Psychiatric Evaluation of Brother Lorne Lei Wray 2007

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CENTRAL FORENSIC CONSULTANTS

 

1005 Cherry St., Suite 215 MICHAEL P. STACY, PH.D. (573) 443-8870

Columbia, MO 65201 Consulting Psychologist (573) 819-4200

     

Psychological Evaluation

 

Lorne Wray

 

Identifying Information:

 

Name: Lorne Wray

Franklin County Circuit Court Case Number: 20R039702116 -- 01

 

Lorne Wray is an African American male, who was evaluated at the request of Mr. John Ferrara, of the office of the Public Defender, who was representing him at that time. He is now represented by Ms. Lisa Preddy, Circuit Defender. The evaluation was requested in order to provide the committing court with information to assist in its consideration of Mr. Wray's petition for Unconditional Release from the Missouri Department of Mental Health. He was interviewed at the office of the Public Defender in Union, Missouri on September 7, 2007.

 

Sources of Information:

 

Information for this evaluation was drawn from multiple sources, including:

 

1. A review of the written information furnished for my inspection by Mr. Ferrara, including police reports and selected legal documents related to Mr. Wray's committing offense and records from his inpatient stay in the Department of Mental Health;

2. A clinical interview, mental status examination, and psychological testing of the petitioner, conducted at the office of the Public Defender September 7, 2007. Time of face-to-face contact was approximately 2 ½ hours.

3. A telephone interview of  the petitioner's sibling on October 4, 2007;

4. A telephone interview of Dick Slusarski, Mr. Ray's forensic case monitor, on December 3, 2007.

 

5. Conversation with Mr. Ferrara, concerning his interactions with the petitioner.

 

Prior to my interview of the defendant, he was advised as to its nature, purpose, and inherent limits on confidentiality. He was told that evaluation was being conducted at the request of Mr. Ferrara, who was identified as my client, for purposes of the evaluation. He was told that I would be preparing a formal report of my findings for submission to the court and could be subpoenaed to testify, and thus the usual psychologist/client privilege would not apply in the case of the current evaluation. My status as a mandated reporter was also explained. Following a spoken explanation, Mr. Wray reviewed a written formal consent document. He then signed it, indicating his willingness to participate in the evaluation.

 

Legal Status:

 

Mr. Wray is currently on conditional release status from the Department of Mental Health. He was originally committed to that department as not guilty by reason of mental disease or defect, on a charge of Aggravated Stalking, on October 6, 1998. He remained on inpatient status at a number of facilities within that department until he was granted a partial conditional release by the court in January 2006. He was then allowed to work outside the facility, returning in the evening. That release was reviewed in January 2007, and he was placed on conditional release and discharged from the hospital in March of this year. He has been residing at the home of a sibling, since that time. He reported that he has continued to see a psychiatrist and his forensic case monitor on a monthly basis.

 

Pertinent Background Information:

 

Detailed information on the petitioner’s biopsychosocial history is available to the court in multiple Department of Mental Health records and will not be repeated here. However, a brief review is appropriate.

 

According to furnished records, Mr. Ray was born in Slater, Mississippi and moved to the St. Louis area, with his mother and siblings, in 1971. His early developmental and medical histories are reportedly essentially unremarkable. He reported that he attended public schools, graduating from high school in Venice, Illinois with a B average. He denied any history of special education, but reported an early history of truancy, leading to being held back one year. He reportedly caught up with this class and continued without further academic difficulty. He reported taking some classes at Bailey Technical School, but did not graduate.

 

He has reported maintaining steady employment, since he began summer employment during high school. He has worked in a variety of positions, including dishwasher, hotel cook, assistant restaurant manager, truck driver, and driver for an automobile storage company. He also reported having been self-employed in the music business and he operated his own delivery service while on partial conditional release.

 

Mr. Wray has never served in the military. He reported that he has never been married, and he has fathered no children. He identified himself as heterosexual and reported that he has dated several women, although he is not currently involved in a relationship.

 

Mr. Wray reported minimal contact with legal authorities prior to the events leading to his current commitment to the Department of Mental Health. According to a 1998 pretrial evaluation report his only known arrest, prior to 1998, was at age 12 when he and friends stole fruit from a fruit stand. He was reportedly taken to detention, but released to his mother without formal charges. He has no prior adult criminal history.

 

Mr. Wray also denied any history of mental illness or mental health care, prior to his current commitment to the Department of Mental Health. Mr. Wray denied any history of the use of alcohol or other substances, a report supported by his siblings and available records. Records indicate that his mother has been diagnosed with, and treated for, schizophrenia. There is no other known history of major mental illness within his family.

 

Since leaving the hospital, Mr. Ray has been residing with his sibling. It was reported that they get along well and there have been no problems as a result of him living in the home. No indication of any problems he has had in the community.

 

Treatment Course within the Department of Mental Health:

 

Available information on Mr. Ray's course of treatment is too great in volume to be repeated here. It is also available to the court in other documents. Therefore, again, only a summary will be provided.

 

Mr. Wray's first contact with the Department of Mental Health was in March of 1998. He was seen by Dr. John Rabun for a pretrial evaluation on March 9. Criminal charges at that time alleged that Mr. Wray had been stalking and harassing the alleged victim through much of 1997. At that time it was alleged that Mr. Wray, among other things, ordered multiple magazines in the name of the alleged victim and his family, reported him to the Division of Family Services for child abuse, made numerous phone calls and sent multiple e-mail messages, threatened to kidnap his children and kill his family, had his address published in the St. Louis Post-Dispatch and had his utilities cut off. Dr. Rabun diagnosed Mr. Wray as suffering from Delusional Disorder and apparently believed that he held, but was not reporting, homicidal ideation toward the alleged victim. As a result, Mr. Wray was involuntarily admitted to the St. Louis Psychiatric Rehabilitation Center on March 28, 1998. He was committed to the Department of Mental Health as not guilty by reason of mental disease or defect on October 6, 1998.

 

According to furnished records, Mr. Wray remained in inpatient status at St. Louis Psychiatric Rehabilitation Center from the time of his admission in March of 1998 through May 2, 2002. Available records indicate that, shortly following his commitment, staff treating Mr. Wray were of the opinion he was no longer suffering from mental disease and his medications were stopped. He reportedly pursued a conditional release. Records reflect the staff opinion that frustration over the delay in his discharge and a lack of medication led to a return of symptoms. He reportedly began believing that he was being persecuted by the Department of Mental Health and the court system and became increasingly preoccupied with injustices toward him, including the original index offense. A review of available records suggests the beginning of a pattern of behavior that appears to have continued through much of his stay. He began writing numerous letters and grievances and eventually began filing lawsuits, principally against staff of the Department of Mental Health. Although he was prescribed medication, he did not take it, and amassed a large quantity. He continued to protest his innocence. He was transferred from program to program, and his care transferred from physician to physician, apparently largely as a result of suits filed against specific staff members, as well as a reported erotomanic delusion concerning a female psychiatrist. His diagnosis apparently remained Delusional Disorder throughout most of his stay, although it was changed to Paranoid Schizophrenia following a change of psychiatrists in December 2001. He had also been diagnosed with a Personality Disorder, Narcissistic Type, although that diagnosis was apparently discontinued prior to his transfer to Southeast Missouri Mental Health Center on May 2, 2002.

 

According to a medical and psychiatric assessment completed following his return to St. Louis Psychiatric Rehabilitation Center, his transfer to Southeast Missouri Mental Health Center followed his having named most of the physicians at the former facility in lawsuits and was intended to determine whether those suits were based on credible grievances or were the result of "persistent delusional thinking."

 

According to available information, while at Southeast Missouri Mental Health Center, Mr. Wray displayed a tendency to become verbally loud, hostile and angry over his preoccupation with having been unjustifiably committed to the department of mental health. There were times that he would not follow rules, apparently viewing them as exploiting him and others and being unfair, and he filed numerous grievances and a suit against the hospital. He continued to decline psychotropic medication. He reportedly displayed no physically threatening or aggressive behavior, did not show signs of significant mood disorder, gave no evidence of hallucinations, and his verbalizations and written communications gave no evidence of loose or disorganized thought processes or formal thought disorder. He was discharged to St. Louis Psychiatric Rehabilitation Center on January 13, 2003, with the diagnosis of Delusional Disorder, Persecutory Type. No diagnosis was offered on Axis II.

 

Within a few weeks of his return to that facility, he again began to refuse to complete chores in the cottage and was seen as trying to convince other clients to not participate in treatment, and as scaring them when talking about the side effects of medication. He filed numerous grievances against staff members and assisted other clients in filing for conditional releases, reportedly prematurely. He reportedly professed a belief that perhaps other clients should not be on medication, behavior seen as contributing to some of them having relapses. He was apparently moved from a cottage to a more restrictive ward environment because of his behavior. According to his discharge summary, he was then helped to realize that his behavior was delaying his own release, and he agreed to work through the treatment program. He was returned to a cottage setting in January 2004. Following his transfer, he reportedly stopped interfering with other patients treatments and ceased filing grievances. He began participating in social and leisure activities, doing cottage chores, and following all rules and regulations. He continued to not accept that he suffered from a mental illness, and he denied that he had ever threatened his victim. However, he did admit that he had harassed him, expressing the opinion that he was justified in doing so, because of the money he was owed. In late 2004, he filed for conditional release, and Dr. Mallya, his treating physician, indicated he would support the release.

 

Mr. Wray, apparently decided to file for unconditional release and requested an independent examination. Such examination was subsequently ordered by the Honorable Cynthia Ecklekamp, judge of the Franklin County Circuit Court. He was evaluated by Dr. Steven Courtois, a forensic examiner at Southeast Missouri Mental Health Center. Dr. Courtois diagnosed him as suffering from a Personality Disorder NOS With Narcissistic and Paranoid Features. He noted his Delusional Disorder was by history, denoting that it was not currently active. Although he did not diagnose an active condition that would qualify as mental disease or defect, Dr. Courtois recommended that Mr. Wray's application for an unconditional release be denied. He recommended a referral to a court of proper jurisdiction to determine the appropriateness of a partial or conditional release.

 

He was granted a two step conditional release on January 24, 2006. Under the conditions of that release, for a period of six months he was to be allowed to leave the facility grounds for 10 hours a day to pursue employment and was granted 48-hour monthly passes to the home of his siblings. He reportedly began working as an independent delivery person, but was unable to earn sufficient income, given the expenses involved, in part because he could not take any routes that required him going into Illinois. In September 2006, he began full-time employment as a driver for St. Louis Auto Auction. According to a discharge summary, his mental status remained unchanged, his interactions with staff and other clients remained congenial, and he functioned well in the community.

 

On March 15, 2007 a provisional conditional release order was signed, and Mr. Wray was discharged from the hospital to the home of his sibling. He has continued to reside there through the present. During my evaluation, he reported that he continues to see a psychiatrist and his forensic case monitor monthly. In my interview with Mr. Slusarski, his case monitor, he described Mr. Wray as an easy client with whom to work and indicated that he has not had any problems while on conditional release. He described him as reliable and punctual and keeping their appointments and as pleasant and cooperative in their interactions. He praised Mr. Ray's intellect, work ethic and desire to be successful. He denied having seen any evidence of active mental illness in Mr. Wray. When asked specifically, he denied that Mr. Wray has ever seemed suspicious are distrustful of him and denied seeing any symptoms of generalized paranoia. He denied being aware of any significant difficulty Mr. Wray had in dealing with others. He denied that Mr. Wray had ever presented as grandiose, expansive, or unrealistic concerning his abilities or uniqueness, and he denied that Mr. Wray had displayed evidence of unrealistic entitlement during their interaction. He did described Mr. Wray as angry, continuing to believe that he's been treated unreasonably by the Department of Mental Health and that he has been robbed of several years of his life. However, Mr. Slusarski also noted that when Mr. Wray was expressing his anger toward the Department, he told Mr. Slusarski that he was not angry with him personally.

 

Clinical interview and mental status examination:

 

Mr. Wray was interviewed by the undersigned clinician at the office of Mr. Ferrara in Union, Missouri. He appeared on time, having driven himself to the appointment. He greeted me appropriately and rapport was quickly established. He was friendly, cooperative, and appeared to be in a good mood. He was appropriately dressed, well groomed, and his behavior was entirely appropriate to the evaluation situation. No gross motor or physical abnormalities were noted, and he appeared to be in no acute distress. His speech was normal in rate, tone, and amount. He appeared to attempt to answer all questions posed to the best of his ability, offering clarification and elaboration as appropriate. He conversed easily and spontaneously. His thoughts appeared well formed and seemed to flow smoothly, without evidence of formal thought disorder. He displayed a full range of affect that varied appropriately with the presented topic of conversation. He denied any significant mood disturbance and no evidence of such was noted.

 

His intellect, assessed informally through vocabulary, syntax, grammar, and use of language, appeared to be at least average. Cognitive functioning was well preserved. During the course of my mental status examination, I administered a G. H. Kent Intelligence Test and the Neurobehavioral Cognitive Status Examination, and his performance was entirely within normal limits.

 

In discussing the circumstances leading to his commitment to the Department of Mental Health, Mr. Wray continued to express the belief that he was wronged by the victim and that his actions were justifiable. Consistent with prior accounts, he reported that he given the victim $6,000, which to promote an album. He contended that the victim failed to promote the album adequately and use the money inappropriately. He reportedly refused to reimburse Mr. Wray. Mr. Wray admitted engaging in a number of behaviors that would constitute harassment, but he denied having made the threats alleged. Interestingly, in my conversation with his siblings, an account of the relationship and interaction between  brother and the victim was quite similar to Mr. Wray's. They reported that they'd known the victim for several years and described themselves as being "in the middle" of the events that transpired, although  indicated that no one had had ever sought their account of what happened.

 

Mr. Wray furnished an account of his behaviors within the Department of Mental Health that paralleled that available in furnished records. He appears to continue to believe that his actions were justified, seeing the only avenues available to him, given his perception of the powerlessness of a committed mental patient, as lying within the legal system.

 

During our discussion, Mr. Wray was able to argue his position logically and articulately. While his speech was animated at times, he did not become angry, but remained polite and appropriate.

 

In discussing his history and his plans for the future, Mr. Wray gave no evidence of pervasive paranoia, grandiosity or unrealistic self perception. While he clearly maintains the belief that he has been treated unfairly by the Department of Mental Health, he gave no indication of similar beliefs extending to other entities. He expressed the opinion he is routinely treated fairly, he denied any belief that anyone seems to have it in for him, and he reported that he is able to get along well with people in general. He denied ever having had problems with anyone else, like those he had with the victim. Information from his siblings supported his report.

 

Clinical Impressions:

 

Mr. Wray has historically carried an Axis I diagnosis of Delusional Disorder. Information in Department of Mental Health records is strongly supportive of that diagnosis having been appropriate in the past. However, those records have referred to that condition on a historical basis since at least June 2005. They do not reflect a current diagnosis of Delusional Disorder and I would concur. Results of the current evaluation give no indication of any active Axis I condition.

 

While in the Department of Mental Health, Mr. Wray was also diagnosed with a Personality Disorder, Not Otherwise Specified, with Paranoid and Narcissistic Features. In my clinical opinion, that diagnosis is less clear. Although aspects of Mr. Wray's behavior, while in the custody of the Department of Mental Health, are clearly suggestive of both paranoia and narcissism, to qualify as personality disorder the pattern of behavior must be enduring, inflexible, and pervasive across a broad range of personal and social situations and must lead to clinically significant distress or impairment in important areas functioning. Available evidence does not reflect a history of such behavior or impairment outside the Department of Mental Health. Mr. Wray denies any such history and his siblings supports his denial. Although my contact with him was admittedly limited, there was no indication of a level of either paranoia or narcissism sufficient to cause functional impairment. His case manager denied the existence of any such symptoms over the course of their interaction. Mr. Wray presents as intelligent, articulate, confident and outspoken. He is idealistic, opinionated, and polemic. He admits that he enjoys both good conversation and a good argument. And, he is angry. However, those qualities do not, in and of themselves, constitute a personality disorder. Therefore, I will defer diagnoses on Axis II. However, because my contact with Mr. Wray is much more limited than that of the clinicians of the Department of Mental Health, I will acknowledge the need to rule out a personality disorder.

 

Diagnoses (DSM-IV-TR):

 

Axis I: No Diagnosis.

 

Axis II: 799.9 Diagnosis Deferred;

Rule Out Personality Disorder Not Otherwise Specified, with

Paranoid and Narcissistic Features.

 

Considerations within Chapter 552 .040.7:

1. It is the opinion of this clinician, to a reasonable degree of psychological certainty, that the committed person presently does not have a mental disease or defect;

 

2. Mr. Wray was committed on a felony charge of aggravated stalking, as described earlier in this report;

3. Mr. Wray's behavior while confined has been described in detail in prior sections of this report;

4. The last reported unlawful or dangerous act on the part of the defendant was a verbal threat of violence on January 3, 2004. Records indicate, during an argument with another mental health client on that date, Mr. Wray said he would "knock that faggot beard off your face. I'm going to hunt you down and kill you, white punk faggot ass." He has no reported history of physical violence since fights as a youth.

5. As detailed previously, Mr. Wray has been on conditional release since January 24, 2006. Initially, his release included leave from the facility for 10 hours a day to pursue employment and a 48 hour pass on a monthly basis. Since March 15, 2007, he has resided in the home of his sibling, with monthly contact with his psychiatrist and forensic case monitor. His release has reportedly been without incident whatsoever.

6. The determination that Mr. Wray is not dangerous to himself or others is not dependent on his taking drugs, medicine or narcotics. No medications have been prescribed since his return to St. Louis Psychiatric Rehabilitation Center in January 2003, and he was reportedly not taking medication for some time prior to that.

  

Respectfully submitted,

   

Michael P. Stacy, Ph.D.

Licensed Psychologist PY01307