Recent Decisions in Capital Cases Reflect Growing Understanding of How Serious Mental Illness Affects Behavior and Culpability

May is Mental Health Awareness Month, and the impact of mental illness is keenly felt on death row: at least two in five people executed have a documented serious mental illness, and research suggests that many more death-sentenced prisoners are undiagnosed. A national majority, 60% of Americans, opposes executing people with serious mental illness. In the past two decades, science and medicine have contributed to a much better understanding of how serious mental illness, which refers to mental, behavioral, or emotional disorders that significantly impair a person’s ability to function in daily life, can affect behavior. In light of these developments, the Ohio and Kentucky legislatures have passed laws barring the execution of people with a serious mental health condition such as schizophrenia or bipolar disorder at the time of their crime, and the California legislature passed a law barring the execution of death-sentenced prisoners who have become permanently mentally incompetent. Legislators in several other states have introduced similar “SMI” bills. 

The new laws resulted in new sentencing opportunities for death-sentenced prisoners whose mental health conditions contributed to their crime. An Ohio judge ruled on May 6 that Stanley Fitzpatrick, who was sentenced to death in 2002 for three murders, could not be executed due to his serious mental illness. A state expert and a defense expert agreed that Mr. Fitzpatrick suffered from a qualifying condition before, during, and after the murders. Ohio’s SMI law requires a diagnosis of either schizophrenia, schizoaffective disorder, bipolar disorder, or delusional disorder. Mr. Fitzpatrick was resentenced to life without parole and will be housed in a mental health treatment facility for at least a year per the judge’s recommendation.   

Decisions on serious mental illness exemptions are pending in at least two other Ohio cases. On May 3, a court set a date of August 5 for a death penalty eligibility hearing for Chad Doerman, accused of killing his three sons in June 2023. Mr. Doerman pleaded not guilty by reason of insanity, and court records stated that he had been examined by two experts who agreed he experienced serious mental illness at the time of the offense. He will be examined by a state expert before the hearing. Ashford Thompson, convicted and sentenced to death for the 2008 killing of police officer, is also awaiting a decision after the state confirmed in December that Mr. Thompson would be evaluated regarding his assertion of delusional disorder.   

Last fall, Ohio courts used the state’s SMI law to resentence two men to life in prison and bar the death penalty in an upcoming trial. A Kentucky court exempted a man from the death penalty in an upcoming trial as well; however, Kentucky’s SMI law is not retroactive, so a person already on death row who had a serious mental illness at the time of their crime could still face execution.  

Additionally, Oklahoma courts recently ruled two death-sentenced prisoners incompetent to be executed under Supreme Court precedent, finding that they did not have a rational understanding of the reason for their execution. On May 13, a judge ruled that Wade Lay’s schizophrenia, delusions, and paranoia made him ineligible for the death penalty. On March 28, a trial court found James Ryder incompetent to be executed based on decades of documented schizophrenia. Both men expressed a belief that their death sentence was part of a wide-ranging political conspiracy. In both cases, Oklahoma Attorney General Gentner Drummond said that the state would seek to reestablish competence so that the men could be put to death, despite documented ethical problems with that practice. Attorneys for the two men said that their mental health conditions had been deteriorating for years and were unlikely to improve.  

In 2006, the American Bar Association, American Psychological Association, and American Psychiatric Association released a joint resolution calling for people with serious mental illnesses to be exempt from the death penalty. Their joint report found that serious mental illness inhibits a person’s ability to recognize the nature of his own conduct, conform his conduct to the law, assist in his own defense, or understand the punishment of death. Serious mental illness also increases the risk of wrongful conviction by making a person more susceptible to false confessions. Organizations including the United Nations and the National Alliance on Mental Illness (NAMI) have joined the call to bar the death penalty for people experiencing serious mental illness.  

Note: This article was updated on June 3, 2024 to clarify California’s SMI bill.