First, I can’t believe almost six years have passed since Elizabeth Smart was found. It seems like yesterday the news came out that she had turned up very much alive, after most people had given up hope. What is also amazing is how long the case against her two alleged kidnappers, Brian David Mitchell and Wanda Barzee, has dragged on. In both cases, it has been the issue of competency to stand trial that has slowed the proceedings.
According to this article, Mitchell has been found incompetent due to a diagnosis of Delusional Disorder, a psychotic disorder that is relatively rare, and can be difficult to treat. Interestingly, the judge on the case has previously ruled against forcibly medicating Mitchell for the purpose of restoration to competency, though that is an option. I won’t comment on the decision, since I am not familiar with the details. Suffice to say, however, recovery from that particular mental health disorder without medication is unlikely. There is no guarantee medication will work, but without medication, the chances are even worse. I have read some legal briefs arguing therapy can be just as effective as medication in addressing the symptoms of a delusional disorder - my experience with this issue would suggest that if he has been in the hospital since 2003 and has not improved without medication, then anti-psychotic medication would be the only other reasonable option. Ultimately, it is the judge’s call. I do wonder, though, why the judge agreed to forcibly medicate Barzee and not Mitchell. I’ll have to dig around online a bit...
I also find this indefinite state of affairs interesting. There is often a provision associated with competency that states competency must be restored within a reasonable time frame, or at least expected to be restored, or else the criminal changes must be dropped. Different states do have different standards, however, and I am guessing Utah can simply keep the charges against someone indefinitely, or at least until the judge decides otherwise. The article mentions federal prosecutors are examining how to prosecute Mitchell - this may be an effort to get a federal judge to medicate Mitchell, but again, I don’t know any details - this is simply hypothetical.
In any event, Mr. Mitchell is being held in a state mental hospital, and it appears he will remain there for the time being. I’ll try to do a bit of research on the previous decisions, and I’ll post if I find anything interesting, or if anything new pops up.