Incarcerating and Executing the Mentally 111 235INCARCERATING AND EXECUTING
THE MENTALLY ILL
Introduction
On any given day, over 100,000 mentally ill individuals are incarcerated in prisons
and jails throughout the United States (Penner & Oss, 1996). The deinstitutional-
ization of state hospitals has led to an influx of mentally ill persons in the jail and
prison systems, as many individuals who were once hospitalized are now incarcer-
ated for their behavior (Belcher, 1988). Despite the prevalence of mental illness
in the criminal justice system, it is not uncommon for the mentally ill to receive
little or no treatment during their incarceration. Perhaps even more disturbing is
the staggering number of mentally ill individuals on death row. Although it is un-
constitutional in the United States to execute a mentally ill person who is unaware
of the nature or reason for his or her punishment, such individuals continue to be
executed (Arrigo & Tasca, 1999; Jacobs, 1998). In addition to the legal issues that:
are raised by the unconstitutionality of such a practice, a number of psychological
issues are raised as well. In order for the court to determine whether a particular
mentally ill inmate is fit for execution, a mental health professional must conduct
a competency for execution evaluation and provide an expert opinion as to the
inmate's understanding of the nature and reason for his or her punishment. Psy-
chologists who conduct such evaluations are often faced with numerous ethical
and moral dilemmas due to the literal life-and-death nature of their decision. The
following illustration of Horace Kelly depicts the most recent case involving the
execution of a mentally ill person.
There is evidence that Horace Kelly suffered brain damage at birth. He was born
over 2 months premature, weighing less than 2 pounds. By the time he was 18 months
old he had endured chronic physical and sexual abuse at the hands of his father. By the
age of 4 his mother reported that he frequently was observed shivering in a trance-like
state. His childhood was further characterized by horrific headaches, terrible nightmares,
and seeing and drawing demons.
When Mr. Kelly was 24 years old he murdered three people over a 6-day period,
crimes tor which he is currently awaiting execution. During the course of his trial,
Mr. Kelly reportedly spent weeks in the corner of his cell curled into a fetal position,
sleeping under the sink, and crying frequently. Horace Kelly appeared for court looking
extremely disheveled with an odor of urine and visible lice in his hair.
Mr. Kelly had virtually stopped talking by the time he reached death row. There
are many documented accounts of his bizarre behavior, delusional thoughts, confused
state, severe distortions of reality, enuresis, nightmares, and suicide attempts. During his
time on death row he has been prescribed numerous different psychotropic medications;
however, his psychological decline has persisted. When asked about the meaning of
execution, Mr. Kelly stated that it was the day that the payrolls would be processed.
Although several psychologists have diagnosed Mr. Kelly with schizophrenia and
mental retardation and a number of neurologists have reported severe brain damage,
Mr, Kelly has been rendered competent to be executed. Once the decision of competency