Mental Illness and the Death Penalty: NAMI Condemns Florida Execution

John Ferguson was executed by the State of Florida at on Monday, Aug. 5 at 6:17 p.m. ET.

NAMI tried to save his life by filing an amicus brief with the U.S. Supreme Court arguing that the Florida state Supreme Court had violated the Eighth Amendment of the U.S. Constitution by applying an outdated standard in previously reviewing Ferguson’s sentence.

The U.S. Supreme Court’s chose not to intervene—a decision which NAMI has condemned.

[Listen to NAMI’s Director of Policy and Legal Affairs, Ron Honberg, discuss the case on the radio program Let's Talk About It!]

Ferguson was 65 years old. He had been on death row for over 30 years. He lived with paranoid schizophrenia, marked by psychosis, involving hallucinations and delusions.

In 2007, the U.S. Supreme Court ruled in the case Panetti v. Quarterman that an individual must have a rational understanding of why he is being put to death and the finality of the death penalty. However, the Florida Supreme Court instead applied a standard of mere factual awareness in Ferguson’s case. It’s not a trivial distinction.

Ferguson’s last words were “I am the “Prince of God.”

He believed that he could not be killed; that his body could not remain in a grave and that would rise from the dead to fight alongside Jesus Christ to save America from a communist plot. He may have been aware of his impending execution, but he did not rationally understand its nature and finality.

Over the course of 40 years, multiple state doctors had diagnosed Ferguson’s mental illness. He was convicted of killing eight people. Constitutional principles did not excuse his horrific crimes, but they did point to life without parole as the most appropriate sentence.

The tragic deaths of Ferguson’s victims ultimately were compounded by an additional tragedy –in which the legal system failed to recognize established medical understanding of serious mental illness. Legal standards generally do not keep pace with scientific and medical knowledge and legal definitions bear little resemblance to the contours of mental illness. Diagnoses may be relevant, but are not determinative and often are distorted.

In Ferguson’s case, the Florida court demonstrated a fundamental misunderstanding of psychotic disorders. Although a person living with schizophrenia may be aware of some aspects of punishment, thought processes may still be strange and not based on logic or reality.

One example—outside the arena of criminal justice—is mathematician John Nash, who won the Nobel Prize for developing game theory. At the same time, he believed he had been recruited by aliens to save the world. Psychosis also can include grandiose and religious delusions.

The divergence between legal and medical proceedings is evident in other stages of criminal proceedings. “Competency” to stand trial hinges on the legal standard of whether or not a person is able to understand charges against them and assist in their defense. “Not guilty by reason of insanity”—which is rarely raised and rarely succeeds—hinges on the ability to recognize right from wrong, even if a person’s sense of “right” is irrationally tied to an imperative belief that doing right means doing wrong.

Both the criminal justice system and mental health care system share some degree of responsibility for the original loss of lives in the Ferguson case. Before the murders, Ferguson had been institutionalized and doctors recommended that he not be released because his mental illness made him dangerous. He was released anyway.

In a special report published in 2009, Double Tragedies, published jointly with Murder Victims' Families for Human Rights, NAMI called the death penalty "inappropriate and unwarranted" for people with severe mental disorders and "a distraction from problems within the mental health system that contribute or directly lead to tragic violence.

The report estimated that over 100 individuals living with mental illness have been executed in the United States and hundreds more are awaiting their death.