Sentencing Orders and Diversion Programs

Not to be snarky, but I think this tidbit from Amen Clinic is dead on the money:

"Psychiatrists are the only medical specialists who rarely look at the organ they treat. Psychiatrists continue to make diagnoses the same way they did 100 years ago, based on clinical exams and symptom clusters. There is a better way. SPECT imaging is a clinically useful way to look at brain function." 18 Ways that SPECT can Help You

We see this in Florida Criminal Law on a regular basis. Uniformed prosecutors, criminal defense lawyers and judges do not understand that the brain is the hardware and mind is the software. Florida Criminal Law has attempted to inch forward into the 21st century with first offender and other diversion programs such as Drug Court, Mental Health Court, and Veteran's Court. Yet these programs - and others - are quite frankly, an intellectual embarrassment. We need a change that is not incremental, but one on an order of magnitude. We need to put the money in the system up front and get the most accurate diagnostic evaluations possible, and that means the use of imaging technologies such as SPECT.

Each of these diversion programs essentially use outdated technology. Sure, they are better than expensive, harsh, incarcerative sentences, yet they usually fail in the long run. Why? They don't look at the organ sought to be treated. 

Florida Criminal Law revolves around discovery - the process of learning about the other side's case in the form of reports, witness lists, depositions, examination of physical evidence and more. Yet when it comes to diversion programs and sentencing orders designed to treat the bodily organ responsible for some of the most dangerous and damaging behaviors which are reasonably foreseeable to recur, we rely on guesswork. This is especially true for Mental Health Court, Veteran's Court, Drug Court and sentencing conditions such as Anger Management and Domestic Violence Intervention Programs. How bad can it get? A war veteran tried and convicted of quadruple homicide when he was making an obvious cry for help for several years. Four innocent people dead, including three children, and the taxpayers literally pay millions of dollars for the sentence imposed. 

For clarity, let me add this disclaimer: Not everyone needs treatment nor a SPECT scan. Yet many do, and guesswork in the place of discovery would often be a ground for a Rule 3.850 Ineffective Assistance of Counsel motion. Yet our laws, rules, procedures, sentencing protocols, treatment diagnostics and basic problem solving skills as lawyers and judges are simply tossed out of the window of common sense.  Our legal test for insanity is from the 1830's. 

Finally, there will be the doubters who question the technology or the approach, and even more who will complain about the cost. Yet these are often the same people calling for more and more prison time without mention of the cost to the taxpayers. Cost is not the excuse, cost is the biggest reason. Inadequately funding diversion programs is foolish, funding them for accurate diagnostics and verifiable treatment results just makes good fiscal sense.

What does the Criminal Mind look like?

AS a practicing lawyer, I like watching television and movies about lawyers about as much as you would like watching . . . a show about your day at work. Before you start to think that your televised workday is so cool, let me quickly throw some ice on that happy thought: Most of what everyone would see about your day at work would be fake, overly glamorized, and just plain wrong. 

For me, this happens whenever I turn on the news and *Surprise!* lawyers and/or crime is the topic. The dramas are wrong, the news is wrong, and it all is . . . wrong, wrong, wrong!

One of my favorite areas of crime and the law involves THE Criminal Mind (there is only one, apparently). Most of the time, these types of shows involve well-spoken psychobabblists deconstructing the (THE) Criminal Mind of someone who did something terrible. This equation degenerates into Law + Crime + Evil + Person = Crap. 

The saddest aspect of all of this nonsense is not the plight of the victim of this episode of made for media victimization. Rather, it is how the public as a whole is victimized by nonsensical thinking, criminal justice system psychobabble and the failure to solve the problem of crime itself. As a result, more and more people will be victimized by the failure of the criminal justice system to actually solve the problem of crime, not just this week's CSI drama.

So let's actually look, yes, look at a healthy brain and that "Criminal Mind."

First, let's look at a SPECT (Single Photon Emission Computed Tomography) scan of a healthy brain (bottom to top view):
 

Courtesty of the Amen Clinics, this is what a human brain looks like in a healthy, young adult. Notice how smooth it is compared to the next image:

These two images are from the perspective of looking from the bottom to the top, and are imaging scans of the surface only. However, a trained psychiatrist can use these scans in conjunction with other tools (patient history, neuropsychological testing and such) in order to make a more accurate psychiatric diagnosis.

Now, I am no medical doctor, but even a lay person can tell that the two images are different. One is healthy, one is not so healthy. Beyond that I cannot tell you much about these scans, except for this: Brain = Behavior.

This equation explains why people break the law - over and over again. People with brain dysfunction act . . . dysfunctional. Most "repeat offenders" don't think they are Jesus, they aren't controlled by microscopic space aliens and they do not hear voices. Some do, with tragic results. 

Thus the solution to the problem of crime is a matter of mental health. Up until the advent of neuroimaging, we could not see a living brain any more than you could look at someone's broken arm, squint your eyes and see the actual bone. Now, trained professionals can actually see the organ responsible for human behavior, make a more accurate diagnsosis, and prescribe a personalized treatment program based on that person's individual needs.

Of course, this is not nearly as much fun as vengence, but I submit that it makes more sense diagnose and treat the next Andrea Yates before she kills her children in a bathtub or someone dies in a domestic dispute.

Respectfully submitted,

Stephen G. Cobb