaped in 1986, he stabbed two men in a Portland, Ore., park.

Knoke, now 48, illustrates another problem: Occasionally, a patient can work the system to win a swift release, and then cause harm.

The career robber avoided lengthy prison sentences twice with insanity judgments in 1981 and in 1984. The first time he got out of the institute in one year, the second time he got out in four – both times using the recommendations of a private psychiatrist he paid.

Then in August 1992 in Portland, Knoke shot security guard Bill Hall in the heart.

Hall, a high school football player and jovial father of four, bled to death.

“I was mortified that this guy would even be walking the streets,” said Hall’s sister, Teresa Nugent Noe.

Fakers abuse patients

Institute officials also acknowledge that the facility, which has buildings dating to the 1950s, is poorly equipped to handle its inhabitants. Patient files describe dangerous conditions.

On institute wards, the elderly are mingled with the developmentally disabled, the severely mentally ill and the sane career criminals. Patients being evaluated for trial competency and newly committed patients are placed on the four maximum-security wards. So are patients who break institute rules.

Several of the patients who have faked mental illnesses have swindled, beaten and raped vulnerable patients, according to patient records.

“It’s not right and it’s really a reflection of how we devalue people with mental illnesses,” said Honberg, with the Alliance for the Mentally Ill. “People with mental illnesses are deserving of protection like everyone else.”

The exploits and crimes of malingering criminals are recounted in numerous files:

Simpson conned vulnerable patients out of money, gambled, sold drugs, and sexually assaulted and beat other patients.

Knoke strong-armed developmentally disabled patients. The highly intelligent patient often turned staff members against each other.

Tyrone Jones, 40, was committed in 1989 after he claimed a genie told him to stab a fellow prison inmate. He has been written up more than 20 times for physically and sexually assaulting patients and staff, threatening to kill patients and selling drugs.

Henderson McClure, 44, was described as “one of the most severe and intractable sociopaths ever known to the state hospital” by his psychiatrist, Dr. David Johnson, in one of his files. He described McClure as “cocky, muscular, arrogant and dangerous,” but not mentally ill.

“I was a predator,” said McClure, who was committed to the institute in 1979 after strangling his fiancee.

McClure admitted raping a female patient on institute grounds in 1988 or 1989, and several patients accused him of pressuring them to have sex with him, according to his medical records. A male patient also accused McClure of raping him, the records say. McClure in 1992 was caught having sex with two patients in his room. He had affairs with four nurses and married one of them.

On numerous occasions he assaulted other patients or staff members, records show. For example, in February 1992 McClure slammed a patient against the wall for dancing with his “girlfriend,” a female patient. Five months later he slapped the girlfriend for following him.

McClure’s files showed he stopped his aggressive behavior in the early 1990s. He was released conditionally, meaning he had to comply with rules set by the institute, and his employer said he was a good worker. But two years ago a girlfriend told prosecutors that he sexually assaulted her. The institute brought him back, although no charges were filed.

“Our assaults are up partly because of our clientele, and because we have inconsistent policies, procedures; and rules, if they exist, are applied haphazardly,” according to a Feb. 1, 2001, memorandum written by Dr. Michelle Moran to several institute psychiatrists.

At the time, the number of assaults was rising from the roughly 300 a year for 2000. Hawkins said patients who fake mental illnesses drain institute resources.

“In general, the patients who malingered mental illness to evade prison and remain here by court order cause most of the management problems for this hospital,” Hawkins said.

“They abuse the staff and attempt to abuse other patients, monopolize staff time with constant demands and demonstrate their continued belief that they, rather than those they harmed, are the victims.”

More than bargained for

But some of the fakers pay a high price for their deception.

They live in crowded, poorly staffed wards where some have been stabbed and slashed in unprovoked knife attacks by psychotic patients. The mentally ill jump on tables, take swipes at invisible demons and endlessly chant babble. Their shrill screams reverberate off concrete, windowless wards.

Bill Labrum says he maneuvered his way into the institute to avoid the brutality of jail.

Labrum, whose diagnosis is “malingered psychosis,” meaning he faked his symptoms, entered the institute in 1990 on a charge of escape from a halfway house. Had he gone to prison, he could have been paroled in October 1994.

Then 20, Labrum, looked like he was 15 and weighed only 125 pounds.

“They said I would get killed or raped” in prison, Labrum said. “I was young and terrified of prison, and I would have said anything to get (to the institute.)”

To help him out, Labrum’s defense attorney, Ralph Rhodes, said he counted on the prosecutor’s sympathy for Labrum’s frailness.

“You have seen this young man. He wouldn’t last a week in (prison),” Rhodes wrote to Steve Feder, then the Arapahoe County Deputy District Attorney. “Do you want that on your conscience?”

Labrum went to the mental institute, not prison. Feder, now in private practice in the Denver area, said he handled hundreds of cases and did not recall the details.

Labrum did avoid prison, he said, but not the violence he feared there – he claimed he was raped. The patient he blamed said the sex was consensual.

Now muscular from weightlifting, Labrum said he battles bouts of hopelessness and depression.

“There is a saying here: Fake it until you make it,” Labrum said. “If you’re not crazy when you get here, you will be before you leave.”

Sunday, August 25, 2002 – PUEBLO – At least 11 residents of Colorado’s…
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