Jason Roof discusses psychiatry and the criminal justice system
University professors, as experts in their fields of study, are in unique positions to apply their knowledge to real-world situations. Jason Roof, an associate clinical professor of psychiatry at UC Davis Medical Center, works in the forensic psychiatry field. His field includes performing mental health evaluations of incarcerated individuals in order to help them access the care they need and determining whether accused individuals are mentally fit to stand trial.
Roof is currently consulting on the trial of John Lee Cowell, a “transient” person who fatally stabbed Nia Wilson and stabbed and wounded her sister, Letifah Wilson, on BART in Oakland on July 22, 2018. Although the courts have been unable to determine whether the attack was racially motivated — Cowell is white and the Wilson sisters are black — Cowell stands accused of the murder of Nia and the premeditated attempted murder of Letifah. Although Roof was unable to discuss the specifics of the trial, he did talk about his extensive background in forensic psychiatry and what motivated him to pursue such a profession.
Roof, also the associate training director of the Forensic Psychiatry Fellowship at the medical center, attended medical school at the University of Texas, Houston. He came to UC Davis after four years of generalized medical training and four years of residency training, eventually becoming a faculty member at the university, specializing in forensic psychiatry.
Roof estimated that he spends 70–80% of his time in direct clinical care — which involves providing services for incarcerated individuals in the Sacramento area. He is also involved in consultations on both criminal and civil cases, describing his profession as “the cross-section between mental health and the law.”
Criminal cases often include general evaluations, sanity evaluations, confidence to stand trial evaluations and risk of dangerousness evaluations. Mental health-related evaluations often occur when the accused individual cites psychiatric or psychological reasons for their actions. Meanwhile, civil cases often involve contested wills and assessing whether people have the mental capacity to make related decisions.
Roof finds deep meaning in the moral questions and quandaries posed by criminal cases.
“I think one of the things that drew me to this area is [that] the stories of what has happened are so compelling very often,” Roof said. “There’s often significant loss, significant tragedy. And I really enjoy being able to walk into a situation and help people understand. Mental health can be challenging because it’s hard to understand why people are doing things. The stakes can be tremendous.”
Roof described his position as “gratifying,” explaining that he gets “the great privilege” of being involved in a trial in a way that many others can’t — “truly learning about individuals,” and how they live and think and about their relationships.
Roof maintained that though mental health disorders do affect a significant portion of the imprisoned population, people accused of crimes may also claim they have a mental health disorder as a way to receive a more lenient sentence, such as in a state hospital rather than a prison. This phenomenon is called “malingering” and can significantly affect the outcome of a trial.
“You can find individuals who have lost their freedom, their reputation, their place in society frankly — maybe they are motivated to use something like a psychiatric symptom of some kind to explain why it is that they’ve done what they’ve done, despite the fact that there is, unfortunately, a stigma related to mental disorders,” he said. “Some individuals may weigh the pros and cons of presenting a mental disorder.”
Judges, attorneys and jurors must take such factors into account during the trial process. In California, when someone is on trial, the court must see that they are “mentally present” and if they have their full mental capacity, Roof explained.
“If someone has a mental disorder, we have to look at whether it’s active and we also have to think about whether it may be impacting their ability to [communicate] with their attorney and their defense,” he said. “If it’s impairing one or both of those, it’s the job of the court to freeze the trial and have that person receive care.”
California is home to approximately 115,000 inmates as of 2017 and it spends three times the national average per prisoner as of 2015, according to the Public Policy Institute of California (PPIC). Of the 35 state-owned facilities, 13 operate beyond the design capacity mandated by the Supreme Court, meaning that many prisoners live in overcrowded conditions.
Other facilities are privately operated, so their inmates are not accounted for in the PPIC estimate.
“About 15,000 additional inmates are not counted in the institutional population because they are housed in camps or in one of the eight contract facilities that the state does not own,” the PPIC article stated.
African-Americans continue to be overrepresented in the California prison population, while foreign-born Californians are not as likely to be imprisoned. Healthcare costs in prisons could be on the rise, since the number of prisoners over 50 has “more than quintupled” between 2000 and 2017.
Roof attributes the skyrocketing prison population to the defunding of mental institutions in the 1970s and 1980s, among other factors.
“Incarceration rates over the past 50 years or so have significantly increased, and we found that the majority of mental health care that’s happening is happening inside of these institutions,” Roof said. “Not having funding has forced people into settings where they get caught up in the criminal justice system.”
Roof added that people accused of crimes frequently have problems with substance abuse. Particularly in the Sacramento area, he said, methamphetamine can be a prominent issue. Others who are accused may suffer from mental disorders. He added that the elderly, as well as people with intellectual disabilities, often struggle the most with being incarcerated.
“When we’re in that setting, we want to be pretty aggressive about making sure that the individual is allied with the services they need,” he said.
According to Roof, the most challenging part of his job is witnessing the struggles of both accused individuals and victims in the criminal justice system.
“[What’s difficult is] the gravity of these kinds of cases, the true impact that [they have] on individuals and the major losses [they can] incur for some individuals,” Roof said. “In doing this work you have to get pretty granular about the events that may occur.”
The complex interplay of “human suffering,” having done harm to someone else and the “guilt and shame” around that is, at times, hard to look at.
“I don’t mean to suggest that if a person makes a decision to harm someone, [then they’re blameless],” he said. “But the setting of being in a jail, being away from individuals that are part of your support group, withdrawing from substances and the people that have access to them [can be hard].”
Still, Roof described the opportunity to apply his professional skills in these court settings as “empowering” and “exciting.” He noted that the work he does can provide “closure” and “clarity” to people involved in the case, for both the accused and the victims.
Written by: Rebecca Bihn-Wallace — campus@theaggie.org
