United States v. Mahoney

United States Court of Appeals
For the First Circuit
No. 12-1882
UNITED STATES OF AMERICA,
Appellee,
v.
BRIAN E. MAHONEY,
Defendant, Appellant.
APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF NEW HAMPSHIRE
[Hon. Joseph N. Laplante, U.S. District Judge]
Before
Lynch, Chief Judge,
Torruella and Stahl, Circuit Judges.
Robert B. Mann, with whom Mann and Mitchell, was on brief for
appellant.
Seth R. Aframe, Assistant United States Attorney, with whom
John P. Kacavas, United States Attorney, was on brief for appellee.
June 3, 2013
TORRUELLA, Circuit Judge. Brian E. Mahoney ("Mahoney")
filed this interlocutory appeal from an order finding him
incompetent to stand trial and committing him to the custody of the
Attorney General for hospitalization and treatment pursuant to 18
U.S.C. § 4241(d).
Mahoney makes four main arguments on appeal. First, he
argues that the commitment order, read in light of the district
court's expressions at the end of the competency hearing, must be
understood to mean that the district court found him competent to
stand trial, but incompetent to represent himself. Second, he
claims that, to the extent the court predicated its finding of
incompetency upon its determination that he had "misunderstandings
of several procedural and constitutional concepts," it applied the
wrong legal standard. Third, he urges us to find that the district
court's decision was clearly erroneous as it was not based on the
opinion of the expert whose evaluation was the most thorough.
Finally, Mahoney argues that, under Indiana v. Edwards, 554 U.S.
164 (2008), the district court had to find he suffered from severe
mental illness in order to deny him the right to proceed pro se.
For the reasons set forth below, we affirm the district court's
order.
I. Background
On January 19, 2011, Mahoney was charged with failing to
register as required under the Sex Offender Registration and
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Notification Act ("SORNA") due to a 1983 Massachusetts conviction
for assault with intent to rape. See 18 U.S.C. § 2250(a). On
April 22, 2011, with the parties' acquiescence, the district court
ordered Mahoney to undergo a mental competency evaluation pursuant
to 18 U.S.C. § 4241(b). Mahoney was thus evaluated at the Federal
Medical Center Devens in Massachusetts ("Devens"). A final report
by Miriam Kissin, Psy.D. ("Dr. Kissin"), concluded that, even
though Mahoney suffered from a chronic mood disorder, he was
competent to understand the proceedings against him and to assist
in his defense. On October 11, 2011, the district court ordered an
additional competency evaluation to be performed by Eric G. Mart,
Ph.D. ("Dr. Mart"), a licensed psychologist.1 A competency hearing
was held on March 27, 2012.
A. Dr. Kissin's Testimony
During the competency hearing, the government presented
Dr. Kissin's testimony. She testified to having met with Mahoney
a total of seven times. During the meetings, she was able to learn
that Mahoney had a history of hyperactivity during childhood and
throughout his adult life. He told her that he was able to
interact with other people and was successfully employed for
several years, although he also said that he was hyperactive in his
interactions, which oftentimes led to interpersonal difficulties.
1
It is unclear from the record when Dr. Mart was appointed, but
reference to said appointment is made in the order requiring an
additional competency evaluation.
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At one point in his life, he sought outpatient treatment and
received therapy and medication.
During the course of their meetings, Dr. Kissin performed
structured interviews by asking questions aimed at assessing
Mahoney's competency. She thus evaluated his (1) understanding of
the facts surrounding the charges pending against him; (2) rational
understanding of the potential implications of the charges; and (3)
ability to make decisions based on information available to him.
She observed that Mahoney had no difficulty answering questions
related to the way the legal system works generally and that he had
a sophisticated understanding of the court system because he had
spent many years doing legal research on his own and had also
enrolled in a paralegal course. Dr. Kissin further testified that
Mahoney expressed displeasure with his attorney because the
attorney did not want to go in the same direction as he did in
relation to his defense and stated that he was better suited to
represent himself.
Dr. Kissin testified that she did not observe any
evidence that Mahoney suffered delusional thoughts while he was at
Devens. She defined the clinical term "delusion" as "a belief an
individual holds that is false and that does not change despite the
individual being offered other information that disputes the false
belief." She also stated that she did not observe any evidence of
"disordered thinking," which she defined as a thought process that
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does not logically flow, but is rather interrupted by psychiatric
symptoms.
Based on her observations, she concluded that Mahoney
suffered from Bipolar Disorder II, a mood disorder that, although
not as severe as Bipolar Disorder I, still causes patients
suffering from it to experience mood swings ranging from mania to
depression. She further diagnosed Mahoney as manifesting certain
features of anti-social personality disorder, which she described
not as a clinical disorder, but as a way to conceptualize the way
a given patient interacts with other people. She observed,
however, that he did not exhibit enough symptoms to receive the
full diagnosis. Dr. Kissin also testified that Mahoney was given
the mood stabilizer Oxcarbazepine, to which he responded well, as
patients suffering from mood disorders often do, but that, even on
medication, he continued to be hypomanic the entire time he was at
Devens.
At the closing of her direct testimony, Dr. Kissin
reported that, at the time she evaluated him, Mahoney was competent
because he exhibited the capacity to understand the charges against
him, consult with his attorney and make decisions in his case.
During cross-examination by Mahoney's attorney,
Dr. Kissin testified that if someone held a delusional belief that
he or she was specifically being targeted by his or her attorney
acting in cahoots with the presiding judge, the delusion would
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certainly affect the defendant's competency. If the belief was not
delusional, then the person's competency would not be compromised.
She again stated that Mahoney had not exhibited any delusional
thoughts while she examined him at Devens.
Dr. Kissin was also briefly cross-examined by Mahoney
himself. He asked if she recalled calling the prosecutor and his
attorney on the phone to find out whether he had been found not
guilty of "aggravated felonious sexual assault."2 Dr. Kissin
answered that she recalled both of them stating that Mahoney was in
fact acquitted of that particular charge. After hearing the
doctor's response, Mahoney became agitated and expressed that he
should not be asked to respond to charges of which he had been
acquitted.3 The district court judge then asked Mahoney if he
2
Mahoney subsequently referred to the charge as "aggravated rape
and felonious sexual assault."
3
Mahoney specifically stated,
I wanted to make the record that I was acquitted. We're
still under the Fifth Amendment. I'm talking about the
Fifth Amendment, judge. I don't even have to answer these
questions. I was acquitted. I'm acquitted. I think we
know that I'm not supposed to answer to the same rape
charge twice. The jury found me not guilty in Suffolk
Superior Court. Then when he said nonetheless, we're
going to go, that should make someone delusional, judge,
yes, and make someone incompetent, absolutely, and it did
when I went on the web page and I sued with David Hiltz
who was in that courtroom February 18 begging me, keep in
control. One thing she didn't say. I've never, ever --
I'm a danger to myself, but others or property, and to be
still held incompetent and violate the United States
Constitution under the Fifth Amendment, she just told you
she made a phone call. That should have been the end of
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believed his attorney was involved in a conspiracy against him and
Mahoney responded, "[a]bsolutely."
Once Mahoney's intervention was over, Mahoney's counsel
resumed Dr. Kissin's cross-examination. He inquired whether, due
to his mood disorder, Mahoney could be competent at one point and
incompetent at another point. Dr. Kissin responded that, if
Mahoney was especially symptomatic, his ability to comport himself
in the courtroom could be affected. She concluded, "[c]ompetency
is point in time. So it is possible that he can be less or more
able to comport himself and be less or more in control of his mood
disorder, that could be to his competency, yes."
B. Testimony of Dr. Mart
Dr. Mart testified that he met with Mahoney three times.
During the first meeting, Dr. Mart was unable to understand exactly
what Mahoney's intentions were. He understood that Mahoney's plan
was to be found competent, try the case himself (because he could
do so better than anyone else), and then plead temporary insanity.
During the second meeting, Dr. Mart observed that Mahoney
exhibited pressured speech, often talked about things and events he
assumed Dr. Mart knew about and rapidly jumped from topic to topic.
During this meeting, Dr. Mart administered a test called the
"Minnesota Multiphasic Personality Inventory-2." The result of
that report. I was acquitted, judge, on May 25, 1984,
whether you like it or not. . . .
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that test was invalid because Mahoney gave variable answers to
questions aimed at assessing a single point, which led Dr. Mart to
believe that his thinking was confused and fragmented.
During that meeting, Dr. Mart also administered Mahoney
the MacArthur Competency Interview for Criminal Adjudication ("Mac-
CAT-CA"), which is aimed at measuring understanding, reasoning and
appreciation. The section regarding understanding is aimed at
measuring the extent to which the testee understands the role of
those involved in a criminal proceeding (i.e. the judge, the
prosecutor, etc.). The second section tests the ability to reason
and distinguish which facts are more important in a hypothetical
situation. Mahoney obtained perfect scores on both of these
sections. The third section tests a person's appreciation for his
or her own legal situation. Mahoney's results fell in the
clinically impaired range in this section. His answers indicated
that he believed his attorney and the district court judge were
conspiring against him.
Dr. Mart diagnosed Mahoney with Bipolar Disorder not
otherwise specified with psychotic features and personality
disorder not otherwise specified with anti-social narcissistic
features. He believed that Mahoney suffered from high levels of
manic excitement that distorted his thought processes. He also
observed that people with bipolar disorders may at times cycle
between moods rapidly. Finally, he testified that Mahoney
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exhibited feelings of grandiosity, which affected his appreciation
of his situation given that he believed he understood the law
better than anyone and no lawyer would know as much as he did. At
the end of the second meeting, Dr. Mart believed Mahoney was not
competent, but that he might improve with medication.
Dr. Mart had a third meeting with Mahoney in March 2012.
At that time, Mahoney expressed that he no longer believed there
was a conspiracy against him. Dr. Mart, however, was not able to
follow what Mahoney was trying to tell him because he spoke of
people and facts Dr. Mart did not know and jumped from one topic to
the next. At the end of that meeting, Dr. Mart believed Mahoney
was not competent because his thought processes were distorted.
Regarding Mahoney's intervention the day of the evidentiary
hearing, Dr. Mart stated that he believed Mahoney was in the grips
of a manic episode.
Finally, Dr. Mart testified that he did not think Mahoney
could represent himself even if he was found competent to withstand
trial because he could not stay on topic or logically tell a story.
C. The District Court's "Preliminary Leanings"
At the end of the evidentiary hearing, Mahoney manifested
that he was inclined to plead guilty. The district court then
expressed that it would take the competence issue under advisement
but that, preliminarily, it did not believe Mahoney was competent
to proceed to trial pro se because he had problems containing his
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emotions, racing thoughts and pressured speech. The court stated,
however, that it deemed Mahoney was "very likely competent to enter
a plea." Lastly, the court expressed that it was unsure if Mahoney
was competent to proceed to trial.
D. The District Court's Order Under § 4241(d)
On June 29, 2012, the district court issued an order
finding, by a preponderance of the evidence, that Mahoney suffered
from a mental disease or defect that rendered him mentally
incompetent pursuant to subsection (d) of § 4241. See 18 U.S.C.
§ 4241(d). Given the finding of incompetence, the district court
ordered that Mahoney be placed under the custody of the Attorney
General and hospitalized to determine if there was a substantial
probability that he would attain competency in the foreseeable
future. See id. § 4241(d)(1).
In the order, the district court noted that Mahoney
presented himself during several hearings in a "very agitated
state" and, although he seemed to understand what was generally
going on, "he exhibited serious misunderstandings of several
procedural and constitutional concepts." It then found Mahoney was
"presently suffering from mental diseases or defects (bipolar
disorder, personality disorder [not otherwise specified] with
antisocial or narcissistic features, problems related to
interaction with the legal system/crime) rendering him mentally
incompetent to assist properly in his defense, and/or to conduct
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his own defense (as he desires to do)." The district court
explained that Mahoney could not proceed pro se given his inability
to communicate coherently. It further stated that, if properly
medicated, Mahoney could be able to assist counsel in his defense,
but that his unwillingness to be represented by counsel mooted the
point. The district court thus committed Mahoney to the custody of
the Attorney General, for a period not to exceed four months, to be
hospitalized and treated and to determine whether he would obtain
the capacity to face the charges pending against him. It is from
this order that Mahoney appeals.
E. The District Court's Subsequent Finding Regarding Mahoney's
Competency
On February 21, 2013, while this interlocutory appeal was
pending, the district court issued an order finding that there was
no substantial probability that, even with continued treatment,
Mahoney would have attained sufficient capacity to allow the
proceedings to go forward and ordered that he remain in the custody
of the Attorney General to undergo a risk assessment under 18
U.S.C. § 4246. See id. § 4241(d). In other words, the court found
it unlikely that Mahoney would be able to face the charges against
him and ordered that he be further evaluated to determine if his
release would be a risk to others, if he could be released under
specific conditions, or if he should be transferred to the custody
of the state where he is domiciled. See id. § 4246.
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We took judicial notice of said order and requested the
parties file supplemental briefs "informing this [c]ourt as to
their respective positions in relation to the present appeal,
including whether the appeal is now moot." The parties complied.
We will address this matter after we address the preliminary
question of whether we have appellate jurisdiction to hear this
interlocutory appeal.
II. Analysis
A. Appellate Jurisdiction
We have not yet decided whether a defendant challenging
an order finding him incompetent and committing him to the custody
of the Attorney General under 18 U.S.C. § 4241(d)(1) can seek
immediate review of such order. In United States v. Filippi, 211
F.3d 649 (1st Cir. 2000), we determined that we had appellate
jurisdiction to review such an order because the constitutionality
of 18 U.S.C. § 4241 was being attacked. No such challenge has been
made in this appeal. Therefore, and although the government does
not challenge the existence of appellate jurisdiction here, we must
raise the issue sua sponte. Díaz-Reyes v. Fuentes-Ortiz, 471 F.3d
299, 300 (1st Cir. 2006).
We find, however, that the requirements of the collateral
order doctrine are present here. See Filippi, 211 F.3d at 650;
United States v. Kane, 955 F.2d 110, 111 (1st Cir. 1992). The
order being appealed is (1) about an issue that is distinct from
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the merits; (2) definitive, because the hospitalization pursuant to
the initial order materialized; and (3) affects interests that
could not be vindicated after the final judgment. See Filippi, 211
F.3d at 650-51. This appeal also presents a significant legal
issue, which is clearly not a "mere[] challenge [to a]
discretionary trial court ruling[]" given that it is not within the
district court's discretion to find a defendant incompetent when
the evidence establishes that he or she is fit to face a trial.
United States v. Kourí-Pérez, 187 F.3d 1, 5 (1st Cir. 1999).
We, therefore, join a number of our sister circuits in
finding that the collateral order doctrine applies to challenges to
orders issued under section 4241(d)(1). See United States v.
Friedman, 366 F.3d 975, 979-80 (9th Cir. 2004); United States v.
Ferro, 321 F.3d 756, 760 (8th Cir. 2003); United States v.
Boigegrain, 122 F.3d 1345, 1348-49 (10th Cir. 1997); United States
v. Davis, 93 F.3d 1286, 1289 (6th Cir. 1996); United States v.
Donofrio, 896 F.2d 1301, 1303 (11th Cir. 1990); United States v.
Gold, 790 F.2d 235, 238 (2d Cir. 1986); see also United States v.
Sherman, 912 F.2d 907 (7th Cir. 1990) (reviewing commitment order
without discussing jurisdiction). We accordingly move on to
address whether the issue on appeal became moot after the district
court issued its order finding it unlikely that Mahoney would
attain competency in the foreseeable future.
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B. Mootness
Some statutory background is in order to properly frame
the issue.
Section 4241 delineates a streamlined procedure courts
must follow to determine a defendant's competency and establishes
several milestones that must be reached to ensure that defendants
are afforded due process and a fair trial. See United States v.
Girón-Reyes, 234 F.3d 78, 80 (1st Cir. 2000). Pursuant to
subsection (a) of § 4241, a district court must order a hearing
once it determines there is reason to believe that a defendant is
suffering from a mental disease or defect that renders him or her
incompetent. 18 U.S.C. § 4241(a); see also Girón-Reyes, 234 F.3d
at 80. In the case before us now, this hearing was held on
March 27, 2012.
Subsection (b) of § 4241 prescribes that, prior to the
date of the hearing, a defendant must submit to a psychiatric or
psychological examination. 18 U.S.C. § 4241(b). In this case,
Mahoney was examined by Dr. Kissin and Dr. Mart prior to the
evidentiary hearing.
Subsection (d) of § 4241 further prescribes that, once
the hearing is held, the district court must make a finding "that
the defendant is presently suffering from a mental disease or
defect rendering him mentally incompetent" only by a preponderance
of the evidence. Id. § 4241(d). Subsection (d)(1) establishes
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that, if a defendant is found to be incompetent, the district court
must place him or her under the custody of the Attorney General to
be hospitalized for up to four months to determine if there is a
substantial probability that he or she will attain competency in
the foreseeable future. Id. § 4241(d)(1). In this case, once the
district court found Mahoney was incompetent, it placed him under
the custody of the Attorney General for a period of four months.
After that initial four-month period, essentially two
things can happen. The first is that a district court could
determine that there is a substantial probability that the
defendant will regain capacity within some additional reasonable
period of time, in which case the defendant will remain in the
custody of the Attorney General for that period of time. See id.
§ 4241(d)(2)(A).
The second thing that could happen is that the district
court could determine, as it did here, that there is no substantial
probability that the defendant will regain capacity in the
foreseeable future, in which case the defendant remains under the
custody of the Attorney General to determine whether he or she can
be released or whether further hospitalization is necessary. See
id. § 4241(d), 4246, 4248. It was precisely the finding that
Mahoney is not likely to attain competency which gave us pause and
prompted us to question whether the challenge to the initial order
had become moot.
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It can be gleaned from the statutory framework set out
above that an initial finding of incompetency inevitably triggers
various consequences for the defendant moving forward. The
defendant will always spend an initial period (up to four months)
hospitalized to determine "substantial probability" of attaining
capacity in the foreseeable future. See id. § 4241(d)(1). If,
after that initial period, the court finds that there is indeed a
substantial probability that the defendant will regain capacity
after further hospitalization, the defendant will be held for an
additional period of time. See id. § 4241(d)(2)(A). A less
friendly standard applies when defendants wish to be discharged and
proceed to trial than the standard they would face at an initial
competency hearing. Compare id. § 4241(d), with id. § 4241(e).
If, on the other hand, the court determines that there is
no substantial probability that the defendant will regain capacity,
as it did here, he or she will have lost his or her chance to go to
trial and will be subject to the custody of the Attorney General
for a more permanent hospitalization. See id. § 4246. Therefore,
a defendant like Mahoney continues to hold a cognizable interest in
the review of the initial determination of incompetency because the
initial finding triggered a series of events resulting in his
continuing confinement. Accord United States v. Evans, 690 F.3d
940, 943 (8th Cir. 2012) (finding that a defendant holds a "legally
cognizable interest" in the outcome of the appeal as to the initial
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incompetency finding despite a subsequent determination because the
initial determination "may impact all subsequent competency
determinations").
We now turn fully to the appeal before us.
C. The Merits
As stated above, Mahoney's first argument on appeal
invites us to interpret the district court's initial order of
incompetency in light of the court's expressions at the end of the
evidentiary hearing regarding his potential competency to plead.
According to him, if thus read, the order must be understood to
mean that the district court found him incompetent to represent
himself at trial, but competent to plead guilty and, thus, to
proceed to trial, given that competency to plead implies competency
to withstand trial. We decline to engage in such a serpentine
reading, as we cannot give any weight to expressions the district
court clearly did not intend to be understood as findings. In
fact, the district court said it would express "preliminary
thoughts" before taking the matter under advisement and stated,
"these are not rulings, they are sort of preliminary leanings and
I just want counsel to be aware of and Mr. Mahoney to be aware of
[that]." We will, therefore, not accord them any weight and will
limit our analysis to the four corners of the order. See, e.g.,
Mandel v. Town of Orleans, 326 F.3d 267, 273 (1st Cir. 2003)
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(refusing to accord law of the case status to findings or comments
that "appear to have been merely preliminary").
Mahoney's second argument is also easily rejected as it
is based on an invitation to stretch the meaning of the district
court's order in an unreasonable manner. Mahoney takes issue with
the portion of the district court's order which states that, during
the evidentiary hearing on competency and several prior hearings,
Mahoney "presented himself in a very agitated state, and while he
appeared to generally understand what was transpiring, he exhibited
serious misunderstandings of several procedural and constitutional
concepts." Based on this statement, Mahoney argues that the
district court applied the wrong legal standard to determine his
competency.
As the government correctly points out, the expressions
at issue can be better understood as descriptive, given that they
are found in the second paragraph of the order where the district
court is explaining its impressions of Mahoney from observations
made the day of the evidentiary hearing and on other occasions.
Furthermore, the district court order nowhere states or even
implies that it was finding Mahoney incompetent because of his lack
of understanding of the law.
Mahoney's third argument on appeal is that the district
court's finding was clearly erroneous as it was based on Dr. Mart's
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findings and not Dr. Kissin's, when the latter's report was more
thorough and was based "on a fount of evidence."
Pursuant to subsection (d) of section 4241, the district
court had to determine, by a preponderance of the evidence, whether
Mahoney suffers from a mental disease or defect rendering him
mentally incompetent to the extent "he is unable to understand the
nature and consequences of the proceedings against him or to assist
properly in his defense." 18 U.S.C. § 4241(d); see also United
States v. Brown, 669 F.3d 10, 17 (1st Cir. 2012) ("The test for
competency is whether the defendant first has sufficient present
ability to consult with counsel with a reasonable degree of
rational understanding, and second has a rational and factual
understanding of the proceedings against him."). When a district
court applies the correct legal standard to a competency question,
we review for clear error. United States v. Figueroa-González, 621
F.3d 44, 48 (1st Cir. 2010). We see no clear error here.
The district court heard the testimony of two experts who
examined Mahoney and they each gave their respective views on the
issue of his competency. Dr. Kissin found him to be competent, but
acknowledged that "[c]ompetency is point in time" and that,
depending on his mood disorder, he could be more or less able to
control himself. She also testified that she never observed any
evidence of delusions regarding a conspiracy between his attorney
and the presiding judge, but acknowledged that such a delusional
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belief could affect a person's competency. Finally, it is
significant that Dr. Kissin testified that, during the hearing,
Mahoney seemed somewhat more agitated than she had seen him
previously.
Dr. Mart, on the other hand, had observed Mahoney
expressing delusional thoughts and behaving hypomanically on
several occasions, including the day of the hearing. The district
court had also observed evidence of the delusional thoughts
involving a conspiracy and directly asked Mahoney during the
hearing if he still held such beliefs, which he confirmed.
Therefore, it is reasonable to conclude that, if
Dr. Kissin had observed evidence of the delusional thoughts Mahoney
expressed to both Dr. Mart and the district court during the
hearing, it is possible that her assessment of Mahoney's competency
would have been different. It is of no consequence that her report
was seemingly more thorough or based on observations made during a
longer period, because she was not able to observe the delusional
thoughts that both experts identified as the type of thought that
affects a person's competency. According to both experts,
delusional thoughts distort a person's understanding of one's legal
situation and one's ability to consult with counsel. Given the
"intensely fact-based nature of competency inquiries," we
comfortably find that the district court did not clearly err in
concluding that Mahoney was incompetent based on Dr. Mart's
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testimony and its own observations of his behavior. Pike v.
Guarino, 492 F.3d 61, 75 (1st Cir. 2007).
Having found that the district court did not clearly err
in finding Mahoney incompetent, we need not reach Mahoney's final
argument on appeal regarding the district court's alleged failure
to find that he suffered from a severe mental illness, a requisite
finding under applicable Supreme Court precedent for a court to
deny a competent defendant the right to self-represent. See
Indiana v. Edwards, 554 U.S. 164, 178 (2008) ("The Constitution
permits States to insist on representation by counsel for those
competent enough to stand trial . . . but who still suffer from
severe mental illness to the point where they are not competent to
conduct trial proceedings by themselves.").
III. Conclusion
For the reasons set forth above, we affirm the district
court's order finding Mahoney incompetent pursuant to section
4241(d).
Affirmed.
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