Walker v. Commonwealth, Record No. 0464-22-2 (July 18, 2023)
In determining what conditions to place on a person found not guilty by reason of insanity, a trial court must balance the acquittee’s need for treatment and supervision with the interests of justice and society.
Facts. Nigel Elliot Walker had a family history of schizophrenia and had himself began experiencing psychotic symptoms as a young boy. He was hospitalized several times for mental health issues, and after six years in the military, he was also diagnosed with PTSD. Throughout this period, he did not consistently take the medications prescribed to him because he did not like how they made him feel.
In September 2015, a VA psychiatrist diagnosed Walker with psychosis and PTSD, with symptoms that were “highly suggestive” of schizophrenia or schizoaffective disorder. She prescribed him medication and required follow-up, but did not find him to be a risk to himself or others based on his insistence that he had no intention of harming anyone.
During this time, Walker was also dating Emily Szabo. In early 2016, however, Emily ended the relationship. Still, she and her parents allowed Walker to live with them temporarily so that he would not become homeless. He continued to take his medication only occasionally. In March 2016, after encouragement from Emily’s mother, Walker returned to the VA for belated treatment. They psychiatrist changed his medication, but again did not detect “suicidal or homicidal ideation,” opining that he had “fair judgment, good insights, and intact impulse control.”
Unfortunately, the new medication seemed to exacerbate Walker’s psychotic symptoms. Over the next few days, he experienced delusional thoughts and exhibited “a variety of emotions and erratic behaviors.” Finally, entirely unprovoked, Walker went to Emily’s father’s bedroom early one morning and choked and stabbed him to death. He later told his psychiatrist that he believed he was back in the military on a government mission that required him to kill the man.
Walker pled not guilty by reason of insanity. While awaiting his sanity evaluation, physicians at his jail observed that he was experiencing psychotic symptoms and failing to regularly take his medication.
In 2017, Walker was found not guilty by reason of insanity for the killing and committed to Central State Hospital. His commitment was renewed in 2018 and 2019. In 2020, the Hospital and Richmond Behavioral Health Authority (RBHA) agreed to a conditional release plan to move Walker to a transitional home. The plan included frequent psychiatric monitoring, substance abuse screening, therapy, and medication administration by staff. It was approved by the court. In 2021, with the Commonwealth’s consent, the court allowed Walker to visit out-of-state family for two weeks.
In 2022, after Walker’s successful solo trip, the RBHA recommended that Walker be able to live independently in an apartment in the community, but the Commonwealth opposed. At a hearing, the prosecutor argued that “compliance was easier to maintain” while Walker was “under intense supervision and monitoring,” and urged the court to prioritize public safety. It did not offer any testimony. Four witnesses who were employees of the transitional home testified that Walker was ready to leave the home, and that he could continue to be monitored. The testimony also showed that Walker had been compliant with all conditions imposed upon him at the transitional home. Walker testified that he would attend college full-time and had “no interest” in stopping his medications. The court, however, agreed with the prosecution, stating that it was “not discounting” the testimony in Walker’s support, but was “mindful” of the “unprovoked” killing he had committed. Walker appealed.
Issue. Whether the circuit court abused its discretion in denying Walker’s release plan to live independently where the Commonwealth offered no evidence that he could not.
Holding. No. Considering the conflicting evidence, including Walker’s mental health history and circumstances of his offense, the circuit court did not abuse its discretion.
Notes. A decision to modify a conditional release plan is a civil proceeding, and the trial court’s decision is reviewed on appeal for abuse of discretion. A person found not guilty by reason of insanity is acquitted of a criminal offense but must be placed in the “temporary custody” of the Commissioner of Behavioral Health and Development Services “for evaluation by skilled professionals.” The purpose of this commitment is to treat the acquittee’s mental illness and protect him and others from his “potential dangerousness.” Thus, “due process requires that the nature and duration of the commitment be reasonable in relation to its purpose.”
By statute, the court has two duties. First, it must determine whether the acquittee requires inpatient hospitalization. Second, if not, it must determine what conditions to impose on the acquittee. The conditions must balance the acquittee’s need for treatment and supervision against the interests of serving justice and protecting society.
Here, after several years of hospitalization, Walker had only been living in a transitional home for thirteen months. Though he had been compliant during this time, he had a long history of stopping his medications. If he began to have mental health issues while living independently, the onus would be on him to seek necessary treatment, which he had been reluctant to do in the past. Walker had also denied wanting to harm himself or others just days before he killed Mr. Szabo. The evidence showed that it was too difficult to monitor Walker’s mental health when his medication was not given to him by mental health staff, and the court agreed to re-evaluate its decision in six months. Thus, the court had properly balanced Walker’s need for treatment and the need to protect society.