Missouri Supreme Court Finds the Opinion of a Treating Professional More Credible than an Evaluating Expert and Denies Habeas Petition
In State ex re. Johnson v. Vandergriff, 668 S.W. 3d 574 (Mo. 2023), the Missouri Supreme Court denied Johnny Johnson’s habeas petition, finding that he did not meet the substantial threshold showing of insanity that is required.
Facts of the Case
On July 26, 2003, in Valley Park, Missouri, Johnny A. Johnson lured 6-year-old Casey Williamson to an abandoned glass factory. At the factory, he attempted to sexually assault her. When she resisted, he struck her in the head at least six times with a brick, and eventually a boulder, until she ceased breathing. Afterward, he attempted to conceal the crime scene by washing the victim’s blood and other evidence from his body in the nearby Meramec River. When questioned by law enforcement, he confessed. He was tried and convicted by a jury of first-degree murder, kidnapping, attempted forcible rape, and armed criminal action. He was sentenced by the trial court to death and three life sentences to be served consecutively. On direct appeal, the Supreme Court of Missouri affirmed his convictions and sentence. Mr. Johnson’s postconviction relief appeal was also denied.
Following the Supreme Court of Missouri’s affirmance of his convictions and sentence, and the issuing of a warrant for execution, Mr. Johnson filed a petition for a writ of habeas corpus claiming his execution would violate the Eighth and Fourteenth Amendments because he was he was severely mentally ill and incompetent to be executed under the standard set by Panetti v. Quarterman, 551 U.S. 930 (2007), and Ford v. Wainwright, 477 U.S. 399 (1986).
In support of his incompetency claims, Mr. Johnson presented a report from a psychiatrist, Dr. Bhushan Agharkar, who conducted an assessment and conducted a single clinical interview with Mr. Johnson. Dr. Agarkar concluded that Mr. Johnson was aware that he was on death row and he was convicted of murder, but that he did not have a rational understanding of the link between his crime and his pending execution. The expert based this conclusion on various delusional beliefs endorsed by Mr. Johnson, including the following: Satan was “using” the state of Missouri to execute him to bring about the end of the world, he was marked with the “Seventh Sign” and the world would be destroyed at his passing, he could enter the heads of the judge and lawyers and influence them, and the spirits of the underworld can influence the state to not execute him for Satan’s purposes. The expert further concluded that while Mr. Johnson reported that he thinks he would die by lethal injection, he does not have a rational understanding of the finality of his punishment. This conclusion was based on Mr. Johnson’s belief that he is a vampire and able to “reanimate” his organs and that he can enter an animal’s mind if he can learn the right “code” to go on living after his execution.
In response, the state argued that while this expert opines that Mr. Johnson “does not have a rational understanding of the link between his crime and punishment” (Johnson, p 577), the expert also opined that Mr. Johnson is “aware that he is sentenced to death for the murder of a child and that the state plans to execute him via lethal injection” (Johnson, p 578). The state argued that his awareness of his crime and the subsequent punishment is evidence of Mr. Johnson’s rational understanding. The defense countered this argument stating that “awareness” of the reason for his penalty is not the same as a rational understanding of the reason for his penalty, citing Panetti.
The state further challenged the credibility of the defense’s expert psychiatrist, arguing that Mr. Johnson’s medical records and an affidavit, dated May 24, 2023, from Ashley Skaggs, the institutional chief of mental health at Potosi Correctional Center, who met with him regularly, do not support Mr. Johnson’s report of auditory hallucinations and delusions. The medical records noted that his current medications were controlling his symptoms. Finally, during Ms. Skaggs’ visits with Mr. Johnson, he made statements about his upcoming execution, his communications with his attorneys, and the status of his legal appeals. Within the affidavit, Ms. Skaggs concluded that Mr. Johnson appeared to understand the nature of his upcoming execution.
Ruling and Reasoning
In a five to one decision, the court denied Mr. Johnson’s petition for habeas corpus, finding that his evidence lacks credibility when viewed in light of the state’s evidence. The court weighed two opposite opinions: the opinion of the defense expert psychiatrist and the affidavit provided by his treating counselor. Because the counselor had been seeing Mr. Johnson over a two-year period, and Mr. Johnson’s medical records did not contain a mention of delusions, the court found the counselor’s opinion more persuasive. The court found persuasive that Mr. Johnson’s recent medical records indicated that his medications were adequately controlling his symptoms. Although the court reviewed the expert’s report, it ultimately found that the expert’s report was contrary to other evidence and found that Mr. Johnson’s evidence lacked credibility.
Discussion
On further appeal, the U.S. Supreme Court denied a stay of execution and petition for writ of certiorari (Johnson v. Vandergriff, 143 S. Ct. 2551 (2023)). Although the dissenting U.S. Supreme Court justices found Dr. Agharkar’s assessment to include compelling evidence, the majority did not discuss the merits of Mr. Johnson’s appeal.
The Johnson case has implications for forensic psychiatrists who evaluate death row inmates during the appeals process. Evaluating psychiatrists should consider conducting the evaluation of the death row inmate over multiple meetings, if feasible. While travel costs may be prohibitive, virtual interviews should be considered. This would increase the data points relied on in rendering opinions and would support the expert’s credibility, especially in the manner the opinion was derived.
While the affidavit from the state’s expert in Johnson was not from a treating psychiatrist, the ethics principles that guide our profession state that treating psychiatrists should generally avoid acting as an expert witness for their patients or performing evaluations of their patients for legal purposes (American Academy of Psychiatry and the Law, Ethics Guidelines for the Practice of Forensic Psychiatry, Adopted May, 2005). In this case, the counselor’s affidavit was instrumental in the court’s denial of Mr. Johnson’s petition for habeas. Such a finding has the potential to destroy the therapeutic alliance between the counselor and Mr. Johnson because the counselor’s opinion was harmful to him In general, clinicians should only serve one of two roles, treating the inmate, or, evaluating the inmate for legal purposes. Serving in both roles creates significant ethics conflict.
- © 2024 American Academy of Psychiatry and the Law
