- Associated Press - Saturday, October 15, 2016

ALLENTOWN, Pa. (AP) - Travis J. Kutz believes tiny robots have been implanted under his skin to control him, according to a psychiatrist’s report.

He hears voices - people crying, his mother being raped. He claims he was once a Navy SEAL, and that he has met President Barack Obama and the secretary of defense.

When Kutz, 24, was arrested last year, police said, he was homeless and caught climbing out the window of his father’s house in Bangor, where he had helped himself to Powerade, ice cream and a can of ravioli.

“I was only breaking in to get something to eat,” he protested to police, an officer wrote in an arrest affidavit.

Everyone involved in Kutz’s case agrees he is severely mentally ill and in need of long-term treatment. Yet jail is where Kutz has languished since his arrest on May 29, 2015.

Given the extent of Kutz’s delusions, a Northampton County judge has declared him incompetent to stand trial and ordered that he be transferred to Norristown State Hospital, a psychiatric facility. But Kutz, like hundreds of mentally ill defendants across the state, faces a long waiting list for the psychiatric help he needs to regain his grip on reality, a requirement for his case to proceed.

Jails were not intended to be way stations for the mentally ill, who often see their conditions deteriorate under the stresses of incarceration. But local prisons have increasingly become just that, as the population in need of services boomed after Pennsylvania closed most of its state mental hospitals without adequately investing in alternatives.

“The system is failing because we don’t have the beds that we need,” said Kutz’s public defender, Syzane Arifaj. “He really needs the highest level of care, but those beds are just so severely limited.”

The state has promised to do better in response to a federal civil rights lawsuit last year by the American Civil Liberties Union of Pennsylvania, which cited waits of a year or more for many mentally ill defendants ordered to be treated at a state mental hospital.

The suit called the delays “an embarrassment to a civilized society” and highlighted one inmate in Philadelphia who took his own life, and another who was murdered while in jail waiting for a placement.

Out of six remaining state mental hospitals, two have secure facilities in which defendants deemed incompetent can be sent for treatment: Norristown for the eastern part of the state, which has 136 forensic beds, and Torrance in the west, which has 100 beds.

Under a January settlement with the ACLU, the state agreed to invest more resources into the mental health system, with an eye to reducing waits for those beds. But one thing the agreement didn’t contain: any expansion of the two hospitals’ capacities, which state officials maintain is unnecessary, despite a waiting list that continues to grow.

When the settlement was signed, the list totaled 220 people, with the line for Norristown particularly jammed. The number had risen to 252 as of late last month, according to the ACLU, including five inmates jailed in Northampton County and four in Lehigh County.

In the end, “very little” has changed since the agreement, said Witold Walczak, the ACLU’s legal director.

“What we haven’t seen is a reduction in the number of people on the waiting list, or the amount of time they are waiting,” Walczak said.

That assessment fits with what the directors of the Lehigh Valley’s two county jails are experiencing.

“Unfortunately, I don’t see any change in that direction,” said Ed Sweeney, Lehigh County’s corrections chief. “I don’t see the state making the determination that they need more forensic beds.”

Dealing with mentally ill prisoners is the “new normal,” said Daniel Keen, Sweeney’s counterpart in Northampton County. “I don’t see any relief button right now.”

In the settlement, the state acknowledged the long waits are a problem that “cannot be justified clinically or legally.” It conceded they are unconstitutional and fail to comply with the 14th Amendment’s guarantee of due process of law.

The Department of Human Services agreed to create 120 new treatment slots, though in the community, and not the mental hospitals. It provided $1 million for housing in Philadelphia to support the mentally ill, and said it would re-examine its waiting list for ways to cut delays.

Human Services Secretary Ted Dallas said that by adding outside resources, officials hope to reduce the amount of time inmates stay at Norristown or Torrance once they are sent there, shifting them as they get better to less burdensome forms of care such as supportive housing.

What the state found, Dallas said, was that inmates were being kept too long at the forensic hospitals. That created a bottleneck for others waiting for beds to open, he said. By increasing the number of discharges and investing in community treatment, the state should ultimately be able to increase new admissions, he said.

Since the 1960s, a philosophical shift has been underway in Pennsylvania and across the nation in how the mentally ill are treated. The new approach, espoused by many advocates for the mentally ill, is that it is better and more humane to treat patients in the least restrictive settings possible.

The change has led to the widespread closure of mental hospitals that used to dot the landscape, but that are now often derided as antiquated throwbacks to a time when the mentally ill were written off and hidden from society.

Dallas said the state continues to believe that adding forensic beds is not the solution, though he acknowledged the waiting list is an ongoing problem.

“Our best judgment after doing the analyses was that (more beds) was not the thing that would help the forensic system get where it would need to be,” Dallas said.

Dallas said fixing the delays will take time. He said he flagged them for attention immediately after assuming his post in 2015.

“It is something that shouldn’t be acceptable to anyone and it is something we have been working hard to address,” Dallas said.

Dallas is the former human services director of Maryland, which has less than half of Pennsylvania’s population but nearly four times as many forensic beds - 853 versus 236, according to the Treatment Advocacy Center, a national nonprofit that supports adding capacity at state mental hospitals. Dallas said it was like “apples and oranges” to compare the two states.

Walczak believes Pennsylvania’s waits are one of - if not the - worst in the nation. He points to Oregon and Washington, where federal courts have found that delays of more than one week are unconstitutional, and he notes Pennsylvania is not “remotely close” to that treatment benchmark.

Given the lack of progress, Walczak predicts the ACLU will be going back into court to force state officials to do more.

“The question may come down to resources and the line in the sand that they drew of no new beds,” Walczak said.

Some of the inmates waiting for beds are accused of serious crimes that make their release unlikely regardless of whether they receive treatment. In Northampton County, the longest waiting is Emanuel Cotto, 27, who is charged with stabbing to death his roommate at a group home for the mentally ill in Bethlehem. He has been jailed since his arrest on Jan. 4, 2015, and was ordered transferred to Norristown in September of that year.

But others like Kutz are imprisoned under charges that, but for their mental illness, would almost certainly see them freed. Of Northampton County’s other incompetent inmates, two face misdemeanor charges of simple assault, court records show. One was homeless and allegedly punched a man in Easton’s West Ward. The other is accused of slugging an emergency room nurse at Easton Hospital.

Two weeks ago, a judge ordered another inmate - the county’s sixth - added to the waiting list. She is charged with shoplifting: She allegedly stole a pair of sneakers and a gallon of soy milk in August from a Wal-Mart in Lower Nazareth Township.

Those inmates cost Northampton County taxpayers nearly $108 a day while they remain jailed.

Almost a year and a half after he was imprisoned, Kutz is No. 15 on the list for Norristown. Local officials calculate the line moves six to eight people a month on average, suggesting it will still be a few months before Kutz is transferred.

In the meantime, Kutz’s father just wants his son to get help, though he never imagined how long it would take.

Pressing charges

Keith Kutz Jr. faced a difficult choice the day his son allegedly broke into his Northampton Street house in Bangor. He knew Travis “doesn’t even belong in jail,” but he was at wits’ end given his son’s mental deterioration, he said.

Keith was in Ocean City, Maryland, when he got a call from a neighbor, who had seen Travis climbing through the window.

Travis had sneaked in once before and stolen money, his father said, and the family had installed a security system to prevent it from happening again. But the one window Travis tried that night wasn’t wired.

Mental illness had taken Keith’s son, making him unrecognizable from the “smart as hell” child he had been before problems surfaced in his late teens.

Months before the break-in, Keith said, he had been forced to kick his son out of the house, after Travis‘ rages became unbearable. Travis‘ stepmother and little sister were afraid of him. He’d punch holes in walls, or get in his dad’s face and scream.

Twice, Keith said, he called police and had his son involuntarily committed to local hospitals. But as soon as Travis could, he would sign himself out and return in no better shape than before.

Travis had that right under the Mental Health Procedures Act, which limits the ability of family members to force mentally ill relatives into treatment. Generally, those presenting a “clear and present danger” to themselves or others can be held for at most five days at a psychiatric hospital, though extensions can be granted with court approval if a doctor believes it is necessary.

Homeless, Travis bounced between his mother’s place and a friend’s, Keith said. Sometimes, he slept in a sleeping bag in the woods behind his father’s home, even in the middle of winter.

“There would be nights when I would go outside to have a cigarette and I could hear him screaming stuff at me from the top of the hill,” Keith remembered.

Travis was always resistant to taking medication, believing others would look differently toward him because of it, his father said. By the time of his arrest, Travis was delusional and would have conversations with the television, Keith said.

Keith said he feared for his son’s safety, that he might do something to harm himself. It was with that in mind that Keith said he decided to press burglary charges.

“Hopefully him going to jail was going to get him some help, because I couldn’t get him help any other way,” Keith said.

He figured his son would be gone for two or three months. The last time he saw Travis was in a district judge’s courtroom shortly after the arrest.

“You could tell he just had pure anger. You could see it in him,” the father recalled.

Keith, a 48-year-old truck driver, said he feels helpless over his inability to do anything for his son. He said he struggles with guilt and wonders whether he made the right decision.

“It’s hard to know that there is nothing I can do,” Keith said.

Jail hasn’t been easy for Travis. Like other incompetent defendants in Northampton County, he is being held under heightened security, isolated in a cell by himself and kept under observation, according to the prison. In November, he was charged with spitting in the face of a guard who was escorting him back to his cell after taking him to shower.

In a letter from jail to his family, Travis wrote about his wife and children - though he has neither, his father said. Authorities have told the family there’s little point in visiting him.

“They said he is nothing but getting worse, that he probably wouldn’t even know who I was,” the father said.

‘Bizarre delusions’

Jailing the mentally ill instead of getting them treatment is a losing proposition for everyone involved, said John Snook, executive director of the Treatment Advocacy Center.

Mentally ill defendants are a greater danger to themselves, to other prisoners, and to guards, Snook said. They are likely to get sicker and, if left untreated long enough, may deteriorate to a point in which they cannot recover, he said.

“A jail is the single worst place you could think of to provide someone mental health services,” Snook said. “It just simply in every way is the wrong process.”

Rory Driscole, a Northampton County public defender who works closely with mental health cases, said he has witnessed that firsthand with clients.

“The more they sit in prison, the more they digress,” Driscole said. “I’ll see them in the very beginning and I’ll see them three months later, and they get worse.”

In some cases, community-based solutions can be found. Brian Watson, deputy administrator for the Northampton County mental health division, said his agency works closely with the prison to shift incompetent defendants into local treatment when possible.

Watson estimated he has a half dozen cases in which that has proven successful. Initially, the prisoners are sent to local hospitals under temporary mental-health commitments, ensuring they get immediate treatment, he said. They are then connected with psychiatrists, nurses and case managers who can provide services at home.

The approach gives the defendants an incentive to take their medications: their desire to stay out of jail.

“We get a lot of buy-in from them because they realize they are going to get help, get treatment,” Watson said.

Arifaj, Travis Kutz’s public defender, said that given the extent of his problems, her client would be unable to care for himself if he was released. Considering his state, she said, he couldn’t comply with doctors’ orders.

Kutz has been evaluated at least three times by psychiatrists and each time they found he remains incompetent, Arifaj said. He was ordered transferred to Norristown on Oct. 2, 2015, by Judge Emil Giordano - exactly one year and one week ago.

Alex Thomas, a doctor who examined him in jail, concluded Kutz was “paranoid, delusional and psychotic” and may suffer from paranoid schizophrenia. In the September 2015 report filed in the case, Thomas said Kutz was refusing medication in the prison, and denied anything was wrong with him.

“He is exhibiting bizarre delusions about being controlled by ‘nanobots,’” Thomas wrote. “He hears voices that scream at him. He is paranoid that his food might be poisoned.”

The case’s prosecutor, Assistant District Attorney James Augustine, said he sympathizes with Kutz, whom he noted has already served more time in prison than he would likely receive if convicted of the burglary of which he is charged.

“It’s not good, but I can’t let him out on the streets. At a minimum, he’s a danger to himself,” Augustine said. “He’s a grown man and he believes in nanobots, so what do you do with the guy?”

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Online:

http://bit.ly/2ecehKh

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Information from: The Morning Call, http://www.mcall.com

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