The Pittsburgh Synagogue Shooting Trial and Mental Illness: Take 1

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

As the record number of mass shootings grows, the Pittsburgh Synagogue mass shooting trial is unfolding. Now almost 5 years since the tragedy when 11 individuals were killed, it is becoming more and more apparent that the focus will be about defining severe mental illness and how it relates to the perpetrator and his eventual sentencing.

The trial is not being televised and mainstream media coverage seems limited. The most extensive I found was in the Pittsburgh Jewish Chronicle.¹

The trial is now in the penalty sentencing stages after a quick admission of guilt on 63 federal counts, many of them potentially justifying the death penalty. So far, in the stage of the crucial consideration of “intent,” the defense has focused on presenting that the perpetrator has a serious mental illness.

The American Psychiatric Association (APA) has a “Position Statement on Issues Pertaining to Capital Sentencing and the Death Penalty,” approved by the Board of Trustees in July 2020.² The conclusion was that defendants should not receive the death penalty if they had a mental disorder or disability that significantly impaired their ability to appreciate the legal consequences of their conduct.

The National Alliance on Mental Illness (NAMI) opposes the death penalty for anyone with “serious” mental illness such as schizophrenia. Reasoning for that recommendation is that individuals with SMI are overrepresented on death row and may have anosognosia, a condition resulting in unawareness of their own mental health.

However, the challenge is how to clarify who has serious or severe mental illness.

So far, the defense has presented 2 expert witnesses that I have read about. One is a neurologist, who told jurors that he diagnosed the shooter with schizophrenia and epilepsy. In the interview, the shooter seemed to have a “flat, rigid affect” and a delusion that ink from his uniform was leaking into his body, although a prison witness said that the ink does come off often.

Another defense expert witness was a psychologist, who said that he thought the shooter was “blatantly psychotic.” He reportedly had been concerned about parking in a handicapped space at the synagogue because it was illegal, yet then laughing because killing others was immensely more illegal. He purposefully used bullets manufactured in Israel to send a message. He smirked when describing shooting 2 worshippers near ovens. Psychological tests were said to indicate that he was not malingering, but that he was delusional that Jews were genocidal. He was said to have a high IQ but low processing speed. Most all of these descriptions have some consistency with—though not diagnostic of—schizophrenia.

The psychologist also reported on his past psychiatric history. Records indicated a reported suicide attempt when was 10; a homicidal attempt to set his mother on fire when he was 13, followed by a 9-month hospitalization; and several more intermittent suicide attempts and hospitalizations, the last being in 2004. One time he was prescribed an antidepressant by a psychiatrist, but the outcome was not mentioned.

This week, the prosecution called their own witnesses. One was a neurologist who found no brain image pathology, nor any reported psychotic symptoms, nor any seizure history. He used his own definition of “delusional” rather than that in the DSM-5. However, he did find a history of some heroin and cocaine use, chronic depression, a reported lack of empathy, and possible lingering childhood trauma. There also was a childhood hobby of making homemade bombs and fires, sometimes a precursor of sociopathy. He was said to be chronically isolated and socially awkward. His conclusion was that the shooter in 2017 became absorbed into far-right anti-Semitism replacement conspiracy theories during his boring breaks from truck driving.

Finally, for the first time, a psychiatrist was called as an expert witness by the prosecution yesterday. It was Park Dietz, who was an expert witness in the 1982 trial of John Hinckley, Jr, as well as Jeffrey Dahmer, Dylan Roof, and Ted Kaczynski. After an evaluation from May 21-23, 2023, he produced a 200-page report, which concluded that the shooter does not have schizophrenia, psychotic symptoms, or epilepsy, and had the legal capacity to form intent to kill. To the contrary, Dietz concluded that nary a single extreme belief on the perpetrator was personally original, but all part of an online subculture rather than mental illness.

With the trial set to resume Monday, some may wonder whether these disparate and differing testimonies reflect to some extent being hired by opposing sides. Certainly, time was not an issue, as more time was available than in a typical clinical evaluation.

What do you think so far?

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times.

References

1. Tabachnick T. Synagogue shooter does not have a mental illness, prosecution expert testifies. Pittsburgh Jewish Chronicle. July 6, 2023. Accessed July 7, 2023. https://jewishchronicle.timesofisrael.com/synagogue-shooter-does-not-have-a-mental-illness-prosecution-expert-testifies/

2. Position Statement on Issues Pertaining to Capital Sentencing and the Death Penalty. APA. July 2020. Accessed July 7, 2023. https://www.psychiatry.org/getattachment/b6a4c514-509a-4725-a6e6-c844aab515fd/Position-Capital-Sentencing-Death-Penalty.pdf