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The balance of protecting rights of the mentally ill with safeguarding society from those who are dangerous to themselves and to others.

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00:00Today, Northampton State Hospital closed. I think my worries about it are the same as they were 15 years ago.
00:16Are the very seriously ill, whose illnesses causes them to be violent or assaultive, are they going to be adequately taken care of?
00:27Or will they just increase the population on our streets and in our jails?
00:35Tonight on Frontline...
00:37Where's your medication, Eddie?
00:38When he's off of medication, you don't want to trust him.
00:41He's on the brink now of being where I'm going to try to get him admitted back to the hospital.
00:46What's the knife there for? Don't touch it.
00:50As mental hospitals around the country are closing, what's to be done with the truly dangerous patients?
00:55Because I can't go on the street right now. I'm not safe enough to go on the street.
00:59Because I'll kill somebody. I will.
01:02Tonight on Frontline, a place for madness.
01:12Funding for Frontline is provided by the Corporation for Public Broadcasting.
01:16And by annual financial support from viewers like you.
01:25This is Frontline.
01:27Frontline is provided by the Corporation for Public Broadcasting.
01:31Frontline is provided by the Corporation for Public Broadcasting.
01:35The Corporation for Public Broadcasting.
01:39The Corporation for Public Broadcasting.
01:39The Corporation for Public Broadcasting.
01:40Good morning, Joe.
01:41Hi. Hello.
01:44How are you doing?
01:44Who's there? Friend or foe?
01:45What's up?
01:50welcome to the boudoir the vivouac nice huh peaceful it's amazing what a stand of sumacs
02:00and a cadillac will make a bedroom there was just a carmorant over there in the water that took off
02:05i've been on a beautiful nature walk this morning i picked the elderberries there
02:10here's the the elderberries you'll like elderberry wine this is a wild cucumber
02:16i got some breakfast money
02:22and i was raised on this very river this is the sandbar i landed on
02:31i'd come here even though this says no trespassing
02:34as long as you're not hurting anybody you should be allowed to be as eccentric as you want to be
02:44you know you shouldn't be put away for it
02:47as people who've come to my aid in the streets when i've been being harassed they they've said
02:52why don't you just let the man live nice he has a right to live to breathe to walk the sidewalks
02:57of this land of america but we don't have much we don't have much tolerance in our society especially
03:02in northampton there's a lot of judgmentalness here this was the let this is the last bastion
03:05of puritanism northampton is the only place in the world where the largest woman's college in the
03:14world is separated by a chain link fence full of holes from a mental hospital and quite a few other
03:20people cross over that boundary that border of the two cultures here that are coexisting side by
03:25side which gives this place the life and the colorfulness when you have all these cultures
03:29that have to coexist on the sidewalks of northampton
03:32i'd like to become a narrator for six whites of henry the eighth
03:38for the past 135 years northampton had the only state psychiatric hospital in all of western
03:47massachusetts there has always been a heightened tolerance here for the deinstitutionalized mentally
03:52ill hey how are you fred right hey fred do you have any id with you police detective tommy o'connor
04:02grew up seeing and talking to x-mental hospital patients along main street have you ever been
04:08in a hospital we're in the northam state hospital yeah yeah here off and on there off and on there
04:14you know yeah about 14 times observation you were in 14 different times how old are you now i'm 52
04:19years old 52 52 yeah that's not bad huh no no no you're feeling healthy yeah i'm feeling healthy
04:25yeah yeah yeah mrs shaw's motel is a refuge for ex northampton state hospital patients who want to go
04:32it on their own well i recall that i must have went through a thousand patients in this place we had
04:41roger roger roger had a problem with eating he was he would eat and drink so much that he would blow
04:48then we had a fellow by the name of mr bradford wonderful fellow and he would go around and cut
04:54all my fir trees down he hated fir trees and then we had peter peter would always screech all night
05:02today i'm so blue sad and brokenhearted and it's all because of you
05:11most of these people i've had here where we're hospital bound
05:15eventually you break them in learn them how to help them to get dressed go shopping cook show them
05:23how to cook and then they have to take the medication you have to keep stressing but i can't give them
05:28the medication i'm not qualified but they have to take it themselves but you remind them that they
05:32have to take it once they say they don't need the medication it doesn't help them then you have
05:38somebody's got to step in and stop it because they go beyond reason and then you can't handle
05:42them all right please point of your honor first matter that i will call your honor is a 209a
05:49restraining order 9345 ro241 aurora mosier and jane mosier and the defendant is david l mosier and
05:58he's your son and is his address it indicates here the streets of northampton
06:05in massachusetts when untreated mental illness results in violence the courts are the last line
06:11of defense for the victims like texan jane mosier and also for the civil rights of the mentally ill
06:17like their son david
06:19it's a very complex issue around the civil rights of the individual and the need to protect society
06:28from people who are acting in dangerous ways but there's been such a bad history in terms of locking
06:34people up against their will warehousing people that i think we have to be very cautious on the one
06:42hand about how much we impose upon people and on the other hand we also have to be protecting our
06:49community
06:4942 years ago when mary pelis first drove into northampton state hospital
06:56there were 2 300 patients locked inside as i came around this corner and saw this huge building
07:06that looked like a fortress because it had all these bars on the windows i became totally petrified
07:14and thought to myself what am i doing here i could hear patients yelling screaming and the closer i got to
07:24the building the more petrified i got but i did have an appointment to meet with the director
07:30of nurses so i had to keep it after several minutes i finally shut my motor off in my car
07:38and decided i'd go in and there i stayed 34 years
07:44shortly after i came here i realized that this wasn't the northampton state hospital but this was the
07:57northampton state warehouse
07:59the northampton state hospital but this was the northampton state hospital but this was the northampton state hospital
08:06they just stayed here they were in locked wards
08:08and it was very distressful
08:11to think that these young patients many of them who were very young when they came
08:17and now we're old and we're still here
08:19many of the patients expressed that to me
08:22say when am i going to get out of here i've been here 40 years i've been here 25 years
08:27and there was no purpose in their life
08:29i can think of the girl that was brought to the convent at the age of 14 and when she was 18 years old she left the convent so
08:38she was brought to the state hospital her family brought her here and there she stayed until i released her
08:43she was way in her 80s at the time she left
08:46we had a problem we had one out of every 300 americans was confined in some kind of mental institution in the united states
08:58and and the conditions were deplorable
09:01uh... it it was worse than than anyone could possibly imagine
09:06hundreds of patients crammed into rooms uh... that were made for twenty uh...
09:13people living in the most despicable imaginable conditions and these were called hospitals so so this was really an outrage
09:22something had to be done about it
09:26steven schwartz one of professor stone's star students did do something about it
09:31in 1973 as a young attorney schwartz was taken to northampton state hospital to see if he would represent patients there
09:39the visit had profound impact
09:42i saw a few people who seemed to be an incredible personal pain
09:46in 1976 i came to a conclusion that what really had to happen
09:51was to have as many people as possible leave that hospital
09:54and live outside of the walls of an institution
09:57where they make choices
09:59most of all where they could be visible
10:01the largest and most heinest crime was that we had made people invisible
10:05and i said to myself i am not leaving until other people do
10:09and i'm still there although there are now
10:12only uh... approximately twenty five people left at the northampton state hospital today
10:16and within a month or two
10:18uh... there'll be nobody left
10:20and so maybe maybe in a couple months from now
10:22um... my commitment will be fulfilled
10:27in 1978 steven schwartz's passion resulted in the most comprehensive victory for hospitalized mental patients in the history of the united states
10:36known as the northampton consent decree
10:39it ordered that all but fifty of three hundred eighty remaining patients must be released to the least restrictive community setting within three years
10:48suddenly the town of northampton became a national laboratory for accelerated deinstitutionalization
10:55glory be to thine and to the sun and to the holy ghost
11:10as it was in the beginning
11:15initially reverend tax moser and his wife jane were enthusiastic supporters of the northampton consent decree
11:22fifteen years ago we we shared the point of view
11:27the deinstitutionalization was one of the best things to come along
11:31these wonderful goals and unfortunately
11:34uh... the events of the last few years including our own personal experience have indicated there's a whole segment
11:39they're very seriously mentally ill
11:42they do not fit into that scenario
11:44while it may not be the last time that i shall preach from a pulpit
11:49it may be the last time that i shall speak as a pastor of a church
11:55i hope you will understand if i have
11:58a lot of deep-seated feelings and emotions this morning
12:02ten years ago the reverend tax and jane moser became deeply worried by the increasingly bizarre and threatening behavior of their eldest son david
12:11a gifted artist by then thirty
12:14and
12:15even looking back over the five plus years that i've been among you
12:19it seems as if that's gone by so very very quickly
12:24because david of course is part of the minister's family where religion has always been an important part of our lives
12:30and still is part of david's life
12:33it is understandable that when he became mentally ill
12:38uh... some of the expression of that illness would be in religious terms
12:42nice to see you
12:45see you
12:46hey
12:47do i get one
12:49when jane and i went to israel in 1983 we invited david to go along
12:55one of the reasons we did that was because we were aware of the fact that he was having difficulty
13:02every place we visited seemed to have unusual importance to him
13:07as if he were the chief actor in the drama of visiting these places
13:14and as we came to the river jordan where traditionally jesus was baptized
13:20he began to be more and more agitated as we were nearing the place
13:24wondering who would baptize him
13:27one of our party took a picture of that baptism
13:32and we still have that picture
13:35it's uh...
13:36whenever i see it it's chilling to me because of the
13:41angelic almost beatific expression on his face
13:46to me it said he was identifying himself with the figure of christ
13:55meanwhile in northampton
13:57the tension between patients civil rights and the community's need to protect itself
14:01was being dramatically played out along main street
14:07although the consent decree had constructed a well-funded system of community services for discharged patients
14:14the town was initially overwhelmed
14:18i used to describe my job as the chair of the mayor's task force on deinstitutionalization as a referee
14:24that was my professional role because people got so worked up
14:29if there was an incident on the streets involving someone who'd come out of the state hospital
14:34then the police would say why did you release that person
14:37and the mayor would say you're endangering my citizens
14:40why is this person on the street
14:42and then the lawyer for the civil rights of the patient would say
14:47they have the absolute right to be on the street
14:49and uh... you would have all these perspectives that everybody would just be outraged at each other
14:55and then it happened
14:57on a winter sunday morning in 1982
15:00a state hospital patient with a long history of arson set fire to a building on main street
15:05killing a mother and daughter who were sleeping inside
15:08even though the patient was in town because of a hospital day pass not the consent decree
15:13the distinction was lost on the community
15:16to the outraged people of northampton
15:19patients rights had overwhelmed common sense
15:22there were a large number of people in town
15:26who just said there's something going on
15:28i don't understand it
15:30someone walked away from that place and he lit a fire and hurt somebody
15:33we need to take a different tact
15:34and so there was enormous pressure on the mayor
15:37but he said rather than yell at each other about what's wrong
15:40let's try to all come together and find a solution
15:43and let's not let the solution
15:45get bogged down in arguments about
15:47do people have rights to leave or do people have rights to stay
15:50are too many people leaving or too many people staying
15:53instead of engaging in that sort of debate
15:55he said to the whole group
15:58what is it going to take to have our community safe
16:00i think that's pbs
16:08you know that educational 57
16:10did you ever watch the moody blues on 57 before
16:13yeah great huh that guy he strums right
16:16and orchestrally comes around and echoes back
16:19it sounds like thunder but it's
16:21after the fire and the anguish
16:23community services gradually became more effective
16:26for ex-hospital patients who chose to accept them
16:28not too many years ago Jim Tedonio
16:32who suffers from manic depressive illness
16:34might have been trapped on a back ward at Northampton State
16:37you know something you know I can't stand
16:39is when you give somebody a handshake and they're like this
16:41a wet noodle
16:44oh yeah dude
16:46I'll see ya
16:48alright
16:49how did it go this morning
16:51I'm doing pretty good
16:53yeah
16:54I still got the crazy thoughts I always get you know
16:57but they're controllable because of the medication
17:00yeah
17:02okay for example you know since I worked in a shoe factory right
17:06I didn't know you worked in a shoe factory
17:08I worked in a shoe factory for two years it ruined my knuckles
17:10I ruined my knuckles because they kept scraping against the thing
17:12every week Jim Tedonio goes to the Starpoint Club
17:16a state funded private club for the mentally ill
17:19and meets with its director Michael Tillier
17:22your landlord has said that you need to leave
17:27yeah
17:29so can you meet one of those Lexus cars
17:31one of those occupancy type buildings
17:34on the archway building
17:35the situation is Jim I've just called Social Security
17:39and you are you're at the top level of your benefits now
17:43so you wouldn't be getting any more than 568 a month
17:46now the Valley Inn is a
17:48it's a nice area of town
17:51you have your own room
17:53there is a shared kitchen
17:55you know something I was a really excellent guitarist
17:57my drummer used to keep on saying
17:59can I play in front of you
18:01Jim are you okay you're tired
18:02I ran all the way to practice
18:04and I wasn't mentally ill at all
18:05what happened
18:07because I got a quarter stuck in my eyeball or something
18:10way back there or something
18:12well you keep talking about you know
18:14this mental illness business
18:16have I ever showed you like really mental illness
18:18I haven't have I
18:20you have been under stress sometimes Jim
18:24you can tell?
18:26well you've told me
18:28yeah but I'm talking about have you ever seen me act
18:30behavior less than normal
18:31what's normal
18:34David came home to live with us
18:37in the fall of 84
18:39because we were all worried about him
18:42he did at that point he was living in a car
18:46the minute he arrived
18:49he picked up a sledgehammer
18:51and started to take apart the back steps of our house
18:55at all times he carried a large machete
18:59at his belt
19:02sometimes he used it to chop down things in our yard
19:07chop down things that we didn't want chopped down very often
19:12and yet there was such a threatening mood about him
19:16that we were reluctant to argue with him about these things
19:21he carried the machete day and night
19:23we were beginning to feel like we were prisoners in our own home
19:33sir you're Leroy Moser
19:35ma'am you're Jane Moser
19:36and then finally
19:39he
19:41threatened my husband
19:43said he would castrate him
19:47castrate him because that was the message in the Old Testament
19:50that he must do this
19:52and it was at that point we called the doctor
19:55we called the police
19:56are you requesting a continuation of this restraining order here
19:59yes we are
20:00we'll prepare a new order and I'll sign a new order at the Senate for a year
20:03thank you very much
20:05thank you
20:07when David was hospitalized in 1984
20:10I think in our naive state
20:12we thought he's in a hospital
20:15now they'll treat him
20:17to our surprise
20:19and frustration under the law
20:22being in a mental hospital
20:24does not guarantee treatment
20:26many mentally ill people
20:29very ill people such as David
20:31think nothing is the matter with them
20:33they're not ill
20:35it's the rest of the world
20:37something else is wrong
20:39in December of 1984
20:40probate court ordered David Moser committed for involuntary treatment of manic depressive illness with psychosis
20:47the judge wrote without treatment Mr. Moser's psychotic condition will worsen and he will become increasingly assaultive
20:54but although the hospital agreed with the diagnosis they accepted David's arguments for release without medication because his resistance was so well organized and so cordial that it did not make sense to force treatment
21:07The whole point of treatment by psychiatry and through the modern medications is to give back to the person who is mentally ill the capacity the ability to make free responsible choices of which they have been robbed by their mental illness
21:25it's a it's a it's a it's a myth to assume
21:32that the person who is mentally ill has this wonderful free capacity to make choices they don't they've lost it
21:40I think that there is a tendency that it's quite dangerous
21:45to say if we will allow older people to die under certain conditions we will allow people who have terminal illness to die under certain conditions we will allow someone who even happens to have a heart attack or a certain medical condition to say I'd rather not get better
21:57but as soon as the person has a mental illness then we decide to intervene in a completely different way we decide to treat them differently and to me the fundamental way to answer all of these questions about who should do what under what conditions is not so much a complicated analysis of government authority and personal choice but it's about a principle of equality
22:18I believe that until and unless we treat people with mental illness in basically the same way we would treat our brothers whether they have mental illness or not we're going to set up construct a set of rules and a set of interventions that are dangerous and that I directly oppose
22:35I like my life very much sometimes I'm walking down the street I feel like clicking my heels if I had boots on you know just jump up in the air and come back down you know sometimes I feel that good you know what
22:56three times a week a nurse brings Jim medications for his manic depressive illness
23:01community supportive services have helped keep him out of the hospital for most of the past five years
23:08I walked up to here just to get exercise finally I looked and said there's a guy that's into antennas and I said I wonder if he's a ham
23:17I said my name is Jim Tedonio my father used to have ham radio and let me talk to Germany when I was a little kid
23:24hello
23:31I thought you were improving
23:32I'm plumping
23:33no I thought you were getting skinny
23:34I'm like one of those hot dogs that plumps when you cook them
23:36hey have your cigarette and then and then come sit down and have a drink
23:39oh you get some get some salsa
23:41I don't I don't have any cream soda that's your favorite
23:43I know but I know do you have any raspberry lime
23:45no I have any root beer
23:47root beer
23:48root beer okay
23:49he really is a top notch guy but one time he said if you don't shave you look like a bum right so I stopped going up here
23:57have you ever forgiven me for calling you uh
24:01I wouldn't I
24:02of course I did
24:03okay
24:04cause I'm a Christian
24:05you know why I called you a bum
24:06do you remember
24:07no I don't
24:08I didn't shave
24:09I said you looked like one
24:11you're not one but you look towards one
24:13but you know that I can shape up
24:15I know you can
24:16if you be my trainer
24:17listen if I didn't care about you why the hell would I say that
24:20why would I say
24:22um
24:23but they could they could have been lighter words though
24:25well I did I was using kind of shock treatment because I wanted you to
24:29the vast majority of people who were released from the state hospital were not causing any problems
24:35and indeed were valuable contributors to the community
24:39but the small number of people who were creating incidents were also creating a real stigma for the whole system
24:48we always thought that the way this worked was you release patients from the state hospital
24:54and the state set up these fancy expensive programs and when you got the person into the program
24:59they're the ones who would successfully stay out of the state hospital
25:02what we found over time was that there were places like Mrs. Shaw's rooming homes
25:08that people went both who were in treatment and people who had decided to bolt from the treatment system
25:16and that there were the Mrs. Shaw's of the world who took care of these people
25:20who knew when they were on medication and when they were off medication
25:23and it became clear to us that we better have a partnership with Mrs. Shaw
25:27When you go by, this is the other door right here, when you go by
25:30when you go by
25:32when you go by
25:33just slowly go by
25:34right here
25:36it's a pathetic sight but what can you do
25:45when he's off medication you don't want to trust him
25:49you don't want to turn your back on him
25:52and he's on the brink now of being where I'm going to try to get him admitted back to the hospital
25:58but he won't go in himself in the losses
26:00he has to show up at the hospital himself to be taken
26:03otherwise I have to call the police and have him taken in bodily
26:07and I'm afraid that he gets violent
26:09and he might hurt one of these police officers
26:11because I've seen him hurt another police officer
26:14Officer Nichols quite a while ago
26:16and I'm afraid he might do the same thing again
26:19he changes, his mood changes
26:23When the police stopped by Shaw's motel
26:25Mrs. Shaw took the opportunity to tell Detective O'Connor about the crisis with Eddie
26:32Now that's the same guy who
26:34Hit Nichols
26:35Officer Nichols
26:36He took a leg of a chair and split open the officer's head, right?
26:39Yeah, yeah
26:40So he's not acting
26:42Well, right now he's acting very weird because he hasn't been taking his medication
26:46and I keep telling the boys don't go near him and don't turn your back on him
26:50because you don't know he's a...
26:51Yeah
26:52He's done it before, right?
26:53Yeah, he's done it before, you just have to do it again
26:55Hi, Mrs. Eddie?
27:00Hi, Mrs. Eddie?
27:03Civil Libertarians have long thought that no one should be punished for their status
27:10Mental illness is a status
27:14So, the status of being seriously mentally ill shouldn't be punished
27:19Hey, Andrew
27:21How are you?
27:22Hey, how you doing?
27:23How are you?
27:24How are you doing?
27:25How are you doing?
27:26Good
27:27Hey, uh, Mrs. Shaw is a little concerned about you
27:29Yeah
27:30But she feels maybe you're not taking your meds or something
27:33What kind of meds are you taking now then?
27:38Navrin
27:39What is it?
27:40Navrin
27:41Navrin
27:42Navrin
27:43In a lawyer's mind, this goes all the way back to John Stuart Mill
27:48We only interfere with a citizen when they cause a danger to someone else
27:54or a harm to someone else
27:56and we'll make a big addition to prove our hearts in the right place
28:00If you're dangerous to yourself, we'll let the state interfere too
28:05What's the knife there for?
28:08What?
28:09Don't, don't, don't touch it, okay?
28:10What's this kind of steak? I'm not hurting nobody
28:12Okay, alright, well where's your steak?
28:13Why don't I hold the knife while we talk to you?
28:14No, no, I'm not hurting nobody
28:15You just want to hold it, okay?
28:17Where's the steak you're cooking?
28:19Ah, put it in the garbage, it's cold caps, will you?
28:22There's no prime a minute, Shaw
28:24No, no, there's no, no, Mrs. Shaw is concerned about you
28:27No, no, I love your people
28:29Yeah, I met you
28:30God bless you
28:31How you doing?
28:32How you doing?
28:33We met that
28:34Oh, those are just me
28:36Friday, actually
28:37We met the other night down by Cathy's Diner
28:40Oh, you're the kid
28:41Oh, I love you
28:42God bless you
28:43Same to you
28:44I believe that when a person is violent or is likely to hurt somebody
28:50That compulsory treatment to prevent violence, even if it's just confinement, is an appropriate intervention
28:59But what you're asking is, should we have a rule?
29:01Should we have a rule that says that if a person has some chance of being violent in the future, let's intervene early and hope that we can successfully stop that violence
29:11And I'm telling you that if there's not a good chance that you're going to succeed, then I don't think you have a right to do that to people
29:17Because then I think you are saying that people with mental illness should be singled out above and beyond all other people in our society for preventive detention, for early intervention
29:27Where's your medication, Eddie?
29:29Well, it's having me out here
29:31You got me out two weeks ahead of time when you run out
29:33Did you run out?
29:34Well, it's on its way
29:35It's on its way out?
29:36Yeah
29:37When did you run out, though?
29:38About a week ago
29:39It's on its way
29:40It's on its way
29:41So you haven't had any meds for a week?
29:42No
29:43And you're supposed to take them every night?
29:44Well, I didn't take them, but see the doctor says, if you're not crazy, you know
29:47Yeah
29:48And you know it, you know one, the three is two, one, two, three is what, three?
29:52Well, one, two, three is three
29:54That's logical, isn't it?
29:55That's what the doctor told you?
29:56Yeah
29:57To the public, it appears that an individual has to be very seriously impaired before they require hospitalization
30:06But that's not true
30:07That's not the case
30:09If you wait until the individual becomes very seriously ill, you may have missed your opportunity to treat them in the earlier stages of their illness
30:17Where it's more treatable
30:19You wait until the person is totally out of control before you can treat them
30:26And it's like waiting for treatment of diabetes until the person is in coma before you treat them
30:33To the relief of the police, a psychiatric crisis team agreed that Eddie was a present danger
30:40They issued the police an emergency order for temporary hospital confinement and evaluation
30:45We have a pink paper, and you need to come with us, okay, we need you to come with us, that the doctor thinks that you should go up there and get a little bit of treatment, maybe some medication
30:56But the law serves, I'm not big at all, I'm not crazy, you've got to get a warrant
31:03The pink paper is like a warrant, okay?
31:05Well, you've got to bring it
31:06What do we have?
31:07Don't you love me?
31:08We do
31:09We do
31:10God bless you, right?
31:11Get my coke, please
31:12I'll grab that
31:13Can I have my property?
31:14Yeah, I'll get your coke
31:15Good job, Eddie
31:16Just stay calm, go up to the hospital, have them talk to you up there, and then you'll be home, okay?
31:23Just want to make sure everything's cool with you
31:27In the state of Massachusetts, a person who is mentally ill has the right to refuse treatment
31:35And a judge must make that decision whether the person will be treated against his or her will
31:43In David's case, David, as I've said before, is articulate, he's bright, he knows the law, he's not retarded
31:55He's extremely intelligent
31:58When rested, as he has been, if he's been in a jail or a hospital for a few days, he calms down a bit
32:09He presents, for a limited period of time, presents himself as a calm, collected, rational person
32:19And because the law is so written, the person must present some dangerousness
32:25A present dangerousness, not yesterday's dangerousness or tomorrow's dangerousness
32:31But today in this hour's dangerousness
32:34Judges find that difficult to order a medication against one's will
32:45We had only seen David a couple times from 85 to 88
32:51He had come in front of our house, shouting, shouting, in the middle of the night
32:58Jane and I had gone to bed about 11.30
33:05And about midnight, she thought she heard a noise downstairs
33:10And I listened and I didn't hear anything
33:12And we both then dozed off to sleep
33:15But within a few minutes, we heard steps across our lower hall and coming up our stairs
33:21And my husband jumped out of bed, turned on the hall light, and it was David
33:31He immediately attacked me, pushed me back into the bedroom
33:37And began pummeling me about the face and about the shoulders and on the left side particularly
33:44Oh, I think he struck me probably 20 or 30 times
33:48And part of that time I was on the floor
33:51When Jane tried to get to the telephone, he took the telephone and threw it at her
33:55And then he began to assault me
33:59Which he had never done before
34:03My wife and I were living on the third floor of this house, my parents' house
34:10When I woke up to a screaming sound that I didn't even recognize as my mother's voice
34:18It was so ghastly
34:20My wife was trying to call 911
34:23She was on the floor, I mean, her knees had given out literally from fear
34:29I went down and at that point, my father was in the hallway
34:36He was naked from the waist down
34:39And David was just pummeling him
34:42I had him up against the wall
34:44And, you know, I've never hit David in my life
34:48I mean, I suppose I should have just gone up and hit him over the head
34:51You know, while his back was to me
34:53But I just started screaming out his name, you know
34:55So he would just get away from my father
34:58And he turned around
35:02And, you know, I'll never forget the look on his face
35:05I mean, it was almost as if he was as scared as I was
35:08I mean, here he was in this fit of rage
35:11And assaulting everyone in sight
35:15And yet, the look of fear in his eyes
35:19And it was odd, it was like he almost
35:24In a matter of a couple seconds
35:26It was like he was going to start a conversation with me
35:29And then immediately took a swing at me
35:31And he missed
35:32And that's when I started hitting
35:33I just hit him over the head
35:34Probably a dozen times
35:36And the only way I could restrain him
35:39Is I just grabbed his hair
35:41And I told my father to do the same thing
35:43So like four fists pulling his hair down to the floor
35:46He just couldn't do any more
35:49Out in the hall
35:52Where the police finally found him
35:54Hangs a painting
35:55David painted for his dad
35:57Many Christmases ago
35:59A painting of Christ in hell
36:02And under that painting
36:04Where David was finally subdued
36:06Our youngest son
36:07In response to
36:09The shouting David was doing at him
36:13Said, go to hell
36:14And David replied
36:16I'm already in hell
36:19I think
36:24That sums up better than any words of mine
36:26His suffering
36:28Which is really
36:31Our greatest suffering
36:34This is David Moser in prison
36:36His belief that he was not mentally ill
36:38And his refusal to plead insanity
36:40For the assault on his parents
36:42Helped to send him to prison for four years
36:44Instead of to the hospital for treatment
36:47Upon his release in December 1992
36:49He was sent to Taunton State Hospital
36:51Where there was an extensive hearing
36:53To determine if he should be committed
36:55The judge ordered David shackled
36:57But allowed him to act as his own co-counsel
37:00So we saw David
37:02Sitting in handcuffs
37:04At the lawyer's table
37:07Cross-examining witnesses
37:12I kept saying it was like Alice in Wonderland
37:16We began to wonder
37:18Where we were
37:19And what was going on
37:21Dr. John Gilmour was the hospital's forensic psychiatrist
37:26Who thought David was mentally ill and dangerous
37:29But David had not allowed Dr. Gilmour to examine him
37:33Explaining in a note he had to be immediately released
37:36To make a report to the FBI
37:39You said that in regards to people reporting things
37:42To the Federal Bureau of Investigation
37:44That your response was
37:46Well, that's all part of the larger picture
37:48Do you recall making that statement here today?
37:52Mr. Moser, the larger picture here
37:54Is that in September of 1988
37:56You broke into your parents' home
37:58And seriously beat your father
38:00And injured your mother
38:02And apparently also injured a police officer
38:05What does that have to do with the Federal Bureau of Investigation?
38:09Mr. Moser, your belief in 1988
38:12That there was serious wrong done against you
38:14Which prompted you to attack your parents
38:15Are now the same beliefs prompting you to seek redress
38:19Through the Bureau of Investigation
38:21Incredible conclusion, sir
38:24Where did you find it?
38:26I know I've only spoken to you for no more than five seconds
38:29Is it written down somewhere that the court can't see it?
38:32Just curious
38:34Judge Joseph Reardon told Frontline
38:37That he was impressed by David's intelligence
38:39Even though Dr. Gilmour had reviewed David's extensive history
38:42Because he had not examined him
38:45The judge was not persuaded by the doctor's testimony
38:48That David was likely to be dangerous
38:50The judge said he was also impressed that David had not been violent in prison
38:55And that David saw his attack on his parents as a punishable act of civil disobedience
39:00Most of David's past medical and police records were not placed into evidence
39:04Although the judge concluded that David was mentally ill
39:10The judge found, there is not clear and convincing evidence that the respondent, if discharged, would create a likelihood of serious harm
39:19Either to his parents, or to himself, or to members of the public by reason of his mental illness
39:24And so he was released not only from the handcuffs, but from the hospital with no treatment
39:33And he's gone
39:36Dear Reverend and Mrs. Moser
39:40Since David has been released against my professional judgment
39:43It is my duty to encourage you to take reasonable precautions to protect yourself
39:48The Northampton Police Department may be able to assist you
39:52I have written them about the potential harm to you
39:55The decision of Judge Reardon is truly a regrettable one
39:59I sincerely hope that your son will not be harmed in the community
40:03And that he will not seriously harm anyone else
40:06He obviously requires intensive hospital care and treatment with antipsychotic medications
40:10Unfortunately, David will now have to be re-arrested before further psychiatric intervention can be undertaken
40:18John Gilmore, forensic psychologist
40:21Certainly, David Moser, at many times, was able to convince different people that he either didn't need, didn't want, and certainly didn't deserve to be forced to take the treatment
40:35He convinced judges of that
40:37He's convinced all the decision makers that we in Massachusetts have empowered to resolve disputes
40:42And while I'm highly sympathetic to the difficulties that the Mosers have experienced
40:49I think, fundamentally, we have to also agree that because these issues are complex
40:54Because people can have different views
40:56Because there are going to be disagreements about whether a person has a condition, whether they don't
41:00Whether a treatment will work, whether it won't
41:03Whether a person's capable of deciding for themselves, whether they're not
41:06We have to trust somebody to decide
41:08And if they decide consistently in the same direction
41:12And we have one judge after another, or one doctor after another, or one family member after another deciding
41:17The fact that the decisions aren't always right is a risk that we have to bear
41:21Dangerousness is one of the real interesting dilemmas
41:25Of course, and that's part of this whole issue of releasing patients into the community
41:31Studies would say that people who were released from the state hospital are not more dangerous than the population at large
41:38But it was our experience that people being admitted to the state hospital often were admitted after an incident
41:45That had, at least from the outside, a very violent-looking sense
41:50There was an explosion at home, the next thing you know, the police arrive, the person is hauled off to the state hospital
41:56So the community's perception was that, indeed, dangerousness and mental illness had a link
42:03The mental health system would say, a very small percentage of the people we release are going to be dangerous
42:10And then the community would say, great, just keep the ones in who are dangerous and release the rest
42:17And then the mental health system, meekly, would have to admit that they couldn't very easily predict who was going to be dangerous and who was not
42:29This is the only active ward at Northampton State Hospital
42:32Roger is one of the last 23 patients, and he has just been told that the hospital is about to close
42:45I've had quite a few changes in my life, and closing the hospital is pretty rough
42:51I wanted to settle down here for a while, because I can't go on the street right now
42:54I'm not safe enough to go on the street, because I'll kill somebody
42:59I will, I'll kill somebody
43:01I have no problems with that at all
43:03We're working on getting me better, so I'll be moving to another hospital
43:09Roger, do you think it's possible to commit a crime because of an illness?
43:16Okay, I'll give you an example
43:19I hear voices, and the voices get louder and louder and louder in my head
43:24And the voices of Satan tell me to kill somebody
43:27And I went off and I took a knife and I was about to do the person in
43:31But the person wasn't home
43:33The person wasn't home
43:35And I turned around and I burned everything that I saw in sight, burned it all down
43:40That's the night when I, that I committed my arson
43:43I was hearing voices in my head, and I had to, I had to release it
43:47Had to release it
43:49And that's when a person becomes suicidal and very, very dangerous
43:53Because he's trying to get rid of these voices, and you just can't do it without the help of medication
44:02I have no doubt that most of the people who do terrible things
44:06Which shock us, have some mental illness
44:12The question is, is it sufficient, is it severe enough, in the minds of a court
44:20So that a jury can say, this person is not criminally responsible
44:26Now that's the moral problem, but I don't think it is the real problem
44:31The real problem today is that, what happens to a person after they're found not guilty by a reason of insanity
44:42How do they keep them in the hospital? That's the problem
44:46Court, rest please
44:50This commitment hearing in Dedham, Massachusetts, is about that practical problem
44:55For the past ten years, Judge Maurice Richardson has been closely monitoring the progress of a man who murdered
45:11And who was found not guilty by reason of insanity
45:14After 21 years of treatment and confinement, John Pavone wants out
45:19Under the statutory standard, it's the burden of the district attorney to prove that the petitioner is mentally ill
45:29And that if he were discharged, there would be a likelihood of serious harm
45:35Physical harm to another person, as evidenced by violent or homicidal behavior
45:40In June of 1972, John Pavone, a Vietnam veteran, took a .22 caliber rifle, drove onto Route 2 outside of Boston, and shot two motorists, killing one of them
45:55He was captured, and immediately diagnosed as a chronic, paranoid schizophrenic
45:59When I first came home from Nam, when I thought, at the dawn over in Sicily, I could see through my eyes, like I had a camera in my eyes
46:07And he could give me the orders on who to shoot
46:11The voices told me to buy a weapon, so I bought a gun off a friend of mine
46:16And I was coming down the highway, and I was getting command hallucinations
46:21Telling me to kill the guy that's driving in the car in front of me
46:25So I pulled up beside him, I shot at him once, I missed him, I went through the windshield
46:30I shot again, and it killed him instantly, I shot him in the back of the head
46:34The bullet went through the back of his brain, and out his throat, killed him instantly
46:39Dr. Greenleaf, can you describe anything that's significant in terms of an increase in privileges
46:46Or any problem that required privileges to be taken away that you can recollect?
46:51Well, for the record, I want to point out that I have the record here for the last ten years
46:58And it includes quarterly review of privileges by me with the attorneys in interest
47:06And I'm much more interested in getting to the doctor's own opinion with respect to the dangerousness of committing them
47:12I got a difficult question, when you get out in the community, there can be some hard times
47:19There can be some people who just treat you badly, for no reason at all
47:23Right
47:24And having nothing to do with a mental illness, do you feel confident about holding yourself in check?
47:29Oh yes, I can do that, I can walk away from trouble, but if someone wants to hurt me or a loved one
47:36I will defend myself or my family
47:40And if they want to get violent, I know how to fight a little bit, I'll get violent too
47:46To protect myself or a loved one
47:48But they have to make the first move, I'm not going to swing on nobody
47:51Doctor, if Mr Pavone failed to participate in his treatment, or failed to take his medications
48:00He has been asked whether he has an opinion as to whether Mr Pavone is likely to engage in the conduct that she's asking him to assume will happen
48:10John is, thankfully, one of those patients who knows that he needs medication
48:15But it's not just an intellectual knowledge, he does not like the way he feels when he starts to lose control
48:23It makes him very uncomfortable, and John has a history that goes back two decades
48:29Whenever he feels that way of asking for more medication
48:34Once the court is not presented with enough evidence to order recommitment
48:38By this very heavy standard of beyond a reasonable doubt, then the obligation is to discharge the patient
48:46What I'd like to have is the middle ground that is referred to as conditional release
48:51With people who have been found not guilty by reason of insanity
48:55To be able to go back to the community on a trial basis, you might call it mental health probation
49:02And prove that they are able to continue on their medication and on their treatment plan
49:08And then when the person has proven himself or herself in that regard
49:12Then you can permanently release them to the community
49:15Because the district attorney presented no evidence that John Pavone was likely to discontinue medications and become dangerous
49:23Judge Richardson released him
49:26With the medications, I'm a good Christian gentleman
49:32When I'm off medication, I'm an animal
49:34I get suicidal, homicidal
49:36And I turn into an animal where
49:39If the meds didn't work with me, I'd be in a rubber room for the rest of my life
49:48This is Haskell, the last building still open at Northampton State Hospital
49:53On August 24th, 1993, the Department of Mental Health began the transfer of the last 17 patients to a city hospital in Springfield, Massachusetts
50:08From a peak of 2,500 patients in 1955, the census of Northampton State is about to be zero
50:17Fifteen years after its signing, the vision of the Northampton consent decree is nearly fulfilled
50:34When you're in the hospital, just the idea that the doorknob doesn't turn when you want to leave means it's definitely not your house
50:43Your home, your dreams start to fade of you ever getting out
50:48When I was really ill, I felt like I had three football helmets on and the world was flat
50:54So I banged my head to the ground
50:57And suddenly, I felt like a bumblebee
51:00What do you call it now? A bumblebee's haven?
51:02What do you call that? A bumblebee's haven
51:04A hive, right
51:06You know how it ripples like that?
51:08My head felt like that
51:09And you know something?
51:10I put my head down on the desk
51:12And when I woke up
51:14I was new, brand new, fresh out, everything
51:18I was bright again
51:20I knew how to sharpen myself like scissors
51:22I did everything
51:23And I was out of there in about two days
51:39Today, Northampton State Hospital closed
51:44I think my worries about it are the same as they were 15 years ago
51:49But now, I have a personal stake in this
51:53And a personal concern
51:55Are the very seriously ill
51:58Whose illnesses causes them to be violent or assaultive
52:02Are they going to be adequately taken care of?
52:04Or will they just increase the population on our streets and in our jails?
52:10And that's a question that remains to be answered
52:14Can you catch them?
52:16See whether you can catch them
52:18Why don't you bring one over to me?
52:20Can you do that?
52:25My parents are in a situation where they're damned if they do
52:29And they're damned if they don't
52:31If they try to get David help
52:34There's suddenly a whole group of people who say
52:35Well, how dare you infringe upon his personal civil liberties?
52:39And then, if they say
52:40Okay, leave him alone
52:42But why aren't those Mosers doing anything about their son David?
52:46It's kind of like, you know
52:48Night of the living dead or something
52:50He's out there
52:52You know, he's not a part of our family anymore
52:54Not a part of our reality
52:56But he's alive
52:58He's just wandering around out there
53:00There, you got one
53:03Oh
53:06That's not what I anticipated
53:08We've lost the son to the illness
53:10That's the ultimate culprit, is the illness
53:13But the system has created so many hurdles
53:16That it's almost impossible to get the necessary help for his mental illness and his pension toward violence
53:20Take very long
53:23There's fear for ourselves, yes
53:26But there's even greater fear for what's going to happen to David
53:30I'm still looking for the white butterfly for Ben, can't seem to find it
53:34After all these years, we, as a family, have not discovered a way to get treatment for our son David
53:43Emma and I found a big bumblebee
53:46Despite all of the fear, despite all of the illness, if David were to come to our war today, we would open the door and bring him in, if he would come
53:59We only wish we knew where he is
54:02That's where he is
54:32At the moment
54:35He was waiting for him
54:38For his support, he began to break his life
54:40For his support, it was to be a war
54:42He didn't feel the same
54:43He'd been Harsh
54:45He'd been a war
54:47He'd be a war
54:49He'd be a war
54:51For his support, he would play
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55:27for its content.
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