Editor’s Note: This essay was originally published on August 30, 2019, but was temporarily removed due to a technical issue. At last count, the story had 4,311 views and 33 comments, which can be read here. We recently learned that in early 2021, the author gained release from the forensic hospital in which he had spent two decades.
Walking into the old Pink Flamingo, its typically dark motif was flooded with light that night. Bartender’s choice. I was annoyed. I should have left immediately.
The half-hour spent walking there, that the Jack on the rocks was only $2.75 and I only had ten dollars in my pocket allowed me to look past this guy’s ignorance. I ordered my first drink and settled in.
It was Monday, March 27, 2000. I was moving to a new apartment the next day. I had to rise early, so I thought a few drinks would help me get a good night’s sleep. Also, our new place was a little further uptown; I wouldn’t be as close to one of my favorite dive bars.
It wasn’t until after that I recalled the server’s face from Christmas Eve (that night, I blacked out after two shots and one beer and was arrested for attacking a police officer). Afterward, I thought: “Wow, I could have killed someone and not known it.” That was the first time I had ever suffered a loss of consciousness. It was scary.
I put the bright bar lights out of my mind and was simply enjoying the moment; an open pack of Marlboro Red’s and the change from my ten sat on the bar in front of me. Good music from the sound system, the crowd was filling in, a young lady sat down next to me, we nodded “hellos.”
Those were my last memories as a free man.
My eyes blurred open as the car turned sharply into the parking lot, bouncing my head off the window, the cuffs pinching my wrists and pulled behind my back informing me I was not a voluntary participant in this ride, the sign on the building indicating that I was about to enter the Buffalo Police Fire Investigator’s office. I went back under.
I awoke in the presence of a plainclothes officer. Sitting across his desk, trying to figure out how and why I was there, I simply asked: “What happened?”
“There was a fire,” he said. I had no idea what day or time it was. I had suffered a total blackout, just like Christmas Eve. I feared the worst, was actually a bit relieved to hear that there was only a fire.
My brain was foggy. Attempting to put the events of the evening into perspective, I asked for a cigarette and a cup of coffee. Reaching into my pocket for a smoke, I pulled out a five-pack of Marlboros. I knew I had been home; I just couldn’t remember being there.
When I left the house, the five-pack of Marlboro’s sat atop the refrigerator in my kitchen. As I felt the smokes in my pocket, I thought: “I must have been home, but when? What happened?” I was clueless.
The fire the officer was referring to was set in my apartment, not the whole building but the living room of a three-bedroom, two-bath, 1800-square-foot luxury apartment.
He went on to say that I already confessed to the crime; I denied it. Then he wanted me to answer other questions (unrelated to the fire), threatening me with 25 years if I didn’t cooperate. I deflected his questions and repeatedly asked for my attorney.
The fire department had arrived in five minutes and the blaze was quickly extinguished. Most of the damage was to the contents, my contents. Thankfully no personal injuries occurred as a result of the arson. Drive by 857 Delaware Avenue in Buffalo today and you wouldn’t be able to pick out the unit that burned.
The police handed me over to the court, the court set bail at $20,000, and off to the holding center I went. While in the holding center I would meet a number of doctors who would interview me with annoying questions and probing accusations.
One of my first interviews was with the forensic psychologist, Dr. Lieberghaul. During our first interview, he read a statement that the Buffalo Police attributed to me when I was in the back of their squad car.
They claimed that I said all sorts of crazy stuff, that I was John Gotti’s son and that I killed people and that I was gonna kill my landlord, Carl Paladino. It was utter nonsense. When the doctor asked me what I thought of that statement, my reply was: “Those are not my thoughts or beliefs, not now, not ever.”
The building was owned by Ellicott Development Corp. Former New York State Gubernatorial candidate Carl Paladino was the CEO at the time. His three children resided directly above our apartment. Dawn (my former fiancé) and I had lived there for two years.
The doctor questioned me as to my relationship with Carl. I was honest that until we declined his offer to renew our lease, things were fine. In January of 2000, the landlord had offered to renew our lease when it expired at the end of March. Dawn and I discussed our options, but we felt that a move back to our old neighborhood was in our best interest.
That’s when things took a turn for the worse.
Carl sent the police to our house the last Sunday in January, seven officers in total, for no other reason than to intimidate me. They raided our unit, making threats as they went from room to room with no search warrant. I was not in violation of any laws or noise ordinances that night. Our only “transgression” was to politely decline the lease renewal.
They returned four more times that night in diminishing numbers. Ultimately relenting after the downstairs neighbor yelled up from her door: “Leave him alone, he hasn’t done anything.”
It was that visit that lead to an eviction hearing on March 10 of 2000. We won that hearing but then Mr. Paladino claimed I called his office and threatened to kill him. Mr. Paladino cited the police visit as impetus for the eviction proceeding. Never offering why the police were dispatched in the first place.
I was not made aware of the threatening phone call until after my arrest on the arson charge.
A mutual friend introduced me to Carl sometime in 1997. I called him for legal help about a year later. He was very helpful and even offered my company a below-market-rate lease on an office in his Ellicott Square Building.
Why he turned on me, sending the police to my house, attempting to evict us and all of the nonsense that followed, is beyond me.
Pause for a moment to reflect back on the night of the fire.
I spend the day shopping, have dinner with Dawn, watch the hockey game on TV, play chess on the internet, walk to a bar, have one drink, lose consciousness, get arrested for something I have no recollection of doing— not to mention that it would be totally out of character for me do—I allegedly spout off to the police all sorts of crazy stories of mayhem and violence, I come to in the presence of a Buffalo Police officer and I refuse to answer any questions even under the threat of 25 years in prison.
Since I cannot recall the time period between my first drink and awakening in front of the fire investigator, I have no defense to the accusations.
While I was in the Erie County Holding Center, Dr. Lieberghaul broached the subject of taking an insanity defense, or CPL 330.20 as it is known. He described in detail the two possible sites I would go to (Rochester or Mid-Hudson) and he assured me I would be home in six months.
When I hesitated, he asked what I wanted to do. I told him I wanted to go to trial, as I was innocent. I swore I had been drugged in the bar.
He retorted, “That will take over a year to go through the courts and cost you over $20,000, money you don’t have.”
I asked how he knew of my finances?
“Your bail is $20,000 and you’re still sitting here” he replied.
“OK, but I still want to go to trial, I am innocent.”
He wouldn’t hear it, and went on to say that they were doing me a favor, that this was a very rare plea, it would only be six months. I resisted, he turned up the heat.
“If you don’t cooperate, I will send you to one of these places and lose you for two years.”
I didn’t know it at the time, but the doctors can say you are not competent to stand trial. You will be sent to a forensic hospital until you have attained competence. These “clients” are referred to as 730s. That is the legal code for people who have been charged criminally but due to their mental illness cannot proceed with assisting in their own defense.
The doctor assured me that I would be home by Christmas if I took the offer.
Up to this point, I was a detainee with criminal charges. I saw the world through that lens. I would not be overly cooperative with the doctors who worked in the jail, as they seemed somewhat incompetent to me. As for taking a plea, in the criminal world it happens all the time. You save the state time and money, they guarantee little or no jail time. Win-Win.
My self-talk at the time was: “Well, these guys (state hospitals) are professionals, they will know that I am not crazy, and they will let me go. They just don’t want involuntary intoxication to be a viable defense strategy, or anyone could do anything and get away with it.”
Your mind can play tricks on you as you sit in a jail cell.
In October of 2000, I accepted the “deal” and became an official CPL 330.20 client under the care of the New York State Office of Mental Health.
On October 18, I was transferred from the Erie County Holding Center to Mid-Hudson Forensic Psychiatric Center in New Hampton, New York. Mid-Hudson is about an hour north of New York City. I was pleased to find out that I could smoke cigarettes and wear street clothes. It wasn’t nearly as bad as I expected. On my first day there, though, I was dismissed of the notion of a six-month stay – the admissions attendant informed me that the average visit was five years, and with my attitude I would be there 25 years.
When you arrive at Mid-Hudson the first thing you notice is the fences: two rows with rolls of razor wire on the ground, the outermost fence high and curling inward at the top, covered with razor wire, a very foreboding sight.
Once inside the compound, a wide expanse of grass and trees gives way to the main building that holds the dining hall, medical and dental clinics, and a large auditorium as well, no longer operational. The building was built in the 1930s and it looks it. Two of the three housing units, identified as Buildings 2 and 3, are visible from the main yard. The other housing unit, Building 4, is barely evident up the hill to the north. Buildings 3 and 4 have three floors each. Two wards per floor make a unit; each unit has 30 to 36 patients. Building 2 houses the pre-discharge co-ed unit, the female unit, and an infirmary. All told, Mid-Hudson serves almost 300 “clients” as we were sometimes affectionately called.
A quick primer on how the mental health system intersects with the criminal justice system thereby feeding the machinery of the state psychiatric centers:
When an individual enters an insanity plea or is found not responsible by a jury (very rare), they are sent to a secure (forensic) hospital for a 30-day evaluation. The purpose of this evaluation is to make a recommendation to the court to determine which “track” the detainee will be placed on.
That track determination will have a powerful effect on the life of the defendant.
Track 1: Dangerously mentally ill and in need of inpatient care at a secure forensic psychiatric center.
Track 2: Mentally ill but not dangerous, inpatient treatment at a non-secure or civil hospital.
Track 3: No longer mentally ill, release to the community with an order of conditions.
Most people hear “insanity defense” and they think the person is getting over on the system. This is far from the case. After the hearing, the client is almost always found to be “dangerous” and in need of further “treatment.”
This places the client back into the secure forensic hospital for a six-month order. When the order starts, more evaluations ensue and invariably dangerousness is determined, thus warranting further commitment. A year is the established timeframe. Once that year expires, more evaluations, more dangerousness, and of course more time. At this stage, two-year retentions are the norm. Clients can challenge the hospital’s decisions, get outside doctors with court-appointed lawyers, and the whole circus becomes quite comical.
If you have money, things change. A good lawyer and a private psychiatrist can work wonders. I have seen arsonists get out in a year; I have seen murderers cleared for the civil in less than three years. The right people in your corner? You can fly through the system.
The first step: Transfer to a civil hospital from the forensic hospital. One must meet certain requirements. You have to show insight into your mental illness, you are required to admit to your crime, you have to agree to take any and all medications for the rest of your life, you must show remorse for your victim(s), and you should thank your doctor for giving you back your sanity.
Diagnosing and treating mental illness is not an exact science. We cannot just X-ray the brain and say “Ah yes, Bill is suffering from paranoid schizophrenia.” Doctors must examine each patient, interview friends and family, and ultimately fill in the gaps. Arrest records are scrutinized, school transcripts are referenced. Psychological testing is usually performed at some level. In most cases, medications are prescribed almost immediately upon admission to psych wards.
The First Component – insight into mental illness – in my case is very difficult. My current diagnosis is Delusional Disorder. Let’s break that down: I am suffering a grandiose delusion because I was told that John Gotti was my biological father.
As an adoptee in New York State, we are not allowed to know the circumstances surrounding our origin. I had tried for years to locate my birth parents. In 2017, through DNA testing, I located a half-sister from my biological father’s side. I am not biologically related to John Gotti. I was lied to. It is embarrassing to acknowledge that at one time I believed it to be true, and I still wonder why someone would lie about such matters.
So my real delusion is being lied to. With no data to refute that lie, I believed it to be true.
Believing a lie as it relates to your origin when you are an adoptee does not make one delusional. It means I was naïve, vulnerable, and gullible.
Over the years I have been assigned at least nine different diagnoses, none of which hold up against any form of close scrutiny. No one cares.
How is this possible?
Early on, the prime piece of evidence as to my mental illness was a statement my former fiancé made to a social worker over the telephone. The statement was as damaging as it was false. I was not made aware of the presence of the document until seven years later, when I was preparing for a court date.
It was an awful account of someone who was clearly suffering from some form of schizophrenia. The behaviors she spoke of have never been observed in my conduct (under 24/7 constant surveillance for nearly 20 years). Independent doctors have testified that they believe the statements to be false as well.
In 2010, I was in session with my treating psychologist and I beseeched her to enlighten me as to why she felt I was so sick. Without hesitation, she quipped, “The things your girlfriend said.”
I rebutted, then she followed with “Oh, and the things you said to the police.” I rebutted the second charge, to which she replied: “Oh, Mr. Sutherland, you have an answer for everything.” I said, “Yeah, it’s called the truth.”
She ended the session early. I was not being cooperative and ready to engage in therapy. In her opinion, I needed an increase in medication.
Another “symptom” I suffer from is the belief that I was drugged in a bar; the hospital calls this a persecutory delusion. I consumed one alcoholic beverage in the bar, I was there for about half an hour with ten dollars in my pocket. What else could explain this phenomenon?
The Second Component – admitting to your crime – is in my case quite difficult as I was in a drug-induced blackout. I have attempted to relive the moment in my mind a thousand times, but I just cannot remember. I have even requested to have hypnotherapy performed at my own expense; the hospital refused to allow it.
The Third Component – medication compliance – I find particularly objectionable. In the past, I was under court order to take any number of powerful high doses of antipsychotics.
Antipsychotics do not agree with me. Their effects have yet to generate a positive outcome in my treatment. I respond best to therapy, therapy without the fear of reprisal. On January 31, 2010, I was rushed to the emergency room at Strong Memorial due to complications from the antipsychotics I was forced to take. My liver, pancreas, and gall bladder were affected. I was very sick; to this day my liver function is not optimal.
Essentially, they have tried to medicate a memory. These meds are very powerful: They cause diabetes, tremors, drooling, weight gain, constipation, and death. But they cannot change history.
The Fourth Component – show remorse for your victim(s) – what if you are the victim?
Finally, I find it difficult to thank an individual for giving me back what was never lost, my sanity.
None of this was ever explained to me. All they kept saying was “Six months and you’ll be home.”
Had anyone taken the time to accurately portray the road ahead, I never would have accepted the plea. The state never would have obtained a conviction at trial.
To obtain a conviction in a criminal court, the state must prove what is known as mens rea. Or criminal mind or criminal intent. They must prove that you planned the act and carried it out. I can assure you I would never plan an act as cowardly as arson in a building with people expected to be sleeping. Let alone with all of my personal property in it as well. Had I gone to trial I may have won. Had I gone to prison I would have been out in as little as four years.
After my first month at Mid-Hudson, I was asking to take back my plea. Not an easy task.
Once you walk through the door to the psychiatric system, all of the protections afforded criminal detainees go out the window. No due process, no speedy trial, no right to see or vet the evidence against you, and most importantly: NO RELEASE DATE!
There are two ways to gain transfer to a civil hospital from a forensic one. The first is your team presents you for transfer at your Hospital Forensic Committee (HFC).
The team, or treatment team as they are commonly called, consists of a psychiatrist, psychologist, social worker, treatment team leader, rehab counselors, recreation counselors, and occupational therapists.
They will meet at set intervals with clients for “Treatment Team Reviews” or anytime you get in trouble. The writing of treatment plans, family contact, and history reviews are a few of the services the team offers.
In forensics, HFCs will happen at six months, one year, and then every two years thereafter. The HFC panel is typically made up of three members (usually a psychiatrist, a psychologist, and a social worker) who work in the hospital but are not on the client’s treatment team.
They will meet prior to the interview, discuss concerns and share comments. The client is called in. He or she will know their team’s recommendation before entering. These meetings typically run 30-45 minutes and can get quite emotional. They discuss the “instant offense” (crime) and how your recovery is going, do you know your diagnosis, symptoms, triggers, early warning signs. They will discuss medications in detail. What you take, how much, the dose and why you take them, and will you take them the rest of your life. Substance abuse is discussed: You will never use again.
If the HFC panel clears you, your papers go to the clinical director of the hospital, then off to Albany and the Division of Forensic Services (DFS). They will scrutinize your record, read the HFC report, and either approve the transfer or return the package back to forensics for more information.
If DFS approves you, your package goes to the court that sent you. And the DA and the court get a shot.
If all goes well, six to nine months after you pass the HFC panel you will be transferred to a civil (non-secure) hospital.
If anyone objects, more hearings and more time. If you get in trouble (fight or serious infraction), the transfer stops.
That’s the “easy way” out. The client can challenge a continued retention. The most common way is to decline the retention and ask for a hearing before a judge. In most cases, Mental Hygiene Legal Services (MHLS) will represent the client, who can petition the court for an independent examiner who will testify at the hearing.
The goal is to establish that the client is not dangerous and can transfer safely to the civil setting. I have challenged every retention application (at least 10). I won one.
That hearing was in December of 2014. The team put me in for transfer, HFC failed me, MHLS begged me not to go (“You don’t have a chance!” the MHLS lawyer said). The judge seemed disgusted that I could spend 15 years locked up in psych centers with no violence, no meds, and no documented symptoms of Serious Mental Illness (SMI).
The judge ruled from the bench and on February 5, 2015, I was sent to the civil hospital in my “catchment area,” Buffalo Psychiatric Hospital.
Getting out of the secure forensic unit is just the start. It took me 15 years, only to get to a civil hospital. At the civil you are considered a CPL (criminal procedure law) detainee; you are not afforded the luxuries and privileges of civilly committed patients. There is a clear pecking order and CPLs are at the bottom. Each civil is different. At the one that I was sent to, Buffalo Psychiatric Center, they expect three to five years as an inpatient (I am in my fourth year), then a two-year stint in special housing (group home) before you are free to live on your own.
The civil has an HFC process that is similar to the forensic. The difference is that the civil clients are required to clear DFS and the courts as well as HFC for each major step along the way. At Buffalo, we have seven steps, three of which are major and require the additional scrutiny of DFS and the courts. They are: E3 (escorted off grounds), U3 (unescorted off grounds), and finally conditional release.
These privileges, once granted, can be revoked at any time by the team for any reason. The time from HFC to enactment is around six months; like forensics, they clear the HFC, clinical director, DFS, and the court. Any objection can trigger a hearing, adding more time.
Every patient leaving the hospital is also subject to a five-year order of conditions that can be extended another five years after that. The entire time you cannot leave the state without permission, and you must submit to drug and alcohol screening and take all prescribed medications.
Failure to comply with your order of conditions can bring you right back to the secure forensic level to start the entire process all over again. It is literally one day to life.
Every major step the courts weigh in on, and this gives the whole process a veneer of authenticity. Sadly, the process is anything but authentic. The hearings are under civil court, which does not afford the protections of the rule of law that every criminal defendant is allowed.
We cannot see all of the evidence against us, and post-conviction reversals are almost unheard of. Unlike criminal plea bargains, we are not told in advance what to expect.
Items like the phone interview with Dawn make it into the record, a doctor writes another report, cites Dawn’s statement from years earlier omitting the date and that it was never vetted for accuracy, breathing new life into a stale lie.
How can this happen? A phone interview with a social worker buries me for 20 years!
At my last retention hearing, my independent examiner noted that in almost 20 years of 24/7 observation, I have never acted in a way consistent with either Dawn’s statement or the police report of my tirade in the back of their car.
He went on to say that it would be totally unprecedented in the history of psychiatry to see a complete and total mitigation of symptoms upon entrance into a corrections facility without medications. So either I was a miracle, or Dawn and the police were inaccurate in their reports.
Reports that I couldn’t challenge.
Sadly, the clients who either plead to an insanity defense or the very few who were found “Not Responsible by Reason of Mental Disease or Defect” are held for years on end with a never-ending series of retention hearings that always seem to seek “further care in an inpatient setting.”
Today is day 7,071. I have seen three presidents take office, watched in horror as a symbol of American capitalism was reduced to rubble, seen wars waged overseas, and witnessed many wonderful people cope with illnesses that are incomprehensible in their effects on the mind, body, and spirit.
Like physical illness, mental illness ravages its victims and their loved ones. The “medical” treatment for psychiatric illness is almost as pernicious as the symptoms it proposes to treat. Antipsychotics, with their god-awful side effects, are overprescribed, electroshock therapy can seem barbaric. It wasn’t long ago that lobotomies were the norm.
The inpatient experience is painful. Mid-Hudson was physically abusive, Rochester and Buffalo psychologically abusive. All sites practice extrajudicial punishment. Usually, overly paranoid staffers collaborate to discredit astute “clients” who see and hear too much.
With very little oversight, when push comes to shove, it’s the “clients’” word versus the staff’s. Who wins? Exactly.
We all get to go to therapeutic programming, receive personal treatment plans; many receive one-on-one therapy. Much of this is to satisfy the accreditation agencies. (To keep the money flowing, Buffalo Psychiatric Center is reimbursed $1,400 per day for my care and treatment; that’s half a million dollars a year.) Therapy sessions also help to justify your continued retention.
I have had the pleasure to work with many a kind caregiver and therapist. Most in the industry are good people. On paper, we have a wonderful system. Sadly, without adequate checks and balances, effective oversight, and quality management, the system is wildly inefficient.
As a society, we take a dim view of people who willfully engage in criminal behavior. As long as the punishment fits the crime, judges can keep their bench seat, politicians can keep the money flowing by seeming “tough on crime,” and underprivileged citizens remain the grist that keeps the mill turning.
We also have a great deal of sympathy for those who are stricken by illness, both physical and mental. Add the label of criminally insane to the mix and the sympathy goes out the window.
Every night that my head hits the pillow I know I am an innocent man; I know I did nothing wrong to lose two decades of my life. The only thing I don’t know is if I will ever be allowed walk this earth a free man.
All because I accepted a “deal” to go home in six months.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.