Attorney’s Selection and Use of Mental Health Records in a Criminal Defense
In Commonwealth v. Noguera, 496 Mass. 601 (Mass. 2025), the Supreme Judicial Court of Massachusetts (SJC) considered whether the failure to obtain all mental health, social security, and military records, and a failure to present these records as evidence at trial, constitutes ineffective assistance of counsel. The SJC ruled that, if defense counsel makes sufficient efforts to obtain records and obtains sufficient records to be reasonably informed about the available options regarding potential mental health defenses, then failure to obtain all records does not constitute ineffective assistance of counsel. The court further ruled that failure to produce records at trial when a mental health defense is not being offered does not constitute ineffective assistance of counsel.
Facts of the Case
Michael Noguera was living with his girlfriend (Ms. Suarez) and a friend (Mr. Smith) in Florida. After being asked to leave, Mr. Noguera withdrew $25,000 from his and Ms. Suarez’s joint bank account and drove with Mr. Smith to Massachusetts. There, Mr. Noguera and Mr. Smith began socializing with a drug dealer (Mr. Jacobs), who observed Mr. Smith not letting Mr. Noguera speak while controlling his cell phone use. Mr. Smith eventually left, attempted to withdraw money from Mr. Noguera’s bank account, and sent numerous messages threatening him and asking him for money. Mr. Noguera told Mr. Jacobs he was angry with Mr. Smith for leaving and trying to steal the money and said he was going to kill him. Mr. Noguera also informed Ms. Noguera of his plans to kill Mr. Smith. Mr. Noguera sent Mr. Smith text messages agreeing to give him money and arranged to meet him at a park, where he shot and killed Mr. Smith in a premeditated fashion. He dismantled the gun and scattered pieces along the highway.
At trial, Mr. Noguera pursued a self-defense theory, testifying that Mr. Smith was violent and controlling. He alleged that Mr. Smith had threatened him and pointed a gun at him on the day of the offense. He reported a physical struggle ensued and that he shot Mr. Smith with his own gun, fearing he was going to be killed. Mr. Noguera also testified that he experienced schizoaffective disorder and bipolar disorder and had been admitted to psychiatric hospitals over 20 times. He testified that he had not taken his prescribed psychiatric medication since leaving Florida with Mr. Smith. No medical records or expert testimony were entered into evidence regarding Mr. Noguera’s mental health history, as he was not pursuing a mental health defense. He also testified that he was under the influence of alcohol and cocaine at the time of the offense.
Mr. Noguera was convicted of all charges, including murder in the first degree, on theories of deliberate premeditation and extreme atrocity and cruelty, and sentenced to life in prison without the possibility of parole. He appealed his conviction and filed a motion for a new trial, claiming ineffective assistance of counsel, citing that his attorney did not obtain all of his mental health records and did not introduce mental health records at trial. His appeal was denied. He again appealed the conviction based on claims of ineffective assistance of counsel, which was consolidated with his direct appeal to the SJC. The SJC remanded the case back to the superior court for an evidentiary hearing, where testimony from defense counsel and a defense-retained forensic psychologist was heard.
Ruling and Reasoning
The SJC affirmed the lower court’s judgment, ruling Mr. Noguera’s defense did not constitute ineffective assistance of counsel at trial. The court relied primarily on prior findings in Commonwealth v. Gibson, 214 N.E.3d 369 (Mass. 2023). Specifically, the court reviewed Mr. Noguera’s claims for a “substantial likelihood of a miscarriage of justice” (Noguera, p 610). In Gibson, the state supreme court ruled that, to determine whether counsel provided ineffective assistance, two questions must be answered: whether defense counsel committed an error in the trial court and whether an error was likely to have influenced the jury’s conclusion.
The SJC determined Mr. Noguera’s defense counsel made sufficient efforts to obtain Mr. Noguera’s mental health and medical records. Although defense counsel did not receive all available mental health records, he reviewed and consulted with two forensic psychologists regarding the records that he did receive. It was the clinical opinion of both forensic psychologists that Mr. Noguera did not meet criteria for use of a mental health defense. One doctor noted the records contained damaging information to the defense (e.g., indications of malingering). The SJC also acknowledged that Mr. Noguera’s defense counsel sought a continuance of trial to further investigate Mr. Noguera’s mental health history and potential impacts on behavior, but this was denied.
The SJC noted that Mr. Noguera’s attorney was aware of the information contained within the mental health records (both received and not received) and informed his consultant forensic psychologists about the information, who both used it to form their psycho-legal opinions regarding the utility of a mental health defense. During the evidentiary hearing, Mr. Noguera’s defense counsel indicated “in no way was I going to introduce those medical records” after his consultation with mental health experts (Noguera, p 618). There was no indication that additional records would have changed defense’s strategy at trial. The SJC ruled that, even if the medical records provided novel information about Mr. Noguera’s mental illness and addiction history, there was overwhelming evidence of premeditation in the offense that contradicted his mental health and self-defense claims. In contrast to another case cited in the opinion, Commonwealth v. Alvarez, 740 N.E.2d 610 (Mass. 2000), there is no indication in Mr. Noguera’s case that the new records would have supported a viable criminal responsibility or mental health defense that was otherwise abandoned.
Discussion
All but four states (Kansas, Montana, Idaho, and Utah) in the country allow a version of an insanity or criminal responsibility defense for individuals with a mental illness. In Massachusetts courts, “a person is not responsible for criminal conduct if, at the time of such conduct, as a result of mental disease or defect, he lacks substantial capacity either to appreciate the criminality [wrongfulness] of his conduct or to conform his conduct to the requirements of the law” (Commonwealth v. McHoul, 226 N.E.2d 556 (Mass 1967), p 557–8). Criminal responsibility laws were designed to provide alternative sanctions to individuals whose mental illness affected their conduct or thinking at the time of the offense: restorative psychiatric treatment rather than punitive punishment. In Massachusetts, individuals who meet criteria for a mental health defense are diverted to receive treatment rather than punishment for behavior for which they lacked control or understanding. Mental health data, including history and current impact of mental health symptoms, may be used as mitigating evidence at trial or during sentencing.
Important to assessing criminal responsibility is understanding the nexus between an individual’s mental state (typically secondary to a major mental illness) and lack of understanding or control in the behaviors at the time of the alleged offense, as outlined in McHoul. In Noguera, given the significant evidence of premeditation, behavioral control, and efforts to avoid detection (e.g., awareness of criminality), Mr. Noguera’s defense team determined (via consultation with multiple psychologists) that a mental health defense was not viable. His attorney took appropriate steps to assess for this defense and then pivoted to a more strategic option after thorough record-gathering and consultation, reflective of proper assistance of counsel.
It is not enough to have a history of mental illness (and records reflecting this historical treatment) to qualify for a mental health defense in an incident where there is no clear evidence of a nexus between acute psychiatric symptoms and criminal conduct. To qualify for this defense, defendants must have active symptoms of a major mental illness (or defect) and those symptoms must directly affect their ability to understand their conduct and conform their behavior to the requirements of the law. The court’s ruling that Mr. Noguera’s attorney did not provide ineffective assistance of counsel by failing to obtain all historical mental health records and enter them into evidence at trial underscores the importance of the nexus between active mental health symptoms and conduct for those intending to utilize a mental health defense at trial. This case is instructive for forensic experts on the matter of nexus and the scope of records that attorneys may gather in advance of trial.
- © American Academy of Psychiatry and the Law
