Mental hospital commitment creates dilemma

State Supreme Court voids man’s stay, but prosecutors pursue civil detention; lawmakers urged to find fix for problem

The state mental hospital in Las Vegas, N.M., says a man who killed his own mother and has been diagnosed with schizophrenia has got to go.

A state district judge committed Justin Quintana, 35, to the Behavioral Health Institute last year after finding him not guilty by reason of insanity in the 2007 shooting death of Susan Kuchma, a beloved state police officer in Las Cruces who grew up in Santa Fe.

But the facility says the unusual order does not follow New Mexico’s laws for committing the mentally ill, arguing it locks away Quintana indefinitely while depriving him of the sort of legal rights that would be afforded to him if he had been convicted or murder.

The case, which landed in front of the state Supreme Court on Monday, has turned into a test of how threadbare New Mexico’s safety net for the mentally ill really is while also raising questions about how far the state can — and should — go to keep people deemed dangerous

and in need of treatment off the streets.

Quintana was 25 years old when investigators say he shot his mother.

Police said at the time that Quintana broke into his mother’s home and stole her service weapon. Quintana went back to his home, called his mother, told her he had the gun and asked that she take him to a nurse, according to initial charges against him.

Kuchma, who was off-duty, went to her son’s house but left after he showed her the gun, according to the statement. Quintana told police he followed his mother and accidentally shot her once in the head after the gun slipped, the statement says.

Police said Quintana dialed 911 himself.

Doctors diagnosed Quintana with schizoaffective disorder, a condition with symptoms of both a mood disorder and schizophrenia.

Family members said at the time that Quintana’s illness first surfaced when he was in college in Arizona and that they had tried to get him treatment.

Quintana complained of things growing from his body and stopped eating at one point, fearing his food was being poisoned.

Concerns about Quintana’s behavior deepened among his family. At one point, his father asked a doctor write a letter that would effectively bar him from buying a gun.

Repeated attempts at treatment all failed, his lawyers say.

Still, Quintana remained close to Kuchma, living near Las Cruces and frequently eating dinner with her.

After the shooting, family partly blamed the mental health system, which seemed unable to do much of anything for a man who slipped away from them.

A judge deemed him mentally incompetent to stand trial on charges of first-degree murder, aggravated burglary and larceny.

Quintana was treated for about nine years at the Behavioral Health Institute before two doctors said that he was competent to stand trial.

Before trial, however, his attorney and prosecutors reached an agreement and got an order from Judge Douglas Driggers finding him not guilty by reason of an insanity.

It was a highly unusual resolution to a first-degree murder case, certainly for New Mexico.

Quintana admitted to the crimes and the judge committed him to the Behavioral Health Institute until he is deemed sane or no longer dangerous. And at that point, he could not be released without the court’s approval.

That is not usually how patients are committed to the hospital, however.

Under New Mexico law, a court can commit a criminal suspect for treatment until they are deemed mentally competent to stand trial.

A patient can also be kept in treatment through a process known as civil commitment. But to be committed for longer than 30 days, there must be evidence that the person is at risk of serious harm to himself or others and that commitment is the least drastic means of providing treatment.

The Department of Health, which runs the Behavioral Health Institute, says that since Quintana was found competent to stand trial and then not guilty by reason of insanity, he does not fall into those categories.

Instead, the agency argues that the order veers from those processes designed to protect patients’ constitutional rights and creates a whole new way of committing a person to New Mexico’s mental hospital.

The department asked the state Supreme Court to stay Driggers’ order.

Erin McSherry, a lawyer for the department, told the state Supreme Court during a hearing on Monday that prosecutors could ask to have Quintana civilly committed, but that he does not qualify. Keeping Quintana amounts to a drain on resources at an institution that has operated at capacity in the past, she added.

“I don’t think the proposal of anyone is to throw someone on the street,” McSherry said, telling the court that the institute is working on a plan to release him that could include care in the community.

But the streets is exactly where prosecutors, Quintana’s lawyer and his own family fear he might land.

Making an unlikely coalition, they asked the court to uphold the commitment, contending it is the best option for a man who is still struggling with mental illness and dangerous if not treated.

Sure, Quintana’s lawyer, Gary Mitchell, told the court, they could pursue civil commitment. But he added: “There’s a total lack of confidence [in the process].”

But the case raised uncomfortable questions about whether a court can commit a person to the state mental hospital for a virtually indefinite period of time and then only allow the individual’s release if a judge — rather than a doctor — approves.

When does what a court believes to be the best option for a mentally ill patient unjustly limit their rights?

Justice Charles Daniels recounted passing several homeless people on the street and asked Mitchell: “Would you involuntarily commit them?”

They had probably not killed their mothers, Mitchell replied, arguing the case is unique.

Still, Daniels raised concerns that the order goes beyond what the law allows.

The five-member court sided with the Behavioral Health Institute, effectively voiding Quintana’s commitment.

But they ordered that the institute not release Quintana for 15 days, giving prosecutors time to pursue civil commitment.

Deputy 3rd Judicial District Attorney Davis Ruark said prosecutors in Las Cruces would do just that, but added after the hearing that it will be up to legislators to close what he argues is a hole that leaves fewer options for resolving cases involving people with mental illnesses.