DECISION & ORDER The defendant, indicted for, among other things, Murder in the Second Degree, entered a plea of not responsible by reason of mental disease or defect on March 16, 2021. Submissions by counsel in lieu of a hearing were received to “determine the defendant’s present mental condition” and the proper course of treatment necessary to assure the safety and well-being of the defendant and the public (CPL §330.20 [6], [7]). Diagnosed with schizophrenia, the defendant underwent his first psychiatric hospitalization in 1979, at age 15. There were subsequent hospitalizations, but he remained generally stable on the medication Mellaril for decades, allowing him to live independently. In 2019, as a result of the discontinuance of the production of Mellaril, the defendant’s medication was changed to Geodone, with devastating consequences. The defendant decompensated, becoming paranoid and belligerent, resulting in his sisters’ driving him to the emergency room for psychiatric admission on May 23, 2019. Although evaluated at the hospital, he was not admitted. On May 24, 2019, the defendant could not sleep and became aggravated and paranoid. He left his home shoeless, in his pajamas, and walked to his father’s home unannounced. Once inside, he attacked his step-mother with a knife, killing her and then turned on his father. He left, assaulted a stranger and stood in traffic until the police came and took him to the hospital. As a result of these events, as indicated above, the defendant was indicted and interposed a defense of not responsible by reason of mental disease or defect. The defense retained Dr. Alexander Sasha Barday, whose expert opinion was that “at the time of the instant offense, Mr. R., as a direct result of his change of medication, was suffering from the acute symptoms of schizophrenia, and as a result of his severely paranoid, and delusional mental state, he lacked substantial capacity to appreciate the wrongfulness of his actions.” The People’s expert, Dr. Marc E. Tarle, agreed with Dr. Barday, concluding: “it is my opinion that the defendant did lack the substantial capacity to know or appreciate the consequences of his act or that such conduct was wrong by reason of mental illness, schizophrenia….” As a result of these opinions, the People agreed to the not responsible plea, which was accepted by this court, and the defendant was committed for an initial evaluation to determine the defendant’s current mental status. This evaluation was done at Kirby Forensic Psychiatric Center by Dr. Luke V. Lee and Dr. Elizabeth Beckford. Both psychiatrists concluded that the defendant currently suffers from a dangerous mental disorder requiring treatment in a secure psychiatric facility. Upon submission in lieu of an initial hearing, “the district attorney must establish to the satisfaction of the court that the defendant has a dangerous mental disorder or is mentally ill” (CPL §330.20 [6]). The evidence in this case establishes by a preponderance of the evidence (Matter of Eric F. v. Hoovler, 152 AD3d 586, 588 [2nd Dept. 2017]), that the defendant currently suffers from a dangerous mental disorder. Dr. Luke concluded: “While Mr. R. does not currently display any current signs or symptoms of an acute or decompensated state of mental illness, he remains with ongoing persecutory delusions…. [H]e does not appreciate the connection between his delusions, paranoia and violent behaviors.” Dr. Luke further found that “Mr. R. will require focused treatment to develop such insight and decrease his risk of future dangerousness.” Supporting this finding, Dr. Beckford found that “Mr. R.’s risk factors for future violence include his mental illness, poor insight, and prior episodes of non-compliance with treatment,” and that “his episodic paranoia is an area that should be closely monitored going forward.” Dr. Tarle is in agreement, stating: “In my opinion, his psychotic features have not been fully stabilized on his medication at the present time and he remains a potential risk to others. In conclusion, the defendant presents with a dangerous mental disorder and requires treatment in a secure facility.” Against this evidence, the defendant presents the statement of Dr. Barday that “it is uncertain that Mr. R. suffers currently from a dangerous mental disorder (emphasis added)” as evidence that he is not currently dangerous, but just mentally ill. This evidence is not sufficient to overcome the preponderance of evidence supporting the People’s position. For the reasons stated, the court finds the defendant currently suffers from a dangerous mental illness in that he currently constitutes a physical danger to himself or others, and accordingly, he is committed to a secure facility to be determined by the New York State Commissioner of Mental Health for six months from the date of this order.
