Panetti Doesn't Need Mental Health Treatment, Prison Doctor Says

Scott Louis Panetti entered Texas prison with a well-documented psychiatric history, including two involuntary commitments at Kerrville State Hospital, and lengthy inpatient stays at Veterans Administration hospitals in Waco, Kerrville and his home state of Wisconsin.

He had buried furniture in the yard. He represented himself at his capital murder trial for the murders of his in-laws wearing a "Tom Mix"-like cowboy outfit, and at times slept through it. His lawyers have claimed he is too incompetent to be executed because his schizophrenia, first diagnosed in 1978, has been left untreated, and his mental health deteriorated.

In 1992, Panetti gunned down his in-laws, Joe and Amanda Alvarado of Kerr County. The murders came two years after he was involuntarily committed at Kerrville State Hospital following threats to his wife and daughter. 

But in the nearly two decades Panetti has been behind bars, information about what specific medical treatment he's received at taxpayer expense for his diagnosed schizophrenia has been hard to obtain, because even inmates have a right to medical privacy.

"He’s not medicated at this time and hasn’t been for much of the past 20 years," is all that Kathryn Kase, of the Texas Defender Service in Houston, will say. Kase and lawyer Gregory Wiercioch of the University of Wisconsin Law School, successfully obtained an execution stay last Wednesday for Panetti, seven hours before he was to be put to death for the 1992 fatal shooting of his in-laws.

Court filings reference how Panetti was treated in 1995, shortly after his conviction, at one of the Texas Department of Criminal Justice's two psychiatric units, the Jester IV unit in Sugar Land. But other than that, public information about his treatment has been spotty.

Until last week.

As the state and Panetti's defense team battled over whether his execution should be halted, a four-page affidavit provided a tantalizing peek into the mental health care he has received. The affidavit from Dr. Joseph Penn, director of mental health services for the Correctional Managed Care division of the University of Texas Medical Branch, shows that Panetti is allergic to the most common drugs used to treat schizophrenia, has been seen mental health professionals at least 14 times, and has never been found to have a serious mental health condition.

"From the mental health notes in the chart, it appears that he has always been described as hyper-religious, but that it did not appear to be affecting his daily functioning," Penn's statement reads. "Mr. Panetti may have had some baseline or chronic residual psychosis or alternatively over-valued religious beliefs all these years, but nothing severe enough to warrant treatment with medications."

Penn's assessment of Panetti, equally revealing and puzzling, was based not on direct examination of the 56-year-old inmate but on mental health staff notes made since 2004. Panetti's medical records before 2004, which are not digitized and in storage, were not consulted.

The only record of note carried from the pre-2004, written medical records is Panetti's allergies to three psychiatric drugs used to treat schizophrenia: Mellaril, Thorazine and Haldol. It is believed that Panetti told TDCJ heath staff of the allergies when he arrived in 1995.

Although Panetti has not been receiving treatment for mental illness, 14 members of the UTMB mental health staff have seen him. What prompted those visits and when those visits occurred is not made clear in Dr. Penn's statement.

"The medical records reflect that none of the 14 UTMB CMC mental health staff who have met with Mr. Panetti in person and evaluated him have identified any clinical signs and symptoms indicating a psychiatric diagnosis or required the need for additional mental health or psychiatric treatment such as psychotropic medications," Penn said in his statement.

The state of Texas has insisted for years that Panetti is not mentally ill, and this week Attorney General Greg Abbott emphasized that view during an interview with Mark Davis, host of a Dallas-Fort Worth radio talk show.

“Anyone can do strange things, and if strange things were good enough to get criminals off of death row, believe me, they’d be doing strange things all the time, every day,” Abbott, said last week. “Based upon the conclusions of many judges in this case, this guy is not insane, and at some point in time, that decision just needs to be put to rest.”

Questions to Penn about the affidavit were referred to UTMB's vice president of offender health services, Dr. Owen Murray.

While he declined to speak about Panetti's case, Murray said all inmates are screened for mental health problems when they first come to TDCJ, and can seek help if they wish.

Of the 273 inmates currently on death row in Texas, 62 — or 22 percent — receive mental health services, he said. He would not say how many of the 62 are treated with medication.

Most of the 109 prison units have mental health teams, and inmates can ask to see a mental health professional, or a correctional officer can refer them if their behavior warrants it.

Michele Deitch, a senior lecturer at the University of Texas LBJ School of Public Affairs, said inmates are entitled to mental health services.

"It doesn’t matter at all if they are coming in with it or they develop the problems while they are in these institutions. They are still entitled, under the Constitution, to that standard of care," she said.

Christine Ayala contributed to this story. 

Disclosure: The University of Texas LBJ School of Public Affairs and the University of Texas Medical Branch are corporate sponsors of The Texas Tribune. A complete list of Tribune donors and sponsors can be viewed here.