Dept. 95--Where the Bizarre Is the Norm : Many Who Appear in Special Court Are Mentally Ill

Bedlam often reigns in Department 95 of Los Angeles County Superior Court. Defendants make obscene gestures, throw things, urinate in their clothes and sing songs.

“If you like the trappings of formality, this isn’t the place,” said Judge Michael D. Pirosh, who last week ended a four-year assignment as Department 95’s presiding judge.

Department 95 is the only county court--and one of a handful nationwide--that deals exclusively with mental competency cases, legal experts say. It is where the county decides whether to commit its defendants to institutions as mentally ill or to let them go free after court hearings and trials.

While other courts occasionally try mental competency cases, most are funneled to Department 95 because of the mental health law expertise of its jurists, public defenders, district attorneys and psychologists.

8,000 Cases in Year

Last year, Pirosh and his colleague, Commissioner David Ziskrout, heard almost 8,000 cases there. In about 75% of the cases, they approved some kind of commitment.

Court officials say that most of the defendants are poor, and a growing number are homeless.

Some are there because of minor misdeeds, like drunkenness or lobbing rocks at passers-by. Some have pleaded innocent to crimes by reason of insanity and are there for jury trials. Some seek release from institutions. Others face conservatorship hearings in attempts by family or the state to gain legal custody.

Every morning, the buses roll in from Camarillo State Hospital, 60 miles northwest of Los Angeles, and Metropolitan State Hospital in Norwalk, bringing patients for court hearings and trials in the converted pickle factory on San Fernando Road that houses Department 95.

In the waiting room, some patients sit listlessly in green and orange vinyl chairs, their ankles shackled with leather restraints. Others pace the corridors, plagued by delusional voices that send them running from imaginary villains.

Distraught Woman

One woman, dishevelled and glassy-eyed, wandered in and out of Ziskrout ‘s courtroom, where he was hearing conservatorship cases. She plucked at the garments of bailiffs, attorneys and onlookers, wailing in loud, urgent tones.

A bailiff gently escorted her back to the waiting room, which is thick with cigarette smoke. The air crackles with tension and frustration. Attendants guard the exits.

From a window, patients stare at a garden patio that adjoins the waiting room. But they aren’t allowed outside--they might scale the 10-foot fence that surrounds the courthouse and disappear. Last year, five patients did just that.

Many judges hate working in Department 95, Pirosh said. Although the standard assignment is two years, one judge disliked it so much that he asked for a transfer after 18 months.

“It has the reputation of being the pits. The worst assignment in the whole district,” Pirosh said.

But Pirosh, a lifelong activist who registered black voters in Mississippi during the early 1960s and spent years providing voluntary legal services for the poor, asked for a second stint in Department 95 after his first term expired two years ago.

Cares for the Underdog

“For many years, I have worked for the underdog. I care, I really care,” he said.

Today, however, Pirosh starts a new assignment in Juvenile Court. After four years, “You burn out,” he said.

“It’s emotionally draining to see how sick these people are, that they don’t have a place to live, that they’re going to be eating garbage for the rest of their lives, that they have no family, or that their family either doesn’t care or has washed their hands of it,” Pirosh said wearily.

Substitute judges can also find Department 95 rough going. Some attempt to hold mentally ill defendants in contempt for making obscene gestures or refusing to cooperate, Pirosh said.

“Now who’s out of touch with reality,” he added with a laugh.

Nevertheless, some deputy public defenders and deputy district attorneys request assignment to Department 95.

“I wanted to get over being intimidated by psychologists and medical terminology,” said Deputy Dist. Atty. Sharon Matsumoto, who admitted that her first days in court were “a little frightening.” Matsumoto recently finished a two-year stint at Department 95.

Deputy Public Defender Richard Brodkin, who left a high-paying private practice 14 years ago to work in Department 95, said he finds the work “incredibly rewarding.”

On the other hand, “There are times when I sit in court and cry,” Brodkin said.

Most Mentally Ill

Social workers, judges, public defenders and district attorneys who work at Department 95 readily agree that most defendants they see suffer severe mental illness.

But that isn’t grounds for commitment under the Lanterman-Petris-Short Act, California’s mental health law that also is known as LPS.

Pirosh and Ziskrout must determine whether defendants are “gravely disabled,” which according to state law means people unable to secure their own food, clothing and shelter or those who are dangerous to themselves or others.

In civil cases, if patients are found to be “gravely disabled,” they can be institutionalized. If not, they must be released--to their children or their parents, to their own homes or to the streets.

“There are times when I feel confident that a person is quite dangerous, yet there’s nothing I can do,” said Roger Maloney, a clinical psychologist who frequently testifies as a court-appointed expert witness.

Added Matsumoto, “Families come to us and say, ‘What does he have to do before you lock him away? Does he have to kill me?’ ”

Criminal cases are different. Those who plead not guilty because of insanity have trials--many of them at Department 95--to determine their sanity. If found insane, they are sent to institutions. If found sane, they return to criminal court to stand trial for the crimes for which they were arrested. Dangerous patients are kept in the Department 95 security cell.

Most Not Dangerous

But most aren’t dangerous--at least not to others, staff members say. Recently, a young woman who argued her case eloquently before Ziskrout was denied permission to leave the hospital because of a history of suicide attempts. Crying violently, she rushed to the restroom and began stabbing at herself with a pencil. Attendants had to pull her out and restrain her.

Pirosh hears about 14 cases on an average day. “It’s really sad. They put their best foot forward. . . . But most of them are clear-cut cases. When someone gets on the stand and says they’re Satan or Chevrolet . . . “ he said, throwing up his hands.

Recently, Pirosh listened as a court-appointed psychologist evaluated the mental competence of an extremely overweight young woman who sat before him in court, hands pressed primly in her lap.

The woman had been hospitalized three days earlier suffering from severe delusions. A psychiatric evaluation team decided to keep her at the hospital under observation for 14 days. According to state law, if a patient contests the hold, the court must hold a hearing within 72 hours.

“She believes she has to kill her mother to get rid of Satan,” the psychologist told Pirosh. The patient seemed not to listen, but her eyes blinked rapidly.

Disturbed Testimony

Later, the young woman herself took the stand. She talked fervently and almost unintelligibly about devils and angels, and at one point, burst into tears. Leaning forward, Pirosh listened attentively. He asked her how she planned to care for herself if released.

The woman said she would live with an aunt or rent an apartment. She told Pirosh she loved her mother. She said she had $4 billion in savings.

After hearing arguments from a deputy public defender and deputy district attorney, Pirosh affirmed the 14-day hold.

Before 1968, patients could be committed indefinitely with the authorization of one or more doctors. “It was like a trapdoor opening up. They’d disappear and you’d never see them again,” said Edward Gilmore, who heads the Los Angeles County public defender’s psychiatric division.

The Lanterman-Petris-Short Act of 1968 brought sweeping changes. It set limits on hold times, tightened standards for committing patients and ensured their rights. California’s state mental hospitals slowly emptied; from 35,000 patients in 1969, the population dwindled to 5,000 today.

But while LPS opened the door for psychiatric patients, it failed to provide a safety net of outpatient programs and community-based care, mental health experts say.

Revolving-Door Syndrome

And once out on their own, many patients simply stopped taking the psychotropic drugs they needed to blunt the full force of their mental illness. Many became part of what Pirosh calls the revolving-door syndrome. About half of the patients in Department 95 are repeaters and some have been in court half a dozen times in four years, he said.

Typically, patients are picked up for violent behavior and hospitalized in one of Los Angeles County’s 46 licensed mental health-care facilities for 72 hours.

There, the patient is given medication to stabilize the symptoms so that he or she is fairly lucid when it comes time to appear before a judge.

Currently, a coalition of mental health groups, including the California Psychiatric Assn. and the California Medical Assn., are lobbying for sweeping changes in commitment laws.

Among their goals are doubling the six-month hold for patients deemed dangerous to others; replacing the 14-day hold with a 30-day certification that includes mandatory outpatient treatment; obtaining more 24-hour treatment beds; establishing post-hospitalization programs and allowing family members to testify about a patient’s mental history.

But Barbara Demming Lurie, director of the Patients’ Rights Advocacy program for the county’s Mental Health Department, said she and other advocates are staunchly opposed to suggestions that LPS be overhauled so that patients can be committed more easily.

Used as Dumping Ground

Lurie points out that many families who tire of caring for mentally ill relatives use the court as a dumping ground.

“Families learn what to say. Sometimes the case gets embroidered and hearsay is presented as evidence,” she said.

Although they sometimes fault the system, most legal experts speak highly of the jurists and attorneys in Department 95.

An attorney and clinical psychologist who teaches at USC Law School, Stephen J. Morse, says that legal professionals who work exclusively with mental health patients develop competence in that field and take the legal rights of mental patients seriously.

“The PD’s (deputy public defenders) argue their cases quite zealously, even when defendants get on the stand and are quite disorganized,” said Morse, who regularly takes students on field trips to Department 95.

“People aren’t treated as freaks here. They’re treated with dignity and respect,” Gilmore said.