APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE [Hon. Joseph N. Laplante, U.S. District Judge].
Robert B. Mann, with whom Mann and Mitchell, was on brief for appellant.
Seth R. Aframe, Assistant United States Attorney, with whom John P. Kacavas, United States Attorney, was on brief for appellee.
Before Lynch, Chief Judge, Torruella and Stahl, Circuit Judges.
TORRUELLA, Circuit Judge.
Brian E. Mahoney ("Mahoney") filed this interlocutory appeal from an order finding him incompetent to stand trial and committing him to the custody of the Attorney General for hospitalization and treatment pursuant to 18 U.S.C. § 4241(d).
Mahoney makes four main arguments on appeal. First, he argues that the commitment order, read in light of the district court's expressions at the end of the competency hearing, must be understood to mean that the district court found him competent to stand trial, but incompetent to represent himself. Second, he claims that, to the extent the court predicated its finding of incompetency upon its determination that he had "misunderstandings of several procedural and constitutional concepts, " it applied the wrong legal standard. Third, he urges us to find that the district court's decision was clearly erroneous as it was not based on the opinion of the expert whose evaluation was the most thorough. Finally, Mahoney argues that, under Indiana v. Edwards, 554 U.S. 164 (2008), the district court had to find he suffered from severe mental illness in order to deny him the right to proceed pro se. For the reasons set forth below, we affirm the district court's order.
On January 19, 2011, Mahoney was charged with failing to register as required under the Sex Offender Registration and Notification Act ("SORNA") due to a 1983 Massachusetts conviction for assault with intent to rape. See 18 U.S.C. § 2250(a). On April 22, 2011, with the parties' acquiescence, the district court ordered Mahoney to undergo a mental competency evaluation pursuant to 18 U.S.C. § 4241(b). Mahoney was thus evaluated at the Federal Medical Center Devens in Massachusetts ("Devens"). A final report by Miriam Kissin, Psy.D. ("Dr. Kissin"), concluded that, even though Mahoney suffered from a chronic mood disorder, he was competent to understand the proceedings against him and to assist in his defense. On October 11, 2011, the district court ordered an additional competency evaluation to be performed by Eric G. Mart, Ph.D. ("Dr. Mart"), a licensed psychologist. A competency hearing was held on March 27, 2012.
A. Dr. Kissin's Testimony
During the competency hearing, the government presented Dr. Kissin's testimony. She testified to having met with Mahoney a total of seven times. During the meetings, she was able to learn that Mahoney had a history of hyperactivity during childhood and throughout his adult life. He told her that he was able to interact with other people and was successfully employed for several years, although he also said that he was hyperactive in his interactions, which oftentimes led to interpersonal difficulties. At one point in his life, he sought outpatient treatment and received therapy and medication.
During the course of their meetings, Dr. Kissin performed structured interviews by asking questions aimed at assessing Mahoney's competency. She thus evaluated his (1) understanding of the facts surrounding the charges pending against him; (2) rational understanding of the potential implications of the charges; and (3) ability to make decisions based on information available to him. She observed that Mahoney had no difficulty answering questions related to the way the legal system works generally and that he had a sophisticated understanding of the court system because he had spent many years doing legal research on his own and had also enrolled in a paralegal course. Dr. Kissin further testified that Mahoney expressed displeasure with his attorney because the attorney did not want to go in the same direction as he did in relation to his defense and stated that he was better suited to represent himself.
Dr. Kissin testified that she did not observe any evidence that Mahoney suffered delusional thoughts while he was at Devens. She defined the clinical term "delusion" as "a belief an individual holds that is false and that does not change despite the individual being offered other information that disputes the false belief." She also stated that she did not observe any evidence of "disordered thinking, " which she defined as a thought process that does not logically flow, but is rather interrupted by psychiatric symptoms.
Based on her observations, she concluded that Mahoney suffered from Bipolar Disorder II, a mood disorder that, although not as severe as Bipolar Disorder I, still causes patients suffering from it to experience mood swings ranging from mania to depression. She further diagnosed Mahoney as manifesting certain features of anti-social personality disorder, which she described not as a clinical disorder, but as a way to conceptualize the way a given patient interacts with other people. She observed, however, that he did not exhibit enough symptoms to receive the full diagnosis. Dr. Kissin also testified that Mahoney was given the mood stabilizer Oxcarbazepine, to which he responded well, as patients suffering from mood disorders often do, but that, even on medication, he continued to be hypomanic the entire time he was at Devens.
At the closing of her direct testimony, Dr. Kissin reported that, at the time she evaluated him, Mahoney was competent because he exhibited the capacity to understand the charges against him, consult with his attorney and make decisions in his case.
During cross-examination by Mahoney's attorney, Dr. Kissin testified that if someone held a delusional belief that he or she was specifically being targeted by his or her attorney acting in cahoots with the presiding judge, the delusion would certainly affect the defendant's competency. If the belief was not delusional, then the person's competency would not be compromised. She again stated that Mahoney had not exhibited any delusional thoughts while she examined him at Devens.
Dr. Kissin was also briefly cross-examined by Mahoney himself. He asked if she recalled calling the prosecutor and his attorney on the phone to find out whether he had been found not guilty of "aggravated felonious sexual assault." Dr. Kissin answered that she recalled both of them stating that Mahoney was in fact acquitted of that particular charge. After hearing the doctor's response, Mahoney became agitated and expressed that he should not be asked to respond to charges of which he had been acquitted. The district court judge then asked Mahoney if he believed his attorney was involved in a conspiracy against him and Mahoney responded, "[a]bsolutely."
Once Mahoney's intervention was over, Mahoney's counsel resumed Dr. Kissin's cross-examination. He inquired whether, due to his mood disorder, Mahoney could be competent at one point and incompetent at another point. Dr. Kissin responded that, if Mahoney was especially symptomatic, his ability to comport himself in the courtroom could be affected. She concluded, "[c]ompetency is point in time. So it is possible that he can be less or more able to ...