The savage murder of therapist Kathryn Faughey by the obviously demented David Tarloff raises the issue of why Tarloff, a known schizophrenic, was not confined in a state mental hospital?

Published reports indicate he has been mentally ill at least since 1991, and that he has had numerous clashes with the authorities. His most recent scrape with the law, the Sunday Post reported, came February 1, just eleven days before the murder. He had punched a security guard at St. John's Episcopal Hospital in Rockaway when he was not allowed to see his mother, who did not want to see him. 

The Times has an exhaustive well-researched story on the case which appeared Monday on page A1, column 1, then jumping to B5. This is sensational placement for a local murder not involving celebrities. The story is long because beside recounting the crime, it also discusses why Tarloff was repeatedly found to be sane. The headline, BEFORE MURDER, TROUBLED QUEST TO FIND MOTHER, The by-line: by Cara Buckley and Al Baker, former Albany reporter; the lede:

"In the eight and a half months before his arrest in the fatal stabbing of a Manhattan therapist, a Queens man became so obsessed with his institutionalized mother that his father kept moving her from nursing home to nursing home, a law enforcement official said on Sunday.

"Each time the man, David Tarloff, found her, trouble eventually ensued, with Mr. Tarloff becoming belligerent and threatening the home's workers, according to officials and court records. His father, Leonard Tarloff, in a vain attempt to keep his son from causing havoc, moved Beatrice Tarloff, his 73-year-old ex-wife, into at least three nursing homes....

"From June 2007 to Feb. 1, Mr. Tarloff's quest was punctuated by three encounters with the police, who took him to three hospitals for psychiatric evaluations. Each time, he was released.

The key paragraphs, in our judgment, come in the middle of the story, on pB5 of the Times:

"And because no centralized system exists to track a person's history in different hospitals around New York City, a hospital would not necessarily know if a patient had been admitted elsewhere for psychiatric reasons, said Dr. Spencer Eth, the medical director of behavioral health services at St. Vincent's Hospital in Manhattan.

"Dr. Eth said most hospital acute care units, where patients considered dangerous are assigned, are short-term facilities. 'In a matter of days or weeks, he'll be discharged again. That's the so-called revolving door.’"

The Times story concludes with this very sad quotation from Robert Tarloff, brother of: "What I want the city to know is that my father and I and our mother all tried our best to keep him in the facility that he was hospitalized in over the many, many years of his illness. But they kept on releasing him, after we told them what had been going on. We did the best that we could, asking them to keep in there." he added.

At first blush, the case appears to be a tragic error. But the more you learn about it, the worse the situation appears. A man with a psychiatric history committed a violent act involving an attempt to reach his mother. He is examined for a day and released. The sitting judge, one Barry Kron, sets him free on his own recognizance without imposing any bail. Ten days later, he stabbed an innocent woman to death on his way to rob a doctor who had a role in his commitment for schizophrenia sixteen years earlier.

The psychiatric history of David Tarloff, particularly his contacts over the years with the police and mental hospitals, should be examined. This is not the case of an ordinary man who suddenly snapped and committed an awful crime that no one could have anticipated. The family knew he had been schizophrenic for years. They tried to get help for him, and protection from him. The neighbors appear to have known of his illness as well. Only the psychiatrist at the nursing home, the very place he became violent, couldn't figure out his condition, or that he just might become violent again if he were frustrated. Who is this genius? Where did he go to medical school, not that it would be their fault?

Michael Daly, the gifted News columnist, writes today on p11. The headline: “THEY OUGHTA BE CONFINED." His clear and compelling lede: "David Tarloff should have been consigned to a nuthouse long before he picked up a meat cleaver. But psychos such as Tarloff are not confined to nuthouses these days unless they do somethhing like hack to death a profoundly decent psychotherapist." Daly recounts the long-term story of the deinstitutionalization of psychiatric patients without making adequate provision for aftercare.

Daly continues: "By recent count, only about one-third of seriously mentally ill patients stay on their meds. A state program called ‘assisted outpatient treatment’ has placed 3,908 individuals under court order to cooperate with mental health officials.

“The result has raised to 69% the number who actually take their pills. These patients also showed and 83% decline in arrests, a 77% decline in hospitalizations and a 47% drop in violent incidents.

“If the courts had put Tarloff under such an order, nobody was saying so yesterday.”

In response to a somewhat similar situation, in which a schizophrenic patient off his meds pushed a woman, a total stranger, into the path of a subway train, the legislature passed Kendra's Law, giving relatives the right to ask a judge to force patients to receive outpatient treatment or to be involuntarily committed. But if the psychiatrists all released Tarloff, what chance would the family have with a judge? They have none with the Manhattan DA, Robert Morgenthau, whose case hinges on Tarloff being rational and his crime premeditated. Monday's Post article on p6, “HACKER PLANNED MURDER,” by Murray Weiss, Larry Celona and Kati Cornell, starts: 

"Prosecutors are looking to hit the accused cleaver killer with a charge of premeditated murder -- despite his long history of mental illness -- because of his actions in the days leading up to the grisly murder of an Upper East Side therapist, authorities said yesterday. 

“The Manhattan DA is hoping that damning evidence – such as surveillance video showing David Tarloff scoping out an escape route and a shopping trip he made before the murder – can halt the accused killer’s anticipated insanity defense.”

It is indeed ironic that, in order to receive the maximum punishment, the killer must be shown to be sane enough to know what he was doing when he killed her, when to most laymen he is certianly crazy. The hospital psychiatrists on Feb. 2 , however, found him sane enough not to be a danger to himself or others. Do they believe that he just slips into insanity to slash people and then reverts to normality? Or perhaps he is sane and the rest of us, who don't see that, are deluded.

We predict, based on experience with such matters, that the outcome of this tragedy will be Kathryn's Law. The first thing it should provide is that all psychiatric records be kept in a place designated by the state, and made available whenever a person is sent for an evaluation. Another suggestion is that when a former mental patient is arrested for violent behavior, the examining psychiatrist should, if he sends the patient back into the street, to sign a statement that, in his professional judgment, the patient is not a threat to himself or others, and state the reasons why he/she came to that conclusion. We are certain that lawyers and mental health personnel can make valuable proposals for Kathryn's Law. The legislature should hear from them. If you have ideas, please send them to us.

Here is one suggestion that has been made: When a person is released from a mental hospital, treat it as if he/she were on probation from prison. Compel them to appear regularly before the counterparts of parole officers. Test their blood to make certain they are taking their medications. Check with their housemates. If they are not in compliance, send them back to the institution. The state has a duty to supervise the people it turns loose on the streets. And the oversight should be far more rigorous than it is today.

Any law, however, is only as effective as the people who enforce it are competent. We should look closely at the doctors who make these evaluations, and have competent senior professionals judge their ability and industry. We know that predicting the behavior of mental patients is difficult, and one is always dealing with uncertainties, just as parole commissions often make judgments on the basis of how effectively prisoners lie to them. It would help, however, if the doctors who make these decisions were as sensitive to the safety of the community as they are to the wishes of the patient.

One feels a strong sense of anger at the brutal death of a woman who healed and comforted others, at the hands of a man who was so obviously psychotic that his family and his neighbors knew it, but the officials whose salary we taxpayers pay couldn't figure it out.

What would he have had to have done during the examination, foam at the mouth, before these doctors could figure out something was wrong?

Maybe it is just too much trouble to commit someone to a hospital, instead of just turning him loose. Could they have been intimidated by the hulking figure? Shouldn't we know what questions they asked, and how Tarloff responded? Are there notes describing the psychiatric examination on Feb. 2? Who said what to whom?

This may be a case for the Office of Professional Medical Conduct, which is under the State Department of Health. Judge Barry Kron, who released Tarloff on his own recognizance, without imposing bail, should also be given the opportunity to explain his decision in a public setting. A city courts spokesman was quoted Sunday night as saying "Bail ... cannot be used for preventative (sic) detention or punishment." The judicial bureaucracy circles the wagons in support of its brother. And if the accused is a mental case, what assurance is there that he will appear at his next court date? Would not even a modest bail have raised Tarloff's consciousness to the extent that he would be aware that there are some negative consequences to an act of violence directed against an individual? When he receives absolutely no punishment for punching a guard, would that appear to be a judgment by the authorities that violence will be tolerated.

Was there an Assistant District Attorney in Queens County involved in these proceedings? What was his/her view of the situation? Do any of these people realize that a good woman is dead as an unintended consequence of their decision to set Tarloff free without any sanction, except a direction to return on Feb. 25, an obligation which he will unfortunately be able to meet because he will be confined elsewhere? Is there an objective standard for rulings on cases like this? Was this decision made at a time when employees wanted to go home? At what level are they subject to review?

As you can see, many questions arise as a result of the tragic death of Dr. Kathryn Faughey, killed by a man who was unquestionably psychotic and had been so for many years. A full-scale investigation should be conducted to find the facts and to determine whether any further action is justified. Legislative and administrative action is probably needed to minimize the number of cases like this one.  Let the authorities give the same attention to this matter that they gave to Nixzmary Brown, the young Brooklyn girl murdered by her mother and/or her stepfather. 

Just as the sinking of the R.M.S. Titanic led to higher standards in ship construction, and other tragedies have led to remedies which have saved the lives of others, let this one result in significant changes in our procedures in dealing with walking time bombs like David Tarloff.

BTW, if the doormen had inspected the suitcases brought in by the stranger, or asked his name, a life might have been saved. They may not have asked the intruder's name to protect patients' privacy, but patients don't usually bring large suitcases to their shrinks. There are more facts on what the doorman did, or failed to do, that have yet to be revealed. 

#449 02.19.2008 2080wds