Psych board overseeing Arizona's criminally insane hasn't met in months. Here's why

Stephanie Innes
Arizona Republic
Arizona State Hospital.

Arizona's Psychiatric Security Review Board for months has been unable to hold required hearings about privileges and treatment plans for some Arizona State Hospital patients.

The board, which has not met since Jan. 28, needs at least three members present for a quorum to meet and make decisions about the psychiatric patients it oversees:  individuals who have committed a violent or dangerous criminal offense and have been found "guilty except insane" in the Arizona court system.

Nearly all of the guilty except insane patients live at the Arizona State Hospital, with a smaller number in community treatment programs.

As of May 11, the "guilty except insane" population in the Arizona State Hospital totaled 102 individuals, according to state Health Department officials. The review board as of this week was overseeing a total of 117 people, the state said.

The board, which was created in 1993, is supposed to have five members appointed by the governor to four-year terms. 

The board has three vacancies and C.J. Karamargin, a spokesperson for Gov. Doug Ducey, said the state actively is looking to fill the three positions. 

The vacant board spots have specific requirements, per state law, which may be part of the reason they've gone unfilled for so long: a licensed psychologist who is experienced in the criminal justice system; a person who is from the general public who is a former judge; and someone who is either a licensed psychologist or a psychiatrist who is experienced in the criminal justice system.

Whoever takes the positions will not hold them for long because the board is set to dissolve in July 2023, shifting duties to the court system, per legislation that Ducey signed into law last year.

Karamargin said even though the appointments to the review board would only be for approximately a year or less, the Governor's Office is hopeful there are people willing to serve.

A 2018 Arizona auditor general's report says that only two other states — Connecticut and Oregon — have psychiatric security review boards serving in a similar function as Arizona's board. 

Advocates for dissolving the Arizona board told the state Senate Judiciary Committee in 2021 that because people found guilty except insane are in the Arizona State Hospital on an order from a Superior Court judge, it makes sense to keep oversight within the court system.

The two sitting board members are board chair and retired psychiatrist Dr. James Clark and Paul O'Connell, who fulfills the board requirement as someone with parole, community supervision or probation experience, state health officials said. O'Connell works for the Arizona Department of Corrections.

Arizona law authorizes the psychiatric review board to release any guilty except insane person under its jurisdiction from the Arizona State Hospital to the community, regardless of their offense, if the person meets statutory release criteria such as such as complying with all required medication regimens, not owning or possessing firearms and not having any contact with the victims.

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Canceled meetings have 'no practical impact' on patients hoping to be released, state says

The Arizona Department of Health Services, which oversees the 390-bed Arizona State Hospital, says the missed meetings have had "no practical impact on patients hoping to be released" because the state hospital has the option of either releasing patients when their sentences expire, or petitioning the court system for civil commitment to a mental health facility, spokesperson Steve Elliott wrote in an email. 

The Arizona Department of Health Services building in Phoenix.

The health department does not have any jurisdiction over the psychiatric security review board, Elliott noted.

The canceled meetings have delayed some statutorily required two-year hearings when the board considers recommendations for changes to a patient’s privileges and treatment plan and evaluates the patient’s progress toward conditional release into the community, Elliott wrote.

Privileges may include passes to leave the facility for specified periods of time, such as two eight-hour passes per week or one 48 hours pass per month. The board in some cases may release individuals under its jurisdiction to a program of treatment in the community.

"To me it does seem concerning that the board is not meeting," Asim Dietrich, supervisory attorney for the Arizona Center for Disability Law said. 

Passes allowing people to leave the hospital for prescribed amounts of time are an important component of re-integration, and if they aren't being provided, that is an issue, Dietrich said.

"If someone does have a release date set, they still need to be able to go into the community and prepare for that release date," he said. "You are putting people in a difficult position to go from the most restrictive environment of ASH right into the community. That's why these passes and things are available, to ease people into life in the community."

Laurie Goldstein, who is chair of the ASH Independent Oversight Committee, said patients have voiced concern about the situation and want the review board to meet regularly.

Board has been criticized for releasing violent offenders into the community

The review board has come under scrutiny for releasing individuals who were later accused of re-offending.

In 2015 the board attracted media attention when Kenneth Dale Wakefield was accused of decapitating his wife and killing his dogs. He also mutilated himself by cutting off his forearm and gouging out an eye. Wakefield later pleaded guilty to second-degree murder and animal cruelty and was sentenced to prison.

He had been convicted previously of attempted second-degree murder in 2004 after stabbing his mother.

The state Psychiatric Security Review Board in 2014 had voted unanimously to conditionally release Wakefield, noting his "mental disease or defect is in stable remission and he is not dangerous if he resides in the residential treatment program as specified in the conditional release treatment plan and is compliant with the terms of his conditional release."

The Arizona Republic reported that two months later, the board revoked the conditional release but Wakefield had served his 10.5 years and the board's jurisdiction was about to expire. The board voted unanimously to order the Maricopa County Attorney's Office to begin civil commitment proceedings, but he was not civilly committed, The Republic reported in 2015.

The most recent incident that drew attention to the review board was the April 2021 murder of 49-year-old Steven Howells in a Gilbert group home. Authorities arrested Christopher Lambeth, a 36-year-old group home resident, in connection with the beating death of his housemate.

Lambeth, who had been diagnosed with schizophrenia, was convicted of murdering his grandparents in Pima County in 2005. He pleaded guilty but insane in that case, and was sentenced to life with parole possible after 25 years.

The state's Psychiatric Security Review Board released Lambeth from the Arizona State Hospital to a step-down facility in August 2020.

Howells' family filed a lawsuit against the group home in 2021 and later added the state of Arizona as a defendant. The lawsuit, which is still pending in Maricopa County Superior Court, says the state's Psychiatric Security Review Board acted "grossly negligently" in its "releasing, handling, placement and monitoring" of Lambeth.

Reach the reporter at or at 602-444-8369. Follow her on Twitter @stephanieinnes

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