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Issue: guilty except insane

Tragedy strengthens effort to eliminate board

fine 3d image of dark grunge prison

Sen. Nancy Barto is spearheading an effort to abolish the state board that decides whether those who commit serious crimes but were found guilty except insane are fit to return to the community.  

The effort gained urgency after a man allegedly beat another resident of his Gilbert group home to death last month – 15 years after he killed his own grandparents and less than a year after the Arizona Psychiatric Security Review Board decided after a brief hearing that he needed less supervision. 

Legislative efforts to reform the board fell short last year, but have picked up steam this session. SB1029 looks to reform the board, and SB1030 would sunset it and move the board’s duties back to the courts in 2023. 

Barto, R-Phoenix, said the two bills – which are waiting for a floor vote in the House – are being rolled into one. SB1030 will have the reforms outlined in SB1029 while still dissolving the board in a couple years. 

Barto said she’d been hearing concerns about the board for years. When she attended a board meeting to see for herself how it operated, she described it as “haphazard” and unusual. 

“It’s hard to overestimate how lack of rules, really has potentially and actually harmed the public in this instance; we need to rectify it,” she said. 

Christopher Lambeth, 37, last appeared in front of the board in August 2020. Previously committed to the Arizona State Hospital after being found guilty except insane in his grandparents’ murder, Lambeth had been living in a transitional facility in Tucson. At the August hearing, which lasted 20 minutes, his request to move to the Phoenix area was unanimously approved and he was placed in a home with only eight hours of supervision a day. 

Nancy Barto
Nancy Barto

Advocates say the subsequent tragedy was preventable, but predictable, and that it speaks to a litany of problems with the board and how it’s run. They say the board handles cases inconsistently, provides inadequate time for clients and attorneys to prepare for hearings and has insufficient written guidelines and procedures.  

Holly Gieszl, a founding member of the Association for the Chronically Mentally Ill, said Lambeth’s case was a prime example of the board’s dysfunction. Gieszl often attends board meetings to represent her own clients, and she remembers Lambeth’s August hearing setting off alarm bells at the time.  

“Chris comes in, they don’t have a risk assessment; they don’t hear from a physician or psychologist, and they let him go to an eight-hour house,” Gieszl said. “Seven months later, he murdered someone.” 

Board members are appointed by the governor. The board is headed by a retired psychiatrist and has a psychiatrist, psychologist, parole officer and a public member. The board is responsible for deciding whether those who committed serious crimes but were found guilty except insane are fit to be discharged from the state hospital. It is also tasked with monitoring the progress of those on conditional release from the hospital. The board deals with roughly 100 cases a year. 

Some of the issues flagged by Gieszl and others were also noted in a 2018 auditor general report. The report stated that the board needed to develop rules and policies to guide its work, issue orders and notices as statutorily required and make sure it was getting consistent information on the patients’ mental health before making decisions.  

It also stated that some mental health reports were much more detailed than others, with some offering only “general conclusion statements with little or no support.” 

“The lack of sufficient information jeopardizes the Board’s ability to make timely and consistent decisions regarding GEI (guilty except insane) persons,” the report stated. 

While board chairman Dr. James Clark has said that the board completed the recommendations outlined by the audit, advocates disagree and also want more changes. 

“What the PSRB has not changed at all is the way that it has gone about assessing risk before it releases somebody,” Gieszl said, adding that her organization is backing the legislation to address those inadequacies. 

Among the changes proposed in the legislation are placing a retired judge as the chair of the board, giving a 45-day notice to patients before hearings and having the board explain its decisions on each patient. After the board sunsets in 2023, the cases would be transferred to the Superior Court where the person was sentenced as guilty except insane. 

Barto said that in stakeholder meetings, board members were resistant to any sort of change. 

“I think they just really think that the status quo is working,” Barto said. “When you look at what just happened, unfortunately, we’ve known this is coming, something like the tragedy that happened with Mr. Lambeth and who he killed. It’s unfortunate that we have such a prime example of the board’s inability to make a better determination of this man’s future.” 

Clark declined an interview, instead referring to his presentations to the Senate Judiciary Committee and House Criminal Justice Reform Committee. He declined to comment on whether the board handled Lambeth’s case appropriately. 

“(D)oing away with the PSRB and having Superior Courts assume jurisdiction and monitoring/oversight/supervision of individuals adjudicated Guilty Except Insane, as SB1030 proposes, would be a major policy change, a step backwards and would add an extra burden on the Superior Courts that is unnecessary,” Clark said in his written statement. 

‘Dysfunctional’ board for insane phasing out

Arizona State Hospital

Arizona will soon do away with the state board responsible for deciding the supervision and placement of those found to be guilty except insane for serious crimes, following years of concern about the board’s inconsistent practices and decision-making. 

The Psychiatric Security Review Board duties will shift back to the Superior Court where the judge made the initial guilty except insane determination. 

Sen. Nancy Barto, R-Phoenix, sponsored the legislation, which also changes the way the board will operate before it sunsets in July 2023.  

“I’m still a bit overwhelmed at our success in getting this through,” Barto said. “This board has been so dysfunctional over the years, and I’m so grateful because we are going to see a changed board in the meantime. They are going to have clear rules; they’re going to have information that’s going to inform their decision-making.” 

The effort suffered a brief setback when Barto’s bill was vetoed by Gov. Doug Ducey, along with 21 other bills, at the end of May when Ducey said he wouldn’t sign any more bills until the Legislature sent him the budget. 

Ducey signed the revived version of the bill June 29. 

Barto’s bill gained steam this legislative session, in part due to tragedy.  

In April, Christopher Lambeth, 37, allegedly beat to death another resident of his Gilbert group home. The incident came less than a year after the review board unanimously approved Lambeth’s request to move to a group home in the Phoenix area with less supervision – only eight hours a day.  

Fifteen years ago, Lambeth killed his grandparents. He was found guilty except insane and committed to Arizona State Hospital, later moving to a transitional facility in Tucson. 

The board’s decision to allow him to move to a home with less oversight came after a 20-minute hearing last August. The fatal beating occurred seven months later. 

“We can only surmise that this was bound to happen at some point,” Barto said. “Unfortunately, we didn’t have this law in place in time to prevent something like this from happening.”  

The law implements several changes to how the board conducts its remaining business. A judge will be appointed as chair, instead of the current retired psychiatrist. Risk assessments will be required for those who request a change in their supervision, and there are more requirements for obtaining certain information from the state hospital. The board will have to submit an annual report to the Legislature outlining its actions. 

Holly Gieszl, a founding member of the Association for the Chronically Mentally Ill, said one of the most important changes is requiring every case to be heard in-person or via video.  

“The PSRB will always be able to see individuals who are appearing before it, presumably lawyers, too, but certainly individuals who are out in the community on community release,” Gieszl said. 

Barto said the changes will also preserve the right to due process for those who come before the board. 

“The embarrassing part of the story is that because the board had such loose rules and procedures – I mean, basically nonexistent rules – in place, they were violating due process and were dragged into court,” Barto said. “They had to suffer the embarrassment of having their judgments overturned in court.” 

A 2018 auditor general report that noted the board’s shortcomings was key in getting the bill passed, Barto said. While the board’s chair has said that the board had followed the report’s recommendations, advocates disagreed. 

“The good work of our auditor general really, really was instrumental here in giving us some legs to stand on to get this through, to make the points that we needed to my colleagues and the governor that, hey, we have problems, and we’re going to fix them, and we did,” Barto said. 

Liana Garcia, Arizona Supreme Court director of government affairs, said the courts aren’t starting from scratch in implementing the processes necessary to oversee guilty except insane cases. Superior courts had jurisdiction over those cases before the guilty-except-insane statutes were overhauled in the 1990s. The psychiatric security review board was established in 1994. 

“So, there is a model for it, and the Superior Court that had jurisdiction over the case when the person was adjudicated guilty except insane would just retain jurisdiction over that person for the term of their sentence,” Garcia said. 

The board doesn’t sunset until July 1, 2023, in order to give the courts time to prepare to oversee the hearings now overseen by the board. Those hearings are to determine level of custody – whether a person found guilty except insane can be released from the state hospital and what level of supervision they need while on conditional release. 

Each year, the review board oversees about 100 cases from across the state and has about 100 statutory hearings. 

Psychiatric security review board Executive Director Hannah Garcia did not return multiple phone calls for comment.